Remission of diabetic symptoms after bariatric surgery initiated a discussion about surgical treatment of metabolic syndrome, which in the last decades has been an epidemic. The intention of the authors was to present different aspects of this topic and possible arguments for and against. The article also presents the official recommendations of the American Diabetes Association published in 2009. Independently of the very circumspect position of this organization, increasing interest in this method of therapy is observed in the medical world.