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Endoscopic bariatric therapies for obesity: a review

Dominic A Staudenmann, Zhixian Sui, Payal Saxena, Arthur J Kaffes, George Marinos, Vivek Kumbhari, Patrick Aepli and Adrian Sartoretto
Med J Aust 2021; 215 (4): . || doi: 10.5694/mja2.51179
Published online: 2 August 2021

Summary

  1. ▪  Obesity is reaching pandemic proportions globally, with overweight or obesity affecting at least two‐thirds of Australian adults.
  2. ▪  Bariatric surgery is an effective weight loss strategy but is constrained by high resource requirements and low patient acceptance.
  3. ▪  Multiple endoscopic bariatric therapies have matured, with well established and favourable safety and efficacy profiles in multiple randomised controlled trials (RCTs), and are best used within a multidisciplinary setting as an adjuvant to lifestyle intervention.
  4. ▪  Three types of intragastric balloon are currently in use in Australia offering average total weight loss ranging from 10% to 18%, with others available internationally.
  5. ▪  Endoscopic sleeve gastroplasty produces average total weight loss of 15–20% with low rates of severe complications, with RCT data anticipated in December 2021.
  6. ▪ Bariatric and metabolic endoscopy is rapidly evolving, with many novel, promising therapies currently under investigation.

  • 1 AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW
  • 2 Praxis Balsiger Seibold und Partner, Bern, Switzerland
  • 3 Université de Fribourg, Fribourg, Switzerland
  • 4 University of New South Wales, Sydney, NSW
  • 5 Royal Prince Alfred Hospital, Sydney, NSW
  • 6 The BMI Clinic, Sydney, NSW
  • 7 Mayo Clinic, Jacksonville, FL, United States
  • 8 Luzerner Kantonsspital (LUKS), Lucerne, Switzerland



Competing interests:

No relevant disclosures.

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