Obesity and polycystic ovary syndrome (PCOS) are common and have important reproductive consequences: ‘metabolic surgery’ – bariatric surgery and laparoscopic ovarian drilling (LOD) – have roles in their management. Using national data to determine age‐stratified incidence rates of these procedures, we found that bariatric surgery is much more common than LOD. While the uptake of bariatric surgery is rapidly increasing, there has been a decline in the use of LOD in young women. It seems likely that other forms of care for PCOS‐related anovulation resistant to clomiphene, such as the use of letrozole or in vitro fertilisation, are taking the place of LOD.