The document discusses bariatric surgery options and outcomes for patients with a BMI over 50 (super obesity). It reviews the trends in various bariatric procedures from the 1990s, including restrictive procedures like vertical banded gastroplasty and laparoscopic gastric banding, as well as malabsorptive procedures like Roux-en-Y gastric bypass. Studies presented show that while super obese patients lose more weight than morbidly obese patients after various procedures, they often do not achieve normal weight. Malabsorptive procedures tend to produce greater weight loss for super obese patients compared to restrictive options.

1. Restrictive Procedures in BMI > 50 Craig B. Morgenthal, MD George S. Ferzli, MD SUNY Health Science Center at Brooklyn

13. Biertho L, Gagner M, et al. Lap gastric bypass vs. LAGB: a comparative study. JACS 2003; 197:536

14. Biertho L, Gagner M, et al. Lap gastric bypass vs. LAGB: a comparative study. JACS 2003; 197:536

20. Results of Vertical Banded Gastroplasty

27. Bloomston M, Rosemurgy A, et al. Outcome following bariatric surgery in super vs. morbidly obese patients. Obesity Surg 1997; 7: 414.

31. Results of Laparoscopic Adjustable Gastric Band