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Bariatric surgery results in dramatic improvement of type 2 diabetes, hypertension, dyslipidemia, and reduction of overall mortality. The anti-diabetes effect of certain bariatric procedures results from mechanisms beyond weight loss, supporting the rationale for surgical treatment of type 2 diabetes, including the less obese patients.

The recognition that mechanisms and benefits of bariatric surgery extend beyond weight loss has raised a question about the appropriateness of the name bariatric surgery, which reflects only the goal of weight-reduction . In fact, the concept of "metabolic surgery" has emerged to indicate a surgical approach aimed at control metabolic illnesses and obesity related diseases such as diabetes ,hypertension, and hyperlipidemia , not just excess weight.

The International Diabetes Federation IDF recommended that surgery should be considered as an alternative treatment option in patients with a BMI between 30 and 35 kg ⁄m2 when diabetes cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors (In Asian, BMI action points may be reduced by 2.5 kg ⁄m2) .