by Robin Blackstone, MD, FACS;
David Engstrom, PhD;
and Lisa Rivera, MPH

INTRODUCTION
Bariatric surgery is achieving increasing acceptance for the treatment of obesity. Obesity-and its role as the central paradigm of modern disease- is slowly penetrating into the consciousness of affected people, and they are increasingly hopeful of remission or cure from their medical problems through bariatric surgery. Primary care doctors, convinced by the positive results they see in patients treated with surgery, are more likely to refer their patients. Finally, payers at all levels are slowly beginning to appreciate there may be some long-term health and financial benefits. It is expected that the Medicare decision to cover surgical treatment for the indication of morbid obesity in their national coverage decision of February, 2006, will create additional pressure on payers and employers to cover these procedures. The publicity surrounding the laparoscopic gastric bypass on Carnie Wilson, widely publicized in People magazine in 1999, has also helped fuel an exponential growth in the number of procedures. The American Society for Bariatric Surgery (ASBS) has estimated that over 177,000 bariatric operations were performed in 2006.

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