This paper is based on observations on a personal series of patients who presented with severe ulcerating esophagitis, unresponsive to medical treatment following a vertical stapled gastroplasty. With one exception this was a late complication in an effective weight loss procedure. The therapeutic modalities chosen to treat this problem depended on patient choice, as well as personal experience with treating earlier cases. Unfortunately, I could. find little guidance in the literature or from my colleagues on how to treat this problem. Conversion to a Roux-Y gastric bypass seemed the most satisfactory solution to the problem, relieving the symptoms and maintaining the weight loss.