Epidemiology of the surgical management of obesity.

Surgical interventions for obesity have quintupled in the world in 15 years (140,000 in 2003 vs. 720,000 in 2018), however growth has slowed since 2011. This progressive increase varies by country and from 2008 through 2018, 6.5 million people have undergone bariatric surgery. Growth was strongest in the Asia/Pacific region. Belgium is the country performing the most operations per number of inhabitants: (127 operations per 100,000). France is in 7th place with 72 operations per 100,000 and 70% of patients are operated in surgical services that perform more than 100 procedures per year. The sleeve gastrectomy (SG) is the most commonly performed intervention while the adjustable gastric band (AGB) has practically disappeared. Along with the intragastric balloon, novel endoluminal procedures are being evaluated. A real management policy is needed to respond to this evolution of both epidemiology and techniques.