But now a new treatment is helping people lose the pounds without going under the knife.
Not only that, it can help get diabetes under control too.
One out of every 9 adults in New York City has type 2 diabetes and we know it's often linked to obesity.
A new device attemps to solve it without surgery, and now doctors are trying to see if it works.
"The actual material of the liner is very similar to Saran wrap," said Dr. Aida Saliby of Beth Israel Medical Center.
That plastic liner is called the endobarrier. It's a new device being tested as a treatment for diabetes and weight loss.
Doctors insert the tube through the mouth. Using a camera they guide it through the stomach and into the first part of the intestine, then they inflate it.
"It's gonna be hooked to the end of the stomach lining where it will be attached," said Dr. Saliby.
As you eat the barrier blocks food from touching the intestines. That's thought to change the release of key hormones that control hunger and blood sugar.
"With this device we want to see if there's an improvement in their diabetes in the next 12 months," said Dr. Saliby, the principal investigator at Beth Israel Medical Center.
It's one of 21 centers in the US testing the endobarrier, all paid for by the company that makes it.
Their studies show that in 9 months, 87% of patients reach their target blood sugar levels and lose on average 18% of their total body weight.
It's supposed to be a temporary fix so they leave it in for up to a year and then doctors remove it the same way they put it in.
But it comes with risks, like nausea and bleeding, and the lining can become displaced and cause a blockage.
Stanley Zareff is not involved in a clinical trial, but he's one of the nearly 700,000 New Yorkers dealing with type 2 diabetes.
"There's always a doubt about what's the risk involved but the upside is if it really does work I would definitely do it," said Zareff.
So far the device has been tested in 1200 people worldwide and is still considered investigational in the United States.
They're still recruiting patients for the trials. The company says they're expecting early results in 2016 and will then apply for FDA approval.
For more information on the new device: