Endoscopic bariatric therapies for obesity: a review

Summary

▪ Obesity is reaching pandemic proportions globally, with overweight or obesity affecting at least two‐thirds of Australian adults.
▪ Bariatric surgery is an effective weight loss strategy but is constrained by high resource requirements and low patient acceptance.
▪ 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.
▪ 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.
▪ Endoscopic sleeve gastroplasty produces average total weight loss of 15–20% with low rates of severe complications, with RCT data anticipated in December 2021.
▪ 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

Correspondence: dominic.staudenmann@magendarmsuisse.ch

Competing interests:

No relevant disclosures.

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