A patient, a surgeon, and an insurance agent walk into a bar -- Evidence-Based Medicine and Decision Making -- Bariatric surgery for uncontrolled hypertension -- Diabetes is an indication for bariatric surgery -- Procedure choice for treatment of diabetes -- Should patients with obesity hypoventilation syndrome undergo bariatric surgery -- Heart failure and bariatric surgery -- Cornary Artery Disease and bariatric surgery -- What are there nutritional "red flags" to look out for prior to bariatric surgery? -- Are there psychiatric diagnoses that preclude safe bariatric surgery? -- Does weight loss prior to surgery accurately predict success following bariatric surgery? -- The ideal weight loss diet for preparing a patient for bariatric surgery -- Is routine upper endoscopy and H. pylori testing indicated in advance of bariatric surgery? -- Manometry is useful prior to bariatric surgery -- Smoking cessation is essential prior to bariatric surgery -- Is the insurance requirement for supervised weight loss prior to bariatric surgery an ethical strategy to prevent non-compliant patients from undergoing surgery? -- Bariatric surgery in the young pediatric population -- Gastric banding, what happened? -- What is the role of bariatric surgery in the management of nonalcoholic steatohepatitis? -- Is Roux in Y gastric bypass less safe than sleeve gastrectomy? -- The national shift to sleeve gastrectomy - long term disappointment and recidivism? -- Single-stage Duodenal Switch Is Better Than Two-Stage -- Reoperation for repair of anastomotic leak -- Gastric sleeve stricture, twist or kink, now what? -- Hiatal hernia complicating bariatric surgery -- Duodenal switch and reflux control -- Endoscopic management of the dilated gastrojejunal anastomoses -- When to include medical therapy for late failure after bariatric surgery -- Does resizing the gastric pouch aid in weight loss? -- Does stoma size matter after gastric bypass? -- Indications, choice of operation and outcomes of metabolic and bariatric surgery in children. -- Pediatric bariatric surgery and developmental milestones -- Surgical approaches for adolescents vs adults, which specialist should perform bariatric surgery in adolescents? -- Will deep brain stimulation eventually replace bariatric surgery? -- How manipulating the microbiome can affect the outcome following bariatric surgery.

This book provides a practical guide to decision making within bariatric surgery. Through uniform and well-structured chapters, topics relating to patient selection, preoperative preparation, the ethics of bariatric surgery, choice of procedure, complications, late failure and management, malabsorptive procedures, and pediatric bariatric surgery are discussed and examined. Difficult Decisions in Bariatric Surgery aims to help readers navigate an increasingly complex surgical specialty and come to reasoned and evidence-based conclusions. This book is of interest to practicing and trainee surgeons, endocrinologists, endoscopists, and pediatricians.