A primer on bariatric surgery: treatment of last resort for morbid obesity.

Morbid obesity represents the highest risk state of a growing national problem that is eminently preventable and therefore highly relevant to the disease management community. The obesity epidemic, the failure of conservative treatments to achieve long-term weight loss and heightened media attention to positive short-term results of bariatric procedures among national celebrities has resulted in a dramatic increase in the number of surgeries performed every year. Familiarity with the clinical issues surrounding morbid obesity and bariatric surgery is therefore essential to the disease management community. This paper reviews the state of bariatric surgery, common surgical approaches, their effectiveness, complications, impact on co-morbidities, cost and evolving insurance coverage policies. I also will propose a proactive approach to arrest disease progression to morbid obesity.