Bariatric and metabolic surgery do you know what it is? Obesity is a disease, but often overlooked, especially in our country through some specific years, there is a lack of understanding of obesity and its harm, and even misunderstanding. As early as 1948, the WHO listed obesity as “a chronic metabolic disease caused by multiple factors”. 2013, the American Medical Association officially listed obesity as a disease and emphasized that obesity can lead to a series of serious health problems. Bariatric and metabolic surgery can be an effective treatment for these problems, but do you know what bariatric and metabolic surgery is? Do you know what bariatric and metabolic surgery is? Bariatric and metabolic surgery is a minimally invasive surgical procedure that removes part of the stomach or achieves weight loss by altering the digestive tract passages to limit food intake, reduce absorption, or both. There are three broad categories of bariatric metabolic surgery: (1) restrictive surgery: reduction of food intake, such as laparoscopic gastric sleeve resection. (2) Restrictive and absorption-altering surgery: reduces food intake so that the body absorbs less of the food it ingests, such as gastric bypass surgery. (3) Absorption-altering surgery: Moderate changes in food intake so that you absorb only a small fraction of the food you ingest, such as biliopancreatic bypass. The most common procedures used today are laparoscopic gastric sleeve resection and gastric bypass surgery. What is laparoscopic gastric diversion? Laparoscopic gastric diversion surgery, also known as gastrointestinal short-circuit surgery, is one of the commonly performed weight loss procedures, where restricting intake while reducing absorption is the main mechanism. The procedure starts with the creation of a volume <50>200 cm. It is currently the gold standard procedure for the surgical treatment of obesity in the United States. This procedure is usually done through minimally invasive surgery. Further studies have shown that the procedure changes the physiological flow of food through partial gastric block, gastrointestinal anastomosis and entero-intestinal anastomosis to eliminate insulin resistance in the patient’s body, and promotes insulin secretion in the patient’s body by changing the intestinal neuroendocrine, reducing islet cell apoptosis and restoring islet function, thus achieving the goal of treating diabetes. What is laparoscopic gastric sleeve resection? Laparoscopic gastric sleeve resection is performed by removing a large portion of the stomach in the direction of the greater curvature of the stomach, preserving 4-8 cm of the gastric sinus above the pylorus, leaving a “banana-shaped” passage about the diameter of the gastroscope, with a volume of about 100 mL. This procedure can be used alone, but for type 2 diabetic patients with severe obesity, and for high-risk patients with other serious complications, this procedure can be performed first, in order to eliminate the relevant high-risk factors earlier by relatively safe means, and then perform gastric diversion in the second stage according to the situation. There are many factors related to the choice of bariatric surgery, both in accordance with the needs of the disease and respecting the patient’s choice and consideration; not only the effect of surgical weight reduction and glucose lowering, but also the side effects of surgical changes to the gastrointestinal tract, and the need to take into account the postoperative surgical-related complications and the monitoring of nutritional complications. The ultimate goal of weight reduction and metabolic surgery is to individualize the surgery as much as possible in order to maximize patient benefits.