Weight loss metabolic surgery has evolved to improve both surgical outcomes and safety, but like other surgical procedures, the safety of weight loss metabolic surgery can be affected by a variety of factors. The factors affecting the safety of surgery can be broadly divided into two aspects – the patient himself and the surgical operation. Those patients who are older, have higher BMI and severe complications tend to be at higher risk when undergoing weight loss metabolic surgery. If the complications are too serious and lead to physical intolerance, they may need to be adjusted first, and the surgery can be performed only after the physical condition has improved; after the surgery, the post-operative management of such patients will also be more demanding. The more experienced the surgeon, the higher the safety of the surgery and the lower the probability of complications, and generally the surgeon with more than 500 cases can be regarded as having reached a mature point. Since obesity often brings various complications, involves many disciplines and is complex, a mature weight reduction and metabolic team should have multi-disciplinary support such as nutrition, metabolic medicine, respiratory medicine and anesthesiology in addition to the main surgeon and nursing staff, so that the surgery plan can be formulated and implemented under the joint discussion of these specialized doctors.