Patients undergoing bariatric surgery continue to feel misunderstood and mistreated by medical and non-medical personnel involved in the treatment of their obesity. Like other forms of prejudice, this most likely is due to a lack of understanding of the disease of morbid obesity, the root causes and the medical consequences if untreated. Despite laws designed to prevent discrimination based on appearance, unfavorable attitudes and practices persist. A plan for continued education of the medical and non-medical communities is essential to breakdown the barriers in place due to ignorance and indifference. Patient support groups continue to play an important role in the ongoing battle to correct the negative effect of these attitudes on the morbidly obese patient.

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This series indicates that more sensitive imaging and more widespread use of endoscopic retrograde cholangiopancreatography, colonoscopy, and liver transplantation have changed the clinical presentation of PVG; PVG may be found in various clinical settings that do not mandate laparotomy; and the significance of PVG must be derived from the clinical context of the individual patient.

Morbid obesity represents a significant health issue. None of the medical methods of weight reduction provide a lasting weight reduction. Surgery offers the only achievable long-term solution. Although not yet universally employed, laparoscopic RYGBP is rapidly becoming the standard operation for the surgical treatment of clinically severe obesity.

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