Newer drugs and endoscopic procedures show proficiency in managing metabolic problems and promise a more substantial weight reduction for patient with obesity and metabolic disorders. However, for the morbidly obese individuals who haven’t benefited from these interventions or aren’t suitable for these measures, metabolic surgery is known to result in substantial and sustained weight lost and with improved metabolic parameters. Improved glycemic control result in decreased risk of long-term complications associated with the metabolic diseases, reduced premature mortality and increased longevity. In 2016, after the second Diabetic Surgery Summit, (DMSS II) the IDF, ADA and over 30 other National Diabetes Societies endorsed the position that metabolic surgery is an essential component of management algorithm.

Our understanding of metabolic surgery has evolved over the years and a plethora of published literature has been enlightening. Today, metabolic surgery is tailored to patient and disease profile. I will present newer evidence in the field of metabolic surgery speaking of its efficacy with special reference to obesity and metabolic disease in Asia. I shall also discuss how as a community we can harmonise care for our patient with the hope of providing the best care to them.