Bariatric surgery was developed with the aim of
weight reduction. Success was defined only by excess
weight loss. Other indices of resolution of metabolic co-morbidities were reported but were mostly secondary. Several communications have reported that regardless of body mass index (BMI), complete or partial remission of
type 2 diabetes (T2D) is possible with such traditional gastrointestinal operations as the
Roux-en-Y gastric bypass, bileopancreatic diversion, and sleeve
gastrectomy. These results mostly occur before
weight loss, positioning
metabolic surgery as a good tool for controlling the current T2D epidemic. Surgery aimed mainly at the diseases, such as diabetes, and not
weight loss are referred to as
metabolic surgery.
Metabolic surgery can effectively treat T2D in individuals with any BMI, including that below 35 kg/m(2). Concurrently, some new procedures were developed to treat patients that in theory do not need massive
weight loss, focusing on a pathophysiological approach to T2D. Those new techniques, mainly duodenal jejunal bypass, ileal transposition, single-anastomosis duodenal ileal or jejunal bypass with sleeve
gastrectomy, and the endoscopic duodenal liner, are experimental procedures, most reporting good metabolic control initially without relation to weight variation.