Gastroenterology and hepatology
Bariatric surgery: indications and complications
Who qualifies for metabolic and bariatric surgery, how sleeve gastrectomy, Roux-en-Y and one-anastomosis bypass differ, complications sorted by timing from leak to internal hernia, post-bariatric hypoglycaemia, lifelong micronutrient monitoring, and drugs and pregnancy after surgery.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Bariatric surgery is the most effective long-term treatment for severe obesity: about 25 to 30% total weight loss, with diabetes remission, lower cardiovascular events and lower mortality. Obesity medicines and the broader approach are in Obesity and metabolic syndrome.
- Sleeve gastrectomy is the commonest operation in Australia, then one-anastomosis and Roux-en-Y gastric bypass. Gastric banding is now rare.
- Physicians meet the late problems: deficiencies, hypoglycaemia, reflux, internal hernia, marginal ulcer, alcohol use disorder and drug absorption.
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Sources
- Australian Obesity Management AlgorithmAU/NZAustralian Diabetes Society, ANZ Obesity Society and Obesity Surgery Society of Australia and New Zealand (ANZMOSS)
- Draft clinical practice guidelines for the management of overweight and obesity (public consultation)AU/NZDeakin University for NHMRC, Draft, November 2024
- Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia (2013, rescinded)AU/NZNational Health and Medical Research Council, 2013; rescinded
- Eisenberg D et al. 2022 ASMBS and IFSO: Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis 2022;18:1345-56American Society for Metabolic and Bariatric Surgery and International Federation for the Surgery of Obesity and Metabolic Disorders, 2022
- Mechanick JI et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures, 2019 update (AACE/TOS/ASMBS/OMA/ASA)Surgery for Obesity and Related Diseases, 2019
- Parrott J et al. ASMBS integrated health nutritional guidelines for the surgical weight loss patient 2016 update: micronutrients. Surg Obes Relat Dis 2017;13:727-41American Society for Metabolic and Bariatric Surgery, 2017
- Peterli R et al. Effect of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass on weight loss in patients with morbid obesity (SM-BOSS). JAMA 2018;319:255-65JAMA, 2018
- Haal S et al. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial. Lancet Gastroenterol Hepatol 2021;6:993-1001Lancet Gastroenterology & Hepatology, 2021
- Last updated
- 14 November 2026
What changed
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