The National Institute for Health and Care Excellence (NICE) specifies that only patients who have a BMI greater than 40kg/m2 or a BMI greater than 35kg/m2 with at least one obesity - related comorbidity should be considered for bariatric surgery. This is a mandatory requirement in the National Health Service and patients who do not satisfy these criteria will not be considered for surgery at our unit. Some procedures, such as intragastric balloon insertion, are licensed for patients with a BMI in the range 30-35kg/m2but it is not our practice to insert balloons into patients with only marginally increased BMI. Please note that the Welsh Weight Loss Surgery Clinic does not include laparoscopic gastric banding as part of its range of treatments. The excessively high rate of long-term complications (up to 50% in several worldwide series) as well as the need for lifelong follow-up has deterred us from offering this procedure to our patients. It is increasingly evident from the worldwide literature that the benefits of sleeve gastrectomy and gastric bypass far outweigh those of banding and with a considerably lower rate of long-term complications. Our overriding intention is to offer the best treatments to our patients, and this has resulted in our decision to not offer gastric banding.