Primary Endoscopic Treatments for Obesity

Abstract

Endoscopic bariatric therapies (EBTs) are suitable alternatives since only a tiny portion of patients with definite indications undergo bariatric surgery. Several endoluminal modalities are currently available, but the level of evidence supporting each of them varies widely. This review aims to summarize the most relevant and novel evidence on EBTs. The intragastric balloon is the oldest EBT, and there is sound evidence supporting its use to address overweight and obesity; there is a novel space-occupying device that causes intermittent gastric outlet obstruction and has recently been approved by the FDA; gastric reduction methods (POSE and Endoscopic Sleeve Gastroplasty) have new and promising data showing its effectiveness and safety; the endoluminal duodenal bypass liner has been abandoned from clinical use due to high rates of serious adverse events. This article reviews the novel and traditional EBTs and their corresponding supportive data for the primary treatment of obesity. Also, we provide insightful personal perspectives on the future of endoluminal bariatric therapies.