title: Bariatric surgery: a history of empiricism, a future in science.
abstract: BACKGROUND
  The observation that obesity can be successfully treated by gastrointestinal surgery is a tribute to the innovative efforts by determined surgeons and the ever improving safety of general anesthesia. Yet as the body of knowledge and discovery on the root causes of human obesity accumulate, surgical approaches to treat morbid obesity are likely to change dramatically. While there is little doubt that dramatic weight loss can be achieved by surgically creating volume and absorption limitation to the reservoir and digestive functions of the gastrointestinal tract, human progress to more processed foods, less physical activity, and the pervasive public opinion that obesity is self-imposed are major obstacles to more widespread application of this approach.
  
  
  CONCLUSIONS
  Here we provide a mechanico-physiologic analysis of current operations, their rationale and limitations, as well as a glimpse of how future interventions might develop as a result of current knowledge in the field. The future of bariatric surgery is discussed in the context of these emerging technologies and in the context of the politics of obesity.
authors.affiliation: Department of Surgery and Medicine, University of Chicago, 5841 S. Maryland MC 6090, Chicago, IL, USA. jalverdy@surgery.bsd.uchicago.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Alverdy
authors.forename: Vivek
authors.initials: V
authors.lastname: Prachand
authors.forename: Brody
authors.initials: B
authors.lastname: Flanagan
authors.forename: William A
authors.initials: WA
authors.lastname: Thistlethwaite
authors.forename: Mark
authors.initials: M
authors.lastname: Siegler
authors.forename: Marc
authors.initials: M
authors.lastname: Garfinkel
authors.forename: Peter
authors.initials: P
authors.lastname: Angelos
authors.forename: Shailesh
authors.initials: S
authors.lastname: Agarwal
authors.forename: Heena
authors.initials: H
authors.lastname: Santry
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods / Q000639:trends; D015992:Body Mass Index; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss