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While greater access to bariatric surgery in public hospitals is greatly needed, the future demands the establishment of a structure that supports access to all current and future therapies in a multidisciplinary setting supporting health improvement for people with obesity rather than weight loss alone. Glucagon-like peptide-1 receptor agonists liragulatide (10-12% TBWL) and, in particular, semaglutide (15% TBWL) have been major advances.9 Bariatric surgery, however, remains the most durable and effective treatment for obesity, achieving in most patients 20-30% TBWL for up to 20 years after surgery10 and improving comorbidities and quality of life. Combined surgery and pharmacotherapy may provide greater efficacy and reduce need for revisional surgery. Keywords: Obesity; Bariatric surgery; Public health; Hospitals EN Obesity Bariatric surgery Public health Hospitals 228 231 4 09/29/22 20220905 NES 220905 The obesity epidemic has been escalating for over 30 years, but little attention has been paid to delivery of effective treatments in the public system With a trebling of incidence since 1975, the World Health Organization estimates that most of the world's population now live in countries where overweight and obesity kill more people than underweight.1 The Australian Burden of Disease Study highlights obesity as the second largest risk for fatal disease and largest risk for non-fatal disease over the past 15 years.2 While death rates have been mitigated by a 35% increase in cardiovascular medicine prescriptions and a doubling of diabetes management therapies,3 our ability to successfully maintain this approach is likely to be overrun as Australian obesity rates climb to over 40% within a decade. [Extracted from the article]