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The way modern men lead their lives—or sometimes are led by it—is far different than the way our ancestors did. The speed of this change has not been followed, however, by the natural physiological modifications that would adapt us to less physical effort and more food availability.We ate the necessary, now we eat unnecessarily. We strived for food, now we call for delivery. The advance of obesity (and its well-known consequences) is the most trivial result in this conjuncture.

Bariatric surgery has grown exponentially in recent years, but its contribution has had little impact on the pandemic of morbid obesity. This book goes into some detail of the history, the present day application of our science to the problem, and predictions for the future.

Several bariatric procedures have been developed in the past decades and were diffused throughout the world. Techniques such as the gastric bypass procedure (GBP), the treatment of choice in some countries (i.e., US and Brazil), may not display the same status in others, with different cultural and socioeconomic conditions. Biliopancreatic diversions (BPDs) are the choice in some other places (Italy, Canada) and gain more adepts in the United States every day. The adjustable gastric banding is the preference in most of Europe and in Australia.

The reader will quickly see that this is not a book based solely on technique, pre- and post-op care, minimally invasive surgery, or any other specific entities peculiar to bariatric surgery. It is all the above, and, as a special treat, a number of videos on technique are included. Our purpose is to emphasize the fact that bariatric operations go far beyond being “just an operation.” A book a bit different from the usual was then pursued, for being a bariatric (or metabolic) surgeon demands knowledge not only of technical aspects of the procedures accepted to date, but also, and perhaps even more, of the physiological complexities involved in the anatomical modifications imposed by each one of them. These alterations have indeed led us to a wide range of new information that we still begin to assimilate. Today, we bariatric surgeons discuss physiology, hormones, central nervous system (CNS) signaling and interact with a variety of medical specialists.

The physiological understanding of each technique was described by its respective inventor. Endocrinologists, psychologists, clinicians, and researchers were also invited to this debate.

We could summarize all this as a great achievement. It is extremely exciting to know that we managed to unite in one publication the most reliable worldwide experience on obesity surgery so far.

Cid Pitombo, MD, PhD
Kenneth B. Jones, Jr., MD
Kelvin D. Higa, MD
José Carlos Pareja, MD, PhD

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