The authors conclude that studies suggest that for some individuals gastroplasty may have significant benefits, particularly in the short term. Long-term follow-up is needed with careful medical and nutritional monitoring to prevent digestive or nutritional complications. However, gastroplasty is not the best treatment for most severely obese patients and patient selection is a key issue. Further research is needed to develop predictors of who may benefit and to compare the various modern surgical procedures. More long-term data is required. Prevention of obesity is still regarded as the best policy