Surgery for morbid obesity: indications, complications, alternatives.

Morbid obesity (100 pounds over ideal body weight) carries with it numerous medical complications and increased mortality which can be improved by weight loss. Medical treatment of obesity is usually not successful, and jejunoileal bypass surgery often produces considerable chronic morbidity which seriously compromises its benefits. Gastric bypass is equally effective and avoids the most severe long-term complications of jejunoileal bypass, but has a higher operative morbidity. Gastric plication will perhaps offer the least operative and chronic morbidity, though few long-term statistics are as yet available.