Bariatric surgery

Bariatric surgery remains the most effective treatment for people with obesity, initially achieving 30% total weight loss (TWL) with sustained long-term outcomes. Both SG and RYGB show similar TWL rates at five years (23.7% vs 27.2%). Complication rates are low (1.5-4.8%), and surgery significantly improves or resolves comorbidities, particularly diabetes. Endoscopic and pharmacological treatments are emerging alternatives but lack the long-term efficacy of surgery.