Over the past century, weight loss surgery has undergone one of the mostremarkable transformations in modern medicine. Once viewed purely as ananatomical procedure to restrict food intake or force malabsorption, bariatricsurgery is recognized today as sophisticated metabolic medicine capable ofaltering neurohormonal pathways and remitting chronic co-morbidities.
The seeds of metabolic surgery were planted nearly a century ago. In 1925, Dr. O. Leyton published a case study in The Lancet describing how a gastrojejunostomy performed to treat a duodenal ulcer unexpectedly improved a patient’s mild diabetes mellitus (Yáñez et al., 2025).
During the mid-20th century, early surgical attempts to treat obesityfocused strictly on malabsorption. In 1953 and 1954, researchers like Dr. Richard Varco, Arnold Kremen, and John Linner experimented with jejuno-ilealbypasses in animal models and humans (Azócar et al., 2021). Later, popularized by Payne and DeWind in the late 1960s, these early intestinal bypasses successfully caused weight loss; however, they caused severe long-term complications, such as hepatic steatosis, severe electrolyte imbalances, and short bowel syndrome, leading surgeons to abandon the technique in search of safer alternatives (Álvarez-Cordero, 1999; Azócar et al., 2021).
The field reached a critical turning point in 1995, when Dr. WalterPories published his landmark paper, "Who Would Have Thought It? An Operation Proves to Be the Most Effective Therapy for Adult-Onset Diabetes Mellitus" (Pories et al., 1995; see Yáñez et al., 2025). Pories demonstrated that bariatric procedures provided durable, complete remission ofType 2 diabetes. Subsequent research established that post-surgical glycemic control occurred rapidly—often before significant weight loss—due to alterations in gut hormone secretion, such as GLP-1, and neurohormonal signaling (Yáñez etal., 2025). Among many other small and big advances throughout decades of research of clinical trials that I cannot fully address in the scope of this blog, finally a paradigm shift happened in 2007 when the American Society for Bariatric Surgery renamed itself as the American Society for Metabolic and Bariatric Surgery (ASMBS) (Yáñez et al., 2025)—know knowing for a fact tat bariatric surgery is not merely about weight loss, but about changing people’s lives.
Modern bariatric surgery offers tailored anatomical approaches depending on a patient's body mass index (BMI), health profile, and metabolic goals.
Initially introduced in 2001 by Dr. Michel Gagner as the preliminary step of a two-stage duodenal switch for high-risk patients, the Vertical Sleeve Gastrectomy quickly emerged as a stand alone procedure (Azócar et al., 2021). VSG involves removing approximately 80% of the stomach vertically, creating a narrow sleeve or tube. Beyond restricting volume, removing the gastric fundus significantly reduces ghrelin (the "hunger hormone"), helping patients control appetite. Today, it is the most common bariatric procedure performed worldwide (Azócar et al., 2021).
First introduced in 1966 by Dr. Edward Mason and Dr. Chikashi Ito, theRoux-en-Y Gastric Bypass has long been considered a gold standard (Azócar etal., 2021). The surgeon creates a small stomach pouch (roughly 30 cc) andattaches it directly to the mid-section of the small intestine (jejunum),bypassing the rest of the stomach and the upper small intestine (duodenum).RYGB combines modest stomach restriction with nutrient malabsorption and potentmetabolic signaling, rendering high success rates for weight loss and Type 2diabetes remission (Yáñez et al., 2025).
Introduced in 2007 by Dr. Andrés Sánchez-Pernaute in Madrid, SADI-S is asimplified variant of the traditional biliopancreatic diversion with duodenalswitch (BPD-DS) (Azócar et al., 2021). It starts with a standard sleevegastrectomy, followed by transecting the duodenum just past the pyloric valveand connecting it directly to a loop of the ileum (200–300 cm from theileocecal valve). By retaining the pylorus and replacing two intestinalconnections with a single anastomosis, SADI-S offers strong weight-loss andglycemic results while reducing long-term nutritional complications compared totraditional BPD-DS (Azócar et al., 2021).
Throughout bariatric history, other techniques have been introduced withvarying popularity (Azócar et al., 2021):
Mexico has played a pioneering role in the international development of bariatric surgery. The history of Mexican bariatric care dates to the late 1960s and early 1970s, with clinical trials of intestinal bypasses conducted at prestigious institutions like the Instituto Nacional de la Nutrición Dr.Salvador Zubirán and the Centro Médico Nacional del I.M.S.S. (Álvarez-Cordero, 1999).
In 1993, Mexican specialists founded the Sociedad Mexicana de Cirugíade la Obesidad, A.C. (now CMCOEM), promoting surgeon training, research, and international collaboration in the bariatric field. Mexico's global leadership was highlighted in 1995 when it co-founded the International Federation for the Surgery of Obesity (IFSO) alongside societies from the US, Italy, and Sweden, and hosted the landmark IFSO World Congress in Cancun in 1997, which established global ethical standards for bariatric surgeons known as the Cancun IFSO Statement (Coran Jr., 1998; Álvarez-Cordero, 1999). Today, Mexico is recognized globally as an epicenter for high-quality, accessible bariatric and metabolic care.
Building on Mexico's rich surgical history, Dr. Sandy Martinez stands out as a top-tier bariatric surgeon in Tijuana, Mexico. Rejecting the high-volume "hospital factory" approach, Dr. Sandy focuses on direct doctor-to-patient care, safety, and personalized treatment plans.
With over 3,500 successful surgical procedures, Dr. Sandy holdselite certifications and international accreditations, including:
Located just minutes—blocks, really—, across the San Diego border, Dr. Sandy’s practice combines advanced surgical techniques, including Sleeve Gastrectomy, forms Gastric Bypass, and SADI-S, with transparent pricing and compassionate 24/7 bilingual support. For patients seeking to transform their health, Dr. Sandy represents the modern standard of excellence in bariatric and metabolic medicine.
Bariatric Nutrition | Behavioral Neuropsychology
Specialistin Bariatric Nutrition, Metabolic Syndrome, and Eating Disorders
