Intestinal bypass was considered the preferred surgical treatment at one time. Then it became gastric bypass. Since 1980, I have been promoting vertical banded gastroplasty. In Europe, the adjustable gastric band is now very popular. It also provides all of the effects one might desire for the treatment of type-2 diabetes.
Ileal transposition needs formal study in humans before it can be recommended, however.
At the June 1999 ASBS meeting, there was discussion regarding research into an implanted electrical stimulator to pace the stomach. Recently there was news regarding research where pacing the vagus nerve in the neck made the depressed patients laugh and lose weight. Bariatric surgery still does not have sufficient data from enough patients with any procedure to say which operation is best. I am concerned about the goals of surgeons and patients and their level of interest in what really goes on inside the body after alterations of the anatomy. I am concerned about the focus on the superficial and results from the first year with a lack of concern about how life will be affected when patients are 10 and 20 years older.