The patient barrier to growth of bariatric surgery: another French paradox?

The bariatric surgery community is complaining about the multiple barriers that hamper the growth of procedures that have been found to be the only effective treatment for morbid obesity. The French situation demonstrates that the number of procedures has stabilized after a period of rapid growth, despite the facts that the needs are not satisfied and that there are less important barriers to surgery than in most countries. This new "French paradox" is understandable if one accepts the reluctance of the public audience and an insufficient level of evidence for a systematic referral to bariatric surgery. Less invasive procedures should make it possible to re-unify the physicians who deal with obesity, as well as the implementation of comparatives and randomized clinical studies.