Bariatric Surgery in Patients With Morbid Obesity and Type 2 Diabetes

T here is an epidemic of obesitythroughout the developed andmuch of the developing world (1– 3). Obesity, typically measured as BMI 30 kg/m2, has three subclasses: obesity 1 (30–34.9 kg/m2); obesity 2 (35–39.9 kg/m2); and extreme obesity (40 kg/ m2). Extreme or morbid obesity is rapidly increasing in the U.S. and may have the potential of decreasing life expectancy. From 1986 to 2000, the prevalence of BMI30 kg/m2 doubled, whereas that of BMI 40 kg/m2 quadrupled, and even extreme obesity of BMI 50 kg/m2 in-creased fivefold (2). Of particular concern is the alarming increasing prevalence of obesity among children (1), suggestin