The vertical banded gastroplasty (VBG) was designed to be a relatively safe and quick bariatric operation in which there was restriction of food intake but no malabsorption. However, over a period of time patients developed maladaptive eating behaviors or had complications related to gastric outlet obstruction that manifested as nausea, vomiting, reflux symptoms, excess weight loss, or staple line failure resulting in weight regain. These complications can be treated by converting the VBG to other bariatric operations but must be performed by experienced surgeons due to higher complication rates.