Obesity is a chronic disease that affects millions of people worldwide and is associated with many health complications. The main goal of obesity treatment is to improve health by achieving and maintaining weight loss or through imposing metabolic changes. For treatment, there are several interventions available, such as diet and exercise, drug therapy, and different surgical procedures. If used as mono-interventional therapy, they often show insufficiency to achieve and maintain adequate long term weight loss and metabolic improvement. Patients seeking low invasive, however still efficient treatment or those with suboptimal treatment results or side effects may benefit, under view of the new developments in metabolic-bariatric surgery, from combined, multi-speed treatment approach. In the first step there’s advantage of a very low invasive metabolic-bariatric surgery, such as Jejuno-Ileal Bipartition (JIB). In case of suboptimal treatment results subsequent sleeve gastrectomy would have leveraging effect. In bariatric-metabolic surgery new understanding of mechanisms of action, which involve not only mechanical restriction or hypoabsorption, but also neurohormonal modulation, gut microbiome alteration, immune system regulation, and epigenetic changes is being applied to the treatment pathways. For optimal success, heterogeneity of treatment modalities need to be incorporated into management plans. Multi-speed, combined metabolic-bariatric surgery leads to additive weight-loss and metabolic benefits and less side effects. Thus, combined surgical approach to obesity treatment are complementary to each other with incremental therapeutical effect. Laparoscopic JIB seems to be one of the promising non-drug interventions, especially for type 2 diabetic patients with poorly controlled diabetes. Pilot results at 2, 5 and 7 years after the operation show that in 5 years after JIB mean BMI decreased by −12.4%. HbA1c decreased in 2 years after the operation by mean of −2.48(−32.3%), after 5 years by −3,51 (−45.8%) and in 7 years there’s still a decrease of −2.39 (−31.2%) noted. Fasting glycaemia dropped by mean of −2.5 mmol/l(−27.3%) in 2 years, in 5 years postoperatively mean change was −4.8 mmol/l(−44.0%) in 7 years the mean decrease was—5.5 mmol/l (−50.4%) in comparison with the pre-op values. Mean hospital stay was 2 days. There was no mortality. Two reoperations (1.13%) were carried out, one as an emergency procedure, second one as elective case. In conclusion, JIB is effective and safe procedure with primarily metabolic effects. It does not necessitate significant lifestyle alterations, mineral and vitamin supplementation, and offers rapid postoperative recovery. JIB provides an anatomy sparing, low risk, potentially reversible, metabolic-bariatric procedure, especially advantageous in a view of possible use of magnetic anastomosis technique. In addition with sleeve gastrectomy JIB carried out concurrently or subsequently to sleeve gastrectomy or vice-versa represents safe, effective, and low invasive metabolic-bariatric procedure, resulting in significant postoperative resolution of metabolic disorders as well as meaningful weight loss.