Currently, the prevalence of obesity and its extreme forms is progressively increasing throughout the world. The article presents analysis of different approaches to the surgical treatment of super and “super-super” obesity. The range of methods varies from one-stage restrictive interventions to the use of multi-component combined operations with long-term preoperative preparation. In general, the opinions of the experts seem to be different, so at the present time there are no uniform recommendations for treating patients with extreme obesity, the fact determining the need for further research