Bariatric surgery is the only documented treatment for weight loss in patients with severe obesity and is associated with an overall decrease in mortality. As a result of a generally more obese population the number of bariatric surgical and endoscopic procedures and different methods have increased dramatically during the latest two decades. However, the long-term consequences remain yet to be shown except for a few bariatric procedures. The aim of this article was to describe the most important bariatric surgical and endoscopic techniques for weight loss and the evidence behind.