This issue of „Postępy Nauk Medycznych” concerning surgical treatment of obesity comprehensively presents the current state of knowledge on this subject. The papers have been drawn up by specialists dealing with these issues in clinical practice. They present their own experiences in this field and achievements of other authors based on the extensive recent literature. This type of study, including epidemiology and non-invasive treatment of obesity, indications for surgical treatment, surgical techniques and instrumentation necessary for the performance of bariatric surgery as well as results of surgical treatment, complications and revision surgeries, is the first detailed presentation of the problem in Poland appearing in published form. The increase of the number of obese persons and the lack of effective non-invasive treatment are the reasons for the development of surgical techniques effective in permanent weight loss as well as in diseases accompanying obesity; hence the usefulness of familiarizing the broad circle of readers of Postępy Nauk Medycznych with these issues. This is a very important topic for GPs, non-surgical specialists and surgeons. The state of knowledge of the medical environment is unsatisfactory in this field. It is necessary to make the medical community aware what a dangerous pathology for health obesity is, and in particular pathological obesity. WHO´s acknowledgement of obesity in 1998 as the epidemic of the 21^{st century underscores the importance of this problem. The implemented preventive programmes – worldwide, European and domestic – will bring results not until several or several dozen years. The scale of the problem is demonstrated by the fact that the number of obese people in the world is greater than the number of undernourished people.}

These data point to the necessity to develop and implement surgical techniques for the treatment of morbid obesity. Technical progress, with the introduction of new technologies and equipment, has helped bring a significant decrease of surgical injuries. Currently all operations for the surgical treatment of obesity can be performed with the laparoscopic technique, which has significantly decreased surgical injury and the percentage of complications, and has improved the quality of life of patients in the post-operative period. Surgical treatments for obesity have had a definite influence on resolution of diabetes mellitus type 2 even in patients who are not obese. During the Congress of the European Association for Endoscopic Surgery in June 2009 Prof. Gagner presented the current achievements in this field. The importance of the problem is reflected by the numerous congresses and world, continental and domestic conventions devoted to this field.

The problem of obesity is becoming more and more important in Poland. The number of people whose BMI is higher than 40 has exceeded 250 000. These people require surgical treatment because non-invasive treatment is ineffective in their case. Presently the number of bariatric surgeries per year in Poland is approximately 1000, and the number required is several times higher. The necessity to develop and promote bariatric surgery is essential. The result of surgical treatment is not only weight loss but first of all the resolution of accompanying diseases – diabetes, diseases of the circulatory system, metabolic syndrome and others – and improvement of the quality of life of these people. The surgical treatment of obesity brings health results as well as economic results in the perspective of development. It was calculated that the cost of surgical treatment of a patient with pathological obesity pays for itself after two years as a result of the decrease of costs of treatment of accompanying diseases. It is important for medical employees, and especially for the political and administrative organs responsible for work in the health services, to understand these issues. Currently in parallel groups of patients only 2 procedures of surgical treatment of obesity (gastric banding and vertical banded gastroplasty) are considered. It is necessary to introduce a separate group, „surgical treatment of obesity” or generally „treatment of obesity”, and include there all ways of treatment, evaluating every procedure separately. This can be done very precisely because the procedures are thoroughly described and technical means necessary for their performance are also described. Currently surgical procedures of obesity treatment are undervalued and this is the next reason for the lack of development of these surgical techniques. Obesity is the epidemic of the 21^{st century and actions appropriate for an epidemic should be taken in order to combat it.}

Prof. dr hab. med. Edward Stanowski