Abstract

Bariatric surgery has become the cornerstone in the management of severe obesity, offering significant and 
sustained weight reduction alongside improvement or resolution of obesity-related comorbidities. This review 
provides a comprehensive analysis of the different bariatric procedures Roux-en-Y gastric bypass (RYGB), sleeve 
gastrectomy (SG), adjustable gastric banding (AGB), and biliopancreatic diversion (BPD) and compares their 
efficacy, complications, ethical implications, and global trends. Early and late complications remain procedure
dependent, ranging from internal hernias and gallstone formation to nutritional deficiencies and psychological 
adjustments. Comparative studies demonstrate that RYGB and SG achieve superior long-term weight reduction 
compared to AGB and non-surgical interventions. Patient selection criteria, ethical considerations, and economic 
impact remain central to optimizing outcomes and ensuring equitable access to treatment. The role of 
multidisciplinary teams is vital for ensuring long-term success, providing holistic care through preoperative 
assessment, psychological counseling, and nutritional follow-up. Advances in surgical technology, patient-centered 
care models, and policy frameworks continue to shape the field. Future research should focus on personalized 
surgical approaches, integration of digital monitoring, and equitable policy development to enhance the safety, 
accessibility, and sustainability of bariatric surgery worldwide.