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The study group consisted of 96 patients who had used a medication for type 2 diabetes; of them, 33 had undergone gastric sleeve surgery and 63 bypass surgery. Both surgical methods resulted in a similar weight loss among the patients. In follow-up 39 out of 88 patients were able to manage without antidiabetic drugs two years after surgery. The costs of antidiabetic drugs two years after surgery were 79% lower than before the operation. Weight reduction surgery decreases the need for antidiabetic drugs. The greatest cost-efficiency is achieved by targeting weight-loss operations to patients using insulin therapy.

Obesity is associated with metabolic complications such as insulin-resistance, type 2 diabetes, dyslipidemia, hypertension and polycystic ovary syndrome. Obesity adversely impacts fecundability and IVF outcomes through a variety of mechanisms, however even modest weight loss can improve situation. Pregnancy may be a significant health risk for morbidly obese women (BMI over 40 kg/m2) and fertility treatments are not recommended before weight loss. The fertile age of women is limited, therefore an efficient treatment of obesity should be chosen. For morbid obesity bariatric surgery combined with lifestyle changes is more efficient treatment than conservative treatment alone. Weight loss is associated with significant improvement in many parameters of reproductive function, chance to get pregnant improves and gestational risks decrease.