A standardized vertical banded gastroplasty (VBG) was carried out by the one surgeon on 60 consecutive morbidly obese patients. All patients were followed at 4 week intervals for 1.5 years. Long‐term follow up was carried out at medians 5.7 and 9.6 years. All patients had significant weight loss at 1.5 years. However, at long‐term follow up, despite an apparently intact gastric restrictive procedure, only 40% of patients had maintained their weight loss. Sixty per cent had regained significant weight and 31% had returned to or were above their pre‐operative weight