Abstract
Obesity is a significant problem worldwide. Several serious diseases that decrease patient quality of life and increase mortality (high blood pressure, dyslipidaemia, type 2 diabetes etc.) are associated with obesity. Obesity treatment is a multidisciplinary and complex process that requires maximum patient compliance. Change of lifestyle is fundamental in the treatment of obesity. While pharmacotherapeutic options are available, their efficacy is limited. Surgical treatment though highly effective, carries the risk of complications and is thus indicated mostly in advanced stages of obesity. Endoscopic treatments of obesity are less invasive than surgical options, and are associated with fewer complications and nutritional deficits. Currently, there is a large spectrum of endoscopic methods based on the principles of gastric volume reduction, size restriction and gastric or small bowel bypass being explored with only few available in routine practice. The aim of this publication is to present an up-to-date summary of available endoscopic methods for the treatment of obesity focusing on their efficacy, safety and nutritional aspects.
Highlights
Obesity is a serious disease that affects hundreds of millions of individuals worldwide.According to the WHO, obesity is defined as abnormal or excessive fat accumulation that presents a significant health risk, and is closely related to long-term complications and numerous associated diseases
This study showed that Duodenal Mucosa Resurfacing (DMR) is an endoscopic technique that leads 7.2 to improved diabetes control in patients with type 2 diabetes mellitus (DM) treated with oral hypoglycaemic agents [58]
The type of bariatric surgery changes the nature of the diet, and there is a postoperative recommendation with standardized loosening that was published in 2019 [16]
Summary
Obesity is a serious disease that affects hundreds of millions of individuals worldwide. Endoscopic Bariatric and Metabolic Therapies (EBMT) represent another progressive alternative that offers higher efficacy than pharmacotherapy and at the same time is less invasive and has a lower incidence of complications than classical surgical treatment. The method of Endoscopic Bariatric and Metabolic Therapies (EBMT) predominantly involve the stomach, but they include procedures that remodel the duodenum or small bowel. The recommended methods are gastric volume reduction including intragastric balloons (IGB), gastric endoscopic remodeling using plication, and thirdly, reduction of calorie intake using aspiration therapy. This classification is based on the methods registered in the USA by the FDA. Based on recent publications and guidelines, endoscopy bariatric procedures are divided into four parts (1) procedures that reduce gastric volume (2) procedures that slow gastric emptying (3) bypass procedures, and (4) other procedures
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