scholarly journals Obesity and bariatrics for the endoscopist: new techniques

2011 ◽  
Vol 4 (6) ◽  
pp. 433-442 ◽  
Author(s):  
Barham K. Abu Dayyeh ◽  
Christopher C. Thompson
Keyword(s):  
Weight Loss ◽  
Weight Loss Surgery ◽  
Population Level ◽  
Primary Treatment ◽  
Significant Shift ◽  
Surgical Interventions ◽  
Obesity Epidemic ◽  
Public Health Burden ◽  
Distribution Tail ◽  
Treatment Of Obesity

Obesity and its associated conditions, including type 2 diabetes and cardiovascular disease, have reached epidemic proportions. Gastrointestinal weight loss surgery (GIWLS) shows the most promise in achieving significant and sustained weight loss and diabetes resolution. However, a large mismatch exists between the magnitude of the obesity epidemic and the number of surgical procedures performed to produce a significant shift in the distribution of obesity on a population level. This mismatch is fueled by high surgical costs, morbidity and mortality associated with surgical interventions, and the fact that the greatest public health burden of obesity comes from those around the center of the population body mass index distribution with mild to moderate obesity, rather than those at the distribution tail with severe obesity that GIWLS targets. New endoscopic methods, capitalizing on advances in our understanding of the physiological mechanisms by which GIWLS works, are developing to provide viable alternatives in the treatment of bariatric surgical complications, and for the primary treatment of obesity. These methods may have the added advantage of reduced invasiveness, reversibility, cost-effectiveness, and applicability to a larger segment of the population with moderate obesity.

Endoscopic Approaches to Obesity Management

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Russell D. Dolan ◽  
Allison R. Schulman
Keyword(s):  
Metabolic Disease ◽  
Weight Loss ◽  
Small Bowel ◽  
Weight Regain ◽  
Caloric Intake ◽  
Annual Review ◽  
Publication Date ◽  
Obesity Management ◽  
Surgical Interventions ◽  
Treatment Of Obesity

The field of endoscopic bariatric and metabolic therapy has rapidly evolved from offering endoscopic treatment of weight regain following bariatric surgery to providing primary weight loss options as alternatives to pharmacologic and surgical interventions. Gastric devices and remodeling procedures were initially designed to work through a mechanism of volume restriction, leading to earlier satiety and reduced caloric intake. As the field continues to grow, small bowel interventions are evolving that may have some effect on weight loss but focus on the treatment of obesity-related comorbidities. Future implementation of combination therapy that utilizes both gastric and small bowel interventions offers an exciting option to further augment weight loss and alleviate metabolic disease. This review considers gastric devices and techniques including space-occupying intragastric balloons, aspiration therapy, endoscopic tissue suturing, and plication interventions, followed by a review of small bowel interventions including endoluminal bypass liners, duodenal mucosal resurfacing, and endoscopically delivered devices to create incisionless anastomoses. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

A Review of Past and Present Weight Loss Strategies and the Potential Role of Bariatric Arterial Embolization

2020 ◽  
Vol 04 (02) ◽  
pp. 195-205
Author(s):  
Varun R. Danda ◽  
Christopher R. Bailey ◽  
Clifford R. Weiss
Keyword(s):  
Weight Loss ◽  
Treatment Options ◽  
Arterial Embolization ◽  
Health Concern ◽  
Lifestyle Modifications ◽  
Obesity Epidemic ◽  
Cost Treatment ◽  
Clinically Significant ◽  
Treatment Of Obesity ◽  
Bariatric Embolization

AbstractThe obesity epidemic is a growing public health concern that has a severe effect on the health care system with significant morbidity, mortality, and cost. Treatment options for obesity include lifestyle modifications, pharmacotherapy, and bariatric surgery. Newer, less-invasive therapies including endoscopic bariatric procedures have been developed in recent years to fill the treatment gap that exists between noninvasive approaches and surgery. Bariatric artery embolization (BAE) is a novel minimally invasive endovascular procedure that has been developed to treat obesity. Recent evidence has suggested that bariatric embolization is well tolerated and can induce clinically significant weight loss through a hormonally mediated mechanism. This article will review existing preclinical and clinical data, and explore future directions of the endovascular treatment of obesity.

scholarly journals The aetiology of childhood obesity: a review

2007 ◽  
Vol 20 (1) ◽  
pp. 29-45 ◽  
Author(s):  
Kimberley L. Procter
Keyword(s):  
Childhood Obesity ◽  
Economic Cost ◽  
Population Level ◽  
Cost Effective ◽  
Positive Energy ◽  
Obesity Epidemic ◽  
Positive Energy Balance ◽  
Treatment Of Obesity ◽  
Children’S Behaviour ◽  
The Individual

Whilst the prevention of childhood obesity is the only viable, enduring, cost-effective solution to the obesity epidemic, effective methods for it remain elusive. Furthermore, strategies to influence obesogenic environments remain relatively unexplored. In order to be able to develop powerful population-level interventions and public health policies to prevent childhood obesity, it is important to understand its aetiology and those environments that are most amenable to measurable change. First, the present paper considers why we should be concerned about obesity in children, from both the perspective of the increased health risk to the individual and the high economic cost of treatment of obesity and related diseases, highlighting why the prevention of childhood obesity is important. Next, the determinants of health behaviour and the obesogenic environment are explored, which helps us to understand why the aetiology is so complex and that potential causal factors should not be considered in isolation, as the interaction between these factors is also important. The paper then considers the multi-factorial aetiology of childhood obesity and the rationale for the increasing trends in obesity that are evident, in order to understand what is changing in society and our children's behaviour that is triggering the positive energy balance leading to obesity. The review emphasises the need for multi-level approaches if we truly want to prevent childhood obesity. It also serves to highlight that there is a need to extend the current research base in order to build a well-founded framework to form the basis of a strategy for the prevention of childhood obesity.

Surgical Treatment Of Obesity

2018 ◽  
Author(s):  
Luise Pernar ◽  
Malcolm K. Robinson
Keyword(s):  
Weight Loss ◽  
Weight Loss Surgery ◽  
The United States ◽  
Health Concern ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Treatment Of Obesity ◽  
Hunger Sensation ◽  
Surgical Treatment Of Obesity

Obesity is associated with numerous comorbidities and shortens life expectancy. Currently, over one third of adults in the United States are obese, making management of obesity a significant public health concern. Given the modest benefits of behavior change alone, weight loss surgery has become a popular tool in the treatment of obesity. Numerous studies have documented the benefits of weight loss surgery in promoting weight loss and resolution of comorbidities. The hormonal and physiologic changes that are induced by some weight loss procedures are not yet fully elucidated, but it is thought that changes in hunger sensation and metabolism drive the observed effects. This review contains 4 figures, 2 videos, 3 tables and 60 references Key words: bypass, obesity, sleeve gastrectomy, surgery, weight loss

scholarly journals Outcomes variation in weight and resolution of obesity co-morbidities between five bariatric operations

2020 ◽  
Vol 10 (4) ◽  
pp. 117-127
Author(s):  
Christopher Finley
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Linear Models ◽  
Weight Loss Surgery ◽  
Continuous Variables ◽  
Obesity Epidemic ◽  
Abdominal Hernias ◽  
Co Morbidity ◽  
Operative Evaluation ◽  
Dichotomous Variables

Purpose: Several bariatric operations are utilized to treat the growing obesity epidemic. The goal of this study was to identify variations in post-operative weight loss and obesity-related co-morbidities between the most commonly performed weight loss operations. Methods: Data from 166,601 patients in the Surgical Review Corporation’s Bariatric Outcomes Longitudinal Database (BOLD) who underwent Laparoscopic Adjustable Gastric Banding (LAGB, n=67,514), Bilio-Pancreatic Diversion/Duodenal Switch (BPD/DS, n=1,673), laparoscopic (LRYGB, n=83,059) and open (RYGB, n=5,389) Roux-en-Y gastric bypass, and Laparoscopic Sleeve Gastrectomy (SG, n=8966 ) was analyzed at baseline, and at 2, 4, 6, 12, 18, and 24 months post-operatively. Weight, BMI, and 29 weight related medical conditions were analyzed. Statistics: Continuous variables were analyzed using ANOVA with treatment in the model. General Linear Models included baseline and post-operative data, modified for binomial distribution of dichotomous variables. Results: BPD/DS patients had the lowest weight at 24 months and highest resolution of hypertension, diabetes, hyperlipidemia, and asthma, but most increase in cholelithiasis, liver disease, abdominal hernias, and psychological disorders. LRYGB best treated GERD and somatic disorders. OSA and gout resolved most after SG. LAGB was least effective in weight loss and co-morbidity resolution, but least likely to develop post-op liver disease, cholelithiasis, abdominal hernias, and symptomatic abdominal skin. Conclusions: Post-operative weight loss and rates of obesity-related co-morbidities vary between LAGB, BPD/DS, RYGB, LRYGB, and SG. Knowledge of these differences can help guide the pre-operative evaluation of obese patients presenting for weight loss surgery

scholarly journals Overview of bariatric and metabolic endoscopy interventions

2020 ◽  
Vol 13 ◽  
pp. 263177452093523
Author(s):  
Augustine Tawadros ◽  
Michael Makar ◽  
Michel Kahaleh ◽  
Avik Sarkar
Keyword(s):  
Weight Loss ◽  
Medical Knowledge ◽  
Endoscopic Management ◽  
Attractive Alternative ◽  
Obese Patients ◽  
Gastrointestinal Physiology ◽  
Surgical Interventions ◽  
Endoscopic Techniques ◽  
Obesity Epidemic ◽  
And Training

The rise of endoscopic techniques allowing weight loss offers an attractive alternative to surgical interventions in Western countries where the obesity epidemic has risen dramatically. Endoscopists are well positioned to manage obesity given their broad-based medical knowledge, understanding of gastrointestinal physiology, and training in endoscopic technique. The field of bariatric and metabolic endoscopy has permitted the development of several efficacious and safe technologies. This review focuses on techniques and devices used for endoscopic management of obesity, as well as the fundamental justifications to offer those therapies to obese patients.

A systematic review of the evidence for interventions to increase levels of physical activity in patients following weight loss surgery

2019 ◽  
Author(s):  
Jennifer James ◽  
Victoria Sprung ◽  
Wendy Hardeman ◽  
Mark Goodall ◽  
Helen Eborall ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Loss ◽  
Weight Loss Surgery

Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

2019 ◽  
Vol 25 (15) ◽  
pp. 1783-1790 ◽  
Author(s):  
Rosario Pastor ◽  
Josep A. Tur
Keyword(s):  
Weight Loss ◽  
Clinical Trials ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Statistical Tests ◽  
Overweight And Obesity ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

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