Severe or morbid obesity, with a BMI exceeding 35–40, is often refractory to all therapies other than surgery. Bariatric or weight loss surgery is not generally recommended in childhood as it is fraught with ethical issues and the potential long-term benefits and complications of enteric diversion are not yet fully understood. On the other hand, it has been suggested that bariatric surgery in adolescents may have less complications and a shorter hospital stay than in adults. The long-term implications of bariatric surgery in children are not yet fully understood, and diligent long-term follow-up of all these patients is required to help determine this.