Obesity is a chronic disease increasing at epidemic rates worldwide. Diet and lifestyle intervention form the basis of healthy weight management but are not effective in promoting substantial weight loss in morbidly obese individuals. Bariatric surgery appears to be the only intervention that produces not only profound and sustainable weight loss but also excellent control of attendant comorbidities, particularly type 2 diabetes mellitus, in this group. However, fears and concerns regarding the safety and aggressiveness of surgery is limiting the acceptance of bariatric surgery as a viable treatment option. Newer, less invasive procedures hold promise to fill the gap between conservative and surgical therapies for weight loss.