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Malabsorption procedures for surgical weight reduction were initially described 50 years ago (1). The jejunoileal bypass and other early forms of intestinal bypass relied on malabsorption of nutrients to induce weight loss. However, the jejunoileal bypass was associated with significant metabolic complications due to the defunctionalized bypassed intestine. Complications, such as severe diarrhea, electrolyte disturbances, hyperoxaluria, nephrolithiasis, anemia, arthritis, liver dysfunction, and even liver failure, eventually led to the abandonment of these first-generation malabsorption procedures by the 1980s. The current malabsorption procedures are based on the biliopancreatic diversion (BPD), which was introduced by Scopinaro in 1976 (2). Unlike the original malabsorption procedures, no blind or defunctionalized segment of small intestine is created, and as a result many of the significant complications of the jejunoileal bypass are avoided. Advantages of the biliopancreatic diversion over other bariatric procedures include fewer dietary restrictions with more normal eating behavior, no excluded gastric remnant that is relatively inaccessible endoscopically, and excellent long-term weight loss. [ABSTRACT FROM AUTHOR]