There are two articles in the latest Archives of Surgery that compare different techniques of bariatric surgery in terms of long term efficacy. (If you're interested, the more complex gastric bypass seems to lead to better diabetes control and quality of life compared to other techniques.) One paper was from Taiwan, the other from Wisconsin. I didn't realize Taiwan had such a problem with Chalupas. But it's true, apparently Taiwan has seen an increasing rise in obesity over the past two decades (that's what you get for aligning with America over the Chinese mainland!). Wisconsin, well, that's where all the Cheeseheads are.
But it's amazing to me the number of bariatric papers that get churned out every year by major surgical journals. It's really difficult to read Archives or Annals or JACS on a month to month basis without seeing at least one paper devoted to bariatrics.
Is this a good thing? Is this science on the march? Are we monthly witnesses to the ineluctable forward thrust of the scientific method in human endeavor?
The bariatric lobby has won the war I suppose. You no longer read dissents that question the philosophical nature of the "disease" of obesity and the appropriate steps a society ought to take to remedy it. The more papers they can manufacture touting the efficacy of chopping your stomach up into various new shapes and forms, the more they can avoid the fundamental question of means and skip ahead to ends. Obesity surgery works. But we've stopped asking why obesity exists to such a grave extent. The ontological nature of obesity has been buried under an avalanche of teleology.
Are we so resigned to the epidemic of morbid obesity that we no longer hope to change human behavior or the way we provide food on a massive scale? Have we become passive reactants to a national health scourge, offering only the option of anatomic rearrangement?
I've always felt that bariatric surgery ought to be an esoteric, poorly understood specialty, where patients were only rarely referred due to underlying metabolic or genetic abnormalities. I never thought it would flourish, sustainably, like the way it has. Surgery departments at major tertiary centers all have their own bariatric programs. The casual prevalence of such a development ought to astound us all.