Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Current Treatment Options in Gastroenterology
Erschienen in: Current Treatment Options in Gastroenterology 2/2023

06.05.2023

Endobariatrics: a Still Underutilized Weight Loss Tool

verfasst von: Niel Dave, MD, Enad Dawod, MD, Okeefe L. Simmons, MD

Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose of review

Bariatric and metabolic endoscopic therapies provide an option for patients seeking clinically significant weight loss with fewer adverse events than conventional bariatric surgery. Our aims are to provide an overview of the current state of primary endoscopic treatment options for weight loss and to emphasize the importance of including these therapies when presenting weight loss options to qualified patients.

Recent findings

Bariatric endoscopy procedures are associated with a lower adverse event rate when compared to bariatric surgery and result in more weight loss than most existing pharmacotherapies approved by the Food and Drug Administration.

Summary

Sufficient evidence exists to implement bariatric endoscopic therapies—namely, the intragastric balloon and endoscopic sleeve gastroplasty—as safe and effective treatment options for weight loss when used in combination with lifestyle changes. However, bariatric endoscopy remains an underutilized option by weight management providers. Future studies are needed to identify patient and provider-level barriers to adopting endoscopic bariatric therapies as an option for the treatment of obesity.
Literatur
1.
2.•
Bray GA et al. Manag Obes. Lancet, 2016;387(10031): p. 1947-56.
3.
Tak YJ, Lee SY. Anti-obesity drugs: long-term efficacy and safety: an updated review. World J Mens Health. 2021;39(2):208–21.PubMedCrossRef
4.
Gómez V, Woodman G, Abu BK. Dayyeh, Delayed gastric emptying as a proposed mechanism of action during intragastric balloon therapy: results of a prospective study. Obesity. 2016;24(9):1849–53.PubMedCrossRef
5.
Mathus-Vliegen EM, de Groot GH. Fasting and meal-induced CCK and PP secretion following intragastric balloon treatment for obesity. Obes Surg. 2013;23(5):622–33.PubMedCrossRef
6.
De Castro ML, et al. Efficacy, safety, and tolerance of two types of intragastric balloons placed in obese subjects: a double-blind comparative study. Obes Surg. 2010;20(12):1642–6.PubMedCrossRef
7.
Ponce J, et al. The REDUCE pivotal trial: a prospective, randomized controlled pivotal trial of a dual intragastric balloon for the treatment of obesity. Surg Obes Relat Dis. 2015;11(4):874–81.PubMedCrossRef
8.
Nikolić M, et al. Position of intragastric balloons in global initiative for obesity treatment. Coll Antropol. 2011;35(4):1353–62.PubMed
9.
Dumonceau JM. Evidence-based review of the Bioenterics intragastric balloon for weight loss. Obes Surg. 2008;18(12):1611–7.PubMedCrossRef
10.
Genco A, et al. BioEnterics intragastric balloon (BIB): a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes. 2006;30(1):129–33.CrossRef
11.
Laing P, et al. Filling the void: a review of intragastric balloons for obesity. Dig Dis Sci. 2017;62(6):1399–408.PubMedCrossRef
12.
Štimac D, Klobučar Majanović S and Belančić. A Endoscopic treatment of obesity: from past to future. Dig Dis. 2020;1–13.
13.
Tsesmeli N, Coumaros D. Review of endoscopic devices for weight reduction: old and new balloons and implantable prostheses. Endosc. 2009;41(12):1082–9.CrossRef
14.
15.
Vantanasiri K, et al. The efficacy and safety of a procedureless gastric balloon for weight loss: a systematic review and meta-analysis. Obes Surg. 2020;30(9):3341–6.PubMedCrossRef
16.
Konopko-Zubrzycka M, et al. The effect of intragastric balloon on plasma ghrelin, leptin, and adiponectin levels in patients with morbid obesity. J Clin Endocrinol Metab. 2009;94(5):1644–9.PubMedCrossRef
17.
Courcoulas A, et al. Intragastric balloon as an adjunct to lifestyle intervention: a randomized controlled trial. Int J Obes. 2017;41(3):427–33.CrossRef
18.
Fuller NR, et al. An intragastric balloon in the treatment of obese individuals with metabolic syndrome: a randomized controlled study. Obesity. 2013;21(8):1561–70.PubMedCrossRef
19.
Sullivan S, et al. Randomized sham-controlled trial of the 6-month swallowable gas-filled intragastric balloon system for weight loss. Surg Obes Relat Dis. 2018;14(12):1876–89.PubMedCrossRef
20.
Vicente Martin C, et al. Preoperative intragastric balloon in morbid obesity is unable to decrease early postoperative morbidity of bariatric surgery (sleeve gastrectomy and gastric bypass): a clinical assay. Surg Endosc. 2020;34(6):2519–31.PubMedCrossRef
21.
Mohammed Amin Mohammed RA, Amany H. Mansour, Emad Elmasry and Gamal Othman. Effects of intragastric balloon versus conservative therapy on appetite regulatory hormones in obese subjects. 2014: Trends in Medical Research.
22.
Forlano R, et al. Effect of the BioEnterics intragastric balloon on weight, insulin resistance, and liver steatosis in obese patients. Gastrointest Endosc. 2010;71(6):927–33.PubMedCrossRef
23.
Delgado AAA, et al. Propofol vs traditional sedatives for sedation in endoscopy: a systematic review and meta-analysis. World J Gastrointest Endosc. 2019;11(12):573–88.PubMedPubMedCentralCrossRef
24.
Barham K. Abu Dayyeh MDN, Tom Lavin, Hisham Hussan, Christopher G. Chapman, Violeta Popov, Andres Acosta, Matthew S. French, Monika Rizk, Mustafa Huseini, Karen Grothe, Matthew Clark, Eric J. Vargas, Christopher C. Thompson. Pivotal randomized-controlled trial of the adjustable (SPATZ-3) intragastric balloon system for weight loss. 2019;GIE oral abstract: trends in medical research. p. AB58-AB59.
25.•
Popov VB, et al. The impact of intragastric balloons on obesity-related co-morbidities: a systematic review and meta-analysis. Am J Gastroenterol. 2017;112(3):429–39. A systematic review and meta-analysis which demonstrated that IGB leads to improvements in markers of metabolic comorbidities and few adverse events.PubMedCrossRef
26.
Lee YM, et al. Intragastric balloon significantly improves nonalcoholic fatty liver disease activity score in obese patients with nonalcoholic steatohepatitis: a pilot study. Gastrointest Endosc. 2012;76(4):756–60.PubMedCrossRef
27.•
Stavrou G, Shrewsbury A, Kotzampassi K. Six intragastric balloons: which to choose? World J Gastrointest Endosc. 2021;13(8):238–59. Systematic review and meta-analysis of patients who had an IGB placed (with no endoscopy required). The study revealed these balloons are effective therapies for obesity treatment.PubMedPubMedCentralCrossRef
28.
Ginsberg GG, et al. A pathway to endoscopic bariatric therapies. Gastrointest Endosc. 2011;74(5):943–53.PubMedCrossRef
29.
Update: potential risks with liquid-filled intragastric balloons - letter to health care providers.
30.
de Moura DTH, de Moura EGH, Thompson CC. Endoscopic sleeve gastroplasty: from whence we came and where we are going. World J Gastrointest Endosc. 2019;11(5):322–8.PubMedPubMedCentralCrossRef
31.••
Abu Dayyeh BK, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT) a prospective multicentre, randomised trial. Lancet. 2022;400(10350):441–51. First prospective, multicenter, randomized trial demonstrating the efficacy and safety of endoscopic sleeve gastroplasty.PubMedCrossRef
32.
Li P, et al. Efficacy and safety of endoscopic sleeve gastroplasty for obesity patients: a meta-analysis. Surg Endosc. 2020;34(3):1253–60.PubMedCrossRef
33.
de Miranda Neto AA, et al. Efficacy and safety of endoscopic sleeve gastroplasty at mid term in the management of overweight and obese patients: a systematic review and meta-analysis. Obes Surg. 2020;30(5):1971–87.PubMedCrossRef
34.
Singh S, et al. Safety and efficacy of endoscopic sleeve gastroplasty worldwide for treatment of obesity: a systematic review and meta-analysis. Surg Obes Relat Dis. 2020;16(2):340–51.PubMedCrossRef
35.
Sarkar A, et al. Safety and efficacy of endoscopic sleeve gastroplasty for obesity management in new bariatric endoscopy programs: a multicenter international study. Ther Adv Gastrointest Endosc. 2022;15:26317745221093884.PubMedPubMedCentral
36.
Gasoyan H, et al. Reasons for underutilization of bariatric surgery: the role of insurance benefit design. Surg Obes Relat Dis. 2019;15(1):146–51.PubMedCrossRef
37.
Beran A, et al. Comparative effectiveness and safety between endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy: a meta-analysis of 6775 individuals with obesity. Obes Surg. 2022;32(11):3504–12.PubMedCrossRef
38.
Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78(3):530–5.PubMedCrossRef
39.
Sartoretto A, et al. Endoscopic sleeve gastroplasty (ESG) is a reproducible and effective endoscopic bariatric therapy suitable for widespread clinical adoption: a large, international multicenter study. Obes Surg. 2018;28(7):1812–21.PubMedCrossRef
40.
Yoon JY, Arau RT. The efficacy and safety of endoscopic sleeve gastroplasty as an alternative to laparoscopic sleeve gastrectomy. Clin Endosc. 2021;54(1):17–24.PubMedPubMedCentralCrossRef
41.
Lopez-Nava G, et al. Gut and metabolic hormones changes after endoscopic sleeve gastroplasty (ESG) vs laparoscopic sleeve gastrectomy (LSG). Obes Surg. 2020;30(7):2642–51.PubMedCrossRef
42.
Vargas EJ et al. Effect of endoscopic sleeve gastroplasty on gastric emptying, motility and hormones: a comparative prospective study. Gut. 2022.
43.
Hedjoudje A, et al. Efficacy and safety of endoscopic sleeve gastroplasty: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2020;18(5):1043-1053.e4.PubMedCrossRef
44.
Abu Dayyeh BK, et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol. 2017;15(1):37-43.e1.PubMedCrossRef
45.•
Hajifathalian K, et al. Improvement in insulin resistance and estimated hepatic steatosis and fibrosis after endoscopic sleeve gastroplasty. Gastrointest Endosc. 2021;93(5):1110–8. This study demonstrates the favorable effect of ESG on the metabolic profile in patients with obesity.PubMedCrossRef
46.••
Sharaiha RZ, et al. Five-year outcomes of endoscopic sleeve gastroplasty for the treatment of obesity. Clin Gastroenterol Hepatol. 2021;19(5):1051-1057.e2. Five-year outcomes of ESG at one tertiary center are described, showing sustainable and significant TBWL at 5 years.PubMedCrossRef
47.
Fayad L, et al. Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc. 2019;89(4):782–8.PubMedCrossRef
48.
Novikov AA, et al. Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic band for weight loss: how do they compare? J Gastrointest Surg. 2018;22(2):267–73.PubMedCrossRef
49.
Ruban A, Ashrafian H, Teare JP. The EndoBarrier: duodenal-jejunal bypass liner for diabetes and weight loss. Gastroenterol Res Pract. 2018;2018:7823182.PubMedPubMedCentralCrossRef
50.
51.
Ruban A, et al. Duodenal-jejunal bypass liner for the management of type 2 diabetes mellitus and obesity: a multicenter randomized controlled trial. Ann Surg. 2022;275(3):440–7.PubMedCrossRef
52.
Jirapinyo P, Haas AV, Thompson CC. Effect of the duodenal-jejunal bypass liner on glycemic control in patients with type 2 diabetes with obesity: a meta-analysis with secondary analysis on weight loss and hormonal changes. Diabetes Care. 2018;41(5):1106–15.PubMedCrossRef
53.
van Baar ACG, et al. Duodenal mucosal resurfacing: multicenter experience implementing a minimally invasive endoscopic procedure for treatment of type 2 diabetes mellitus. Endosc Int Open. 2020;8(11):E1683-e1689.PubMedPubMedCentralCrossRef
54.
van Baar ACG, et al. Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes mellitus: one year results from the first international, open-label, prospective, multicentre study. Gut. 2020;69(2):295–303.PubMedCrossRef
55.
Hadefi A, et al. Endoscopic duodenal mucosal resurfacing for nonalcoholic steatohepatitis (NASH): a pilot study. Endosc Int Open. 2021;9(11):E1792-e1800.PubMedPubMedCentralCrossRef
56.
Thompson CC, et al. Aspiration therapy for the treatment of obesity: 4-year results of a multicenter randomized controlled trial. Surg Obes Relat Dis. 2019;15(8):1348–54.PubMedCrossRef
57.
Thompson CC, et al. Percutaneous gastrostomy device for the treatment of class II and class III obesity: results of a randomized controlled trial. Am J Gastroenterol. 2017;112(3):447–57.PubMedCrossRef
58.
59.
Espinós JC, et al. Gastrointestinal physiological changes and their relationship to weight loss following the POSE procedure. Obes Surg. 2016;26(5):1081–9.PubMedCrossRef
60.
Espinós JC, et al. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity: the primary obesity surgery endolumenal (POSE) procedure. Obes Surg. 2013;23(9):1375–83.PubMedCrossRef
61.
López-Nava G, et al. The primary obesity surgery endolumenal (POSE) procedure: one-year patient weight loss and safety outcomes. Surg Obes Relat Dis. 2015;11(4):861–5.PubMedCrossRef
62.•
Miller K, et al. MILEPOST multicenter randomized controlled trial: 12-month weight loss and satiety outcomes after pose (SM) vs. medical therapy. Obes Surg. 2017;27(2):310–22. This was a multicenter randomized control trial done on subjects who underwent the POSE procedure. In this study, patients who underwent POSE had a 12-month TBWL of 13.0% compared to the controls who had 5.3% (p < 0.01). In addition, in this study no device or procedure-related adverse events occurred.PubMedCrossRef
63.
Sullivan S, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: the ESSENTIAL trial. Obes. 2017;25(2):294–301.CrossRef
64.
Chow A, et al. Trends in the utilization of intragastric balloons: a 5-year analysis of the MBSAQIP registry. Obes Surg. 2022;32(5):1649–57.PubMedCrossRef
65.•
Mosli MM, Elyas M. Does combining liraglutide with intragastric balloon insertion improve sustained weight reduction? Saudi J Gastroenterol. 2017;23(2):117–22. A retrospective analysis which shows the additional weight loss with combination therapy with ESG and medications, when compared to ES alone.PubMedPubMedCentralCrossRef
66.
Zerrweck C, et al. Preoperative weight loss with intragastric balloon decreases the risk of significant adverse outcomes of laparoscopic gastric bypass in super-super obese patients. Obes Surg. 2012;22(5):777–82.PubMedCrossRef
67.
Vicente C, et al. Usefulness of an intra-gastric balloon before bariatric surgery. Rev Esp Enferm Dig. 2017;109(4):256–64.PubMed
68.
Marinos G, et al. Weight loss and improved quality of life with a nonsurgical endoscopic treatment for obesity: clinical results from a 3- and 6-month study. Surg Obes Relat Dis. 2014;10(5):929–34.PubMedCrossRef
69.
Jirapinyo P, Thompson CC. Gastric plications for weight loss: distal primary obesity surgery endoluminal through a belt-and-suspenders approach. VideoGIE. 2018;3(10):296–300.PubMedPubMedCentralCrossRef
Metadaten
Titel
Endobariatrics: a Still Underutilized Weight Loss Tool
verfasst von
Niel Dave, MD
Enad Dawod, MD
Okeefe L. Simmons, MD
Publikationsdatum
06.05.2023
Verlag
Springer US
Erschienen in
Current Treatment Options in Gastroenterology / Ausgabe 2/2023
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-023-00420-6

Weitere Artikel der Ausgabe 2/2023

Current Treatment Options in Gastroenterology 2/2023 Zur Ausgabe

ReviewPaper

Endoscopic Treatment of Non-malignant Esophageal Perforation: Time to Go Vacuum?

ReviewPaper

The Emerging Role of Endoscopic Ultrasound-Directed Transgastric ERCP (EDGE)

ReviewPaper

Current Screening and Management Strategies for Dysplasia in IBD

ReviewPaper

Diagnosis and Management of Opioid-Induced Esophageal Dysfunction

ReviewPaper

Updates in the Medical and Nutritional Management of Short Gut Syndrome

ReviewPaper

The Importance of Nutrition and Obesity Education in GI Fellowship: How to Train the Next-Generation of Gastroenterologists

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise