We have reviewed data from 200 patients who underwent weight-reducing surgery in a district general hospital. Mean age was 38.5 yr (range 14-60 yr) and mean body mass index (BMI) 45.7 kg m-2 (range 30.0-86.8 kg m-2). There was one death, which resulted from pulmonary embolus 3 weeks after surgery. Upper abdominal surgery of this type is justified in the morbidly obese and problems were not encountered that would exclude its practice from non-specialized units.