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Endoscopic Management of Clinically Severe Obesity: Primary and Secondary Therapeutic Procedures

  • Health Services and Programs (R Welbourn and C Borg, Section Editors)
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Abstract

Purpose of Review

In the treatment of epidemic obesity and metabolic disorders, conservative approaches often fail to achieve the treatment goal in patients with very high BMI. To date, bariatric surgery accomplishes the most sustainable results in patients with morbid obesity. This leads to a treatment gap for lower and middle classes of obesity defined by BMI. Primary endoscopic procedures, which are less invasive than surgery, may be able to sufficiently fill this gap. Furthermore, secondary endoscopic procedures have developed into an essential addition regarding complication management of bariatric surgeries. The purpose of this review was to point out the latest developments in the field of bariatric endoscopy, including both primary and secondary procedures.

Recent Findings

Innovative devices and their possible applications will be discussed. These include various endoscopic suturing techniques as well as newly developed implants for the upper gastrointestinal tract to counteract the obesity epidemic.

Summary

The growing understanding of the pathophysiology of obesity and the role of the gastrointestinal tract allows for the development of more effective endoscopic procedures regarding obesity treatment.

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Author information

Authors and Affiliations

  1. Department of Surgical Endoscopy, Sana Hospitals Germany, Obesity Center NRW, Huerth, Germany

    Christine Stier

  2. Department of General, Visceral and Transplant Surgery, RWTH University Aachen, University of Aachen, Aachen, Germany

    Christine Stier

  3. University Hospital Wuerzburg, Wuerzburg, Germany

    Ilja Balonov

  4. Department of General, Visceral, Tumor and Transplant Surgery, University Hospital of Cologne, Cologne, Germany

    Raphael Stier

  5. Department of Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy

    Sonja Chiappetta

  6. Department of Internal Medicine I, Endocrinology and Diabetes Unit, University Hospital Wuerzburg, Wuerzburg, Germany

    Carnina Teresa Fuss

  7. Department of Gastroenterology, Mayo Clinic Rochester, Rochester, MA, USA

    Barham Abu Dayyeh

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  1. Christine Stier
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  2. Ilja Balonov
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Correspondence to Christine Stier.

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Conflict of Interest

Christine Stier, Ilja Balonov, Raphael Stier, Sonja Chiapetta, Carina Fuss, and Barham Abu Dayyeh declare that they have no conflict of interest.

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All reported formerly studies/experiments with human or animal subjects performed by the authors were performed in accordance with all applicable ethical standards including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines.

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Stier, C., Balonov, I., Stier, R. et al. Endoscopic Management of Clinically Severe Obesity: Primary and Secondary Therapeutic Procedures. Curr Obes Rep 9, 339–347 (2020). https://doi.org/10.1007/s13679-020-00385-y

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