Intestinal bypass for obesity a summary and perspective.

Intestinal bypass for obesity can be justified only if the risks of excess weight are higher than those of the surgery. Indications for this surgery need to be carefully defined and the patient and family should clearly understand the potential risks and benefits. Weight loss results from a decrease in food intake, altered taste preferences, and malabsorption. The benefits of this treatment are permanent weight loss, improved psychosocial function, and a reduction in medical morbidity. The potential risks consist of mortality, a variety of postoperative complications, liver failure, renal stones, and the consequences of bacterial overgrowth in the defunctionalized bowel. This operation trades the consequences of a short bowel for obesity and should only be undertaken where a skilled team of surgeons, internists, and psychiatrists are available and able to provide the necessary preoperative and postoperative managements.