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The main cause of the development of metabolic syndrome seems to be an imbalance of calorie intake and energy expenditure. However genetic and epigenetic factors, sedentary lifestyle, poor food quality, and disturbances in gut microbiota also play a major role. There is no single effective method of treatment for metabolic syndrome. Dietary therapy and an increase in physical activity along with pharmacological treatment are not fully effective to recommend them as a therapy for metabolic syndrome. Today, modern bariatric-metabolic procedures such as laparoscopic sleeve gastrectomy or single anastomosis gastric bypass give the best chances of successful resolution of metabolic syndrome.