Obesity has increased rapidly and is now so prevalent in the UK that it is described as an epidemic. Lurking in the shadow is a tidal wave of diabetes. The expression ‘diabesity’ describes the co-existence of both epidemics. Indeed, the UK has one of the highest incidences of severe obesity in the world with more than 50% of adults who are overweight (BMI > 25) and ≥ 40-years-old having intermediate hyperglycaemia, commonly referred to as pre-diabetes (Mainous III et al., 2014). The personal and economic burdens are a challenge to the National Health Service (NHS) since both diseases are associated with significant morbidity. In 2013–14, the number of NHS-commissioned bariatric surgery procedures performed in England was 6380 (Health and Social Care Information Centre, 2015). As advocates of the efficacy of exercise to prevent obesity and diabetes, many sport and exercise scientists might consider operative solutions to be anathema. Nevertheless, considering the challenge that diabesity poses, active management of the problem should attract equal priority. However, it is important to emphasise that bariatric surgery is not a panacea for all people with obesity. Awareness of the risks and benefits of the various procedures and the commitment required to behaviour change for a successful long-term outcome must be understood.