[Metabolic/bariatric surgery is effective : What is the evidence regarding hard endpoints and long-term outcomes?]

Metabolic/bariatric surgery is considered to be safe and the most effective treatment for obesity and its associated medical problems. It not only leads to sustained weight loss but also improves a variety of metabolic disorders, such as type 2 diabetes, reduces the risk of several obesity-associated cancers and increases life expectancy. The most commonly performed procedures worldwide are Sleeve gastrectomy, Roux-en‑Y gastric bypass and one anastomosis gastric bypass. Newer techniques, such as single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) show promising results, especially in patients with a high body mass index (BMI). A growing number of studies now provide data on hard clinical endpoints and long-term outcomes. The choice of surgical procedure is made individually and within an interdisciplinary setting. Lifelong follow-up care is crucial to ensure long-term success. Numerous studies also demonstrate significant improvements in the quality of life and a reduction in overall mortality through metabolic/bariatric surgery.