Over two-thirds of the United States is overweight or obese, and over 5% of the country is morbidly obese. Numerous public health preventative measures have been established to help battle this public health epidemic. Surgical obesity treatment, although now gaining popularity, has been an underutilized treatment option for obesity. Patients with a body mass index (BMI) of >40 or >35 kg m⁻² with two or more comorbid conditions are eligible for bariatric surgery. Currently, the three most popular bariatric surgeries are Roux-en-y gastric bypass, sleeve gastrectomy and gastric banding procedures, all overwhelmingly performed laparoscopically. The purpose of this article is to discuss the heterogeneity of bariatric surgery. In our practice, among 834 patients operated over a 4-year period (2006–2010), patients were of an average age of 45 years (16–73 years), 80.4% were female patients, 82.5% had private insurance, 61% were White, 17% were Hispanic and 9% were Black. Patients had an average BMI of 46.2 kg m⁻² (30.1–75.3 kg m⁻²), waist circumference of 133.6 cm (68.6–207.8 cm) and four preoperative comorbidities (0–11 comorbidities). Variation exists in surgeon practice patterns for preoperative weight-loss recommendations and complication rates based on surgery case volume. Despite variation in patient, surgeon and hospital characteristics, bariatric surgery outcomes are generally highly safe and effective.

美国超过三分之二的人口超重或肥胖，超过 5% 的人口属于病态肥胖。已经制定了许多公共卫生预防措施来帮助应对这一公共卫生流行病。手术肥胖治疗虽然现在越来越受欢迎，但一直是一种未得到充分利用的肥胖治疗选择。体重指数 (BMI) 为 >40 或 >35 kg m ^-2且患有两种或多种合并症的患者有资格接受减肥手术。目前，三种最流行的减肥手术是Roux-en-y胃绕道手术、袖状胃切除术和胃束带手术，绝大多数都是通过腹腔镜进行的。本文的目的是讨论减肥手术的异质性。在我们的实践中，在 4 年期间（2006-2010）接受手术的 834 名患者中，患者平均年龄为 45 岁（16-73 岁），80.4% 是女性患者，82.5% 有私人保险，61%白人、17% 是西班牙裔、9% 是黑人。患者平均BMI为46.2 kg m ⁻² (30.1–75.3 kg m ⁻² )，腰围为133.6 cm (68.6–207.8 cm)，有4种术前合并症(0-11种合并症)。根据手术病例数，外科医生的术前减肥建议和并发症发生率的实践模式存在差异。尽管患者、外科医生和医院的特点各不相同，但减肥手术的结果通常是高度安全和有效的。