Obesity among adults has increased 60% since 1991, and 25% of children are overweight or obese. Direct and indirect costs of obesity represent almost 17% of total health care costs. People who are morbidly obese are far more likely to develop diabetes, hypertension, sleep apnea, osteoarthritis, and some forms of cancer, as well as depression and anxiety disorders than people who are not obese. Medical treatment of obesity only has long-term success rates of approximately 5%. Studies have validated that bariatric surgery, on the other hand, has greater success rates for weight loss maintenance. Of current surgical options, Roux-en-Y gastric bypass offers the best results:complications ratio and is seen as the "gold standard" in bariatric surgery.