Endoscopic treatments of obesity: a comprehensive review.
BACKGROUND
Obesity remains a significant problem in the United States. Bariatric surgery is the most effective treatment for obesity, but it is cost-prohibitive on both a national and individual scale. Access is also limited, and less than 1% of the eligible population receives bariatric surgery. Endoscopic therapies for obesity have emerged as an alternative to bariatric surgery, 2 of which have recently been approved by the U.S. Food and Drug Administration (FDA). This study provides a comprehensive overview of the endoscopic treatments of obesity and summarizes their outcomes.


OBJECTIVE
To provide clinicians with a comprehensive overview of the endoscopic treatments of obesity.


METHODS
University Hospital, United States.


METHODS
Multiple searches of PubMed were conducted using various keywords and MeSH terms. Backwards citation searching and hand-searching were also conducted to ensure completeness.


RESULTS
The current endoscopic treatments of obesity can be divided into 6 main categories: 1) space-occupying devices, 2) restrictive procedures, 3) bypass liners, 4) electrical stimulation, 5) aspiration therapy, and 6) other therapies. Intragastric balloons, a space-occupying device, are the best-studied of all the treatments. They show 30%-50% excess weight loss after device removal but lack significant long-term follow-up.


CONCLUSIONS
With the recent Food and Drug Administration approval of intragastric balloons, this treatment is likely to rise in popularity. Short-term outcomes appear promising but long-term results are unclear.
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Christopher J
CJ
Neylan
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Daniel T
DT
Dempsey
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Colleen M
CM
Tewksbury
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Noel N
NN
Williams
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: dumonk@uphs.upenn.edu.
Kristoffel R
KR
Dumon
D050110:Bariatric Surgery / Q000295:instrumentation / Q000379:methods*; D018795:Device Approval; D004599:Electric Stimulation Therapy / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D015905:Gastric Balloon; D006801:Humans; D009765:Obesity / Q000601:surgery*; D017792:Surgical Stapling; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
Bariatric surgery; Endoscopy; Obesity