Strict regulation of bariatric surgery based upon objective needs for this therapy could create in Belgium an important reduction in--actually overused--surgical gastric banding procedures especially among the female population 18-50 year not corresponding with Class III obesity or with Class II + comorbidities in the near future. With the progressive popularity of the gastric bypass procedure that can also be carried out laparoscopically in specialised obesity centres and better reflecting the prevalence of obesity eligible for surgery in the male population and among the older age groups, the number of bypass interventions will probably increase without compensating for the diminishing number of interventions with adjustable gastric band. Short-term projections without the above mentioned regulation of bariatric surgery and with ongoing constant increase of obesity prevalence indicate that the annual number of interventions based on the latest data of the national health insurance will know a 60% growth in 2006 and could reach 20.000 procedures in 2007.