Metabolic Surgery in a Pill.

Bariatric surgery has evolved from a very effective treatment of weight to a treatment of "metabolism" and end-organ damage. Even though surgery was designed with the aim of causing mechanical restriction and calorie malabsorption, mechanistic work in humans and rodents over the last 10 years or so has informed us that this could not be further from the truth. Dietary, pharmacological, and medical device interventions for weight loss and metabolic control have also evolved rapidly only very recently. In this Crosstalk we discuss how close we are to harnessing the clinical efficacy of surgery through a metabolic "polypill."