Our data demonstrate EndoBarrier as highly effective in patients with refractory diabesity. Maintenance of improvement after EndoBarrier removal was achieved in 68%. There were high patient satisfaction levels and an acceptable safety profile. As endoscopy units are ubiquitous, our service could be readily disseminated. Hepatic Abscess is a known risk as a result of EndoBarrier treatment. Clinicians should be vigilant for this complication but if it occurs the device can, if necessary, be removed. These data are supportive of risk:benefit being strongly towards benefit and they support the continuance of EndoBarrier as an important treatment option for refractory diabesity.