Personalized Approach for Obese Patients Undergoing Endoscopic Sleeve Gastroplasty

Obesity is a chronic, relapsing disease representing a major global health problem in the 21st century. Several etiologic factors are involved in its pathogenesis, including a Western hypercaloric diet, sedentariness, metabolic imbalances, genetics, and gut microbiota modification. Lifestyle modifications and drugs often fail to obtain an adequate and sustained weight loss. To date, bariatric surgery (BS) is the most effective treatment, but only about 1% of eligible patients undergo BS, partly because of its negligible morbidity and mortality. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, endoscopic, bariatric procedure, which proved to be safe and effective. In this review, we aim to examine evidence supporting the role of a personalized and multidisciplinary approach, guided by a multidisciplinary team (MDT), for obese patients undergoing ESG, from patient selection to long-term follow-up. The cooperation of different health professionals, including an endocrinologist and/or obesity medicine physician, a bariatric surgeon, an endoscopist experienced in bariatrics, a registered dietitian, an exercise specialist, a behaviour coach, a psychologist, and a nurse or physician extender, aims to induce radical and sustained lifestyle changes. We also discussed the relationship between gut microbiota and outcomes after bariatric procedures, speculating that the characterization of gut microbiota before and after ESG may help develop new tools, including probiotics, to optimize weight loss outcomes.

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890 The Impact of Multidisciplinary Evaluation Before and After Endoscopic Sleeve Gastroplasty on Weight Loss and Quality of Life

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000593096.54600.48 ◽

2019 ◽

Vol 114 (1) ◽

pp. S515-S516

Author(s):

Ivo Boškoski ◽

Vincenzo Bove ◽

Lucrezia Laterza ◽

Camilla Gallo ◽

Rosario Landi ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Endoscopic Sleeve Gastroplasty ◽

Before And After ◽

Sleeve Gastroplasty ◽

The Impact

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Efficacy and Safety of Endoscopic Sleeve Gastroplasty versus Laparoscopic Sleeve Gastrectomy in Obese Subjects with non-alcoholic steatohepatitis (NASH): Study protocol for a randomised controlled trial (TESLA-NASH study)

10.21203/rs.3.rs-618551/v1 ◽

2021 ◽

Author(s):

LUCIA LAVIN-ALCONERO ◽

TATIANA FERNANDEZ-LANAS ◽

PAULA IRUZUBIETA COZ ◽

MARIA TERESA ARIAS-LOSTE ◽

JUAN CARLOS RODRIGUEZ DUQUE ◽

...

Keyword(s):

Metabolic Syndrome ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Standard Treatment ◽

Liver Histology ◽

Obese Patients ◽

Efficacy And Safety ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty

Abstract Background : Non-alcoholic steatohepatitis (NASH) is a growing public health problem that affects more than 5% of the population. The standard treatment is weight loss with diet and exercise, which has been shown a histological and analytical improvement in patients capable to achieve a 5-10% reduction in their body weight. However, less than 25% of subjects achieve this goal. Bariatric surgery (BS) is the treatment of choice for its efficacy in obese patients. This intervention has resolved NASH in 85% of cases. However, bariatric endoscopy (BE) is presented as a therapeutic alternative with good results in terms of efficacy, long-term weight loss, and safety, decrease of adverse events. Methods : The TESLA-NASH study is a randomized, controlled, open-label, unicentric clinical trial with a medical device. The aim of this study is to evaluate and compare the efficacy and safety of endoscopic sleeve gastroplasty (ESG) versus laparoscopic sleeve gastrectomy (LSG) in liver histology improvement of patients with obesity +/- metabolic syndrome and NASH. A total of 30 patients will be randomized 1:1 to the experimental or control group. Discussion : Gastric bypass surgery and restrictive surgical treatments have been successful improving metabolic syndrome, insulin resistance and liver histology of obese patients. Currently, endoscopic techniques which are less invasive, are being developed, showing fewer complications and lower sanitary cost, and gastric restrictions with similar characteristics to the traditional surgical method. The tubulization or vertical gastroplasty with the OverStitch system (Apollo Endosurgery, Austin, TX, USA) is one of the most promising one. However, currently, any method is accepted as a standard treatment for NASH. Trial registration : Clinical trial.gov: NCT04060368. Registred on 19 August 2019, https://clinicaltrials.gov/ct2/show/NCT04060368 Protocol version: v 2.0, dated 15 nov 2019.

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Gut microbiota characterisation in obese patients before and after bariatric surgery

Beneficial Microbes ◽

10.3920/bm2017.0152 ◽

2018 ◽

Vol 9 (3) ◽

pp. 367-373 ◽

Cited By ~ 15

Author(s):

G. Campisciano ◽

S. Palmisano ◽

C. Cason ◽

M. Giuricin ◽

M. Silvestri ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Gut Microbiota ◽

Good Health ◽

Normal Weight ◽

Obese Patients ◽

Before And After

Intestinal microbiota analysis of obese patients after bariatric surgery showed that Proteobacteria decreased after laparoscopic sleeve gastrectomy (SG), while it increased after laparoscopic gastric bypass (LGB). Comparing to normal weight (NW) patients, obese patients that were selected for SG showed an almost equal amount of Firmicutes and Bacteroidetes and the ratio was not affected by the surgery. Obese patients before LGB showed a predominance of Bacteroidetes, whose amount regained a relative abundance similar to NW patients after surgery. Obese patients before LGB showed the predominance of Bacteroides, which decreased after surgery in favour of Prevotella, a bacterium associated with a healthy diet. The bacteria detected at the highest percentages belonged to biofilm forming species. In conclusion, in this study, we found that the characterization of the gut microbial communities and the modality of mucosal colonisation have a central role as markers for the clinical management of obesity and promote the maintenance of good health and the weight loss.

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SHORT-TERM WEIGHT LOSS OF THE ENDOSCOPIC SLEEVE GASTROPLASTY FOR PRIMARY OBESITY

10.1055/s-0040-1704625 ◽

2020 ◽

Author(s):

AJ del Pozo-Garcia ◽

DR de la Cruz ◽

T Valdés-Lacasa ◽

S Nevado ◽

R Polanco ◽

...

Keyword(s):

Weight Loss ◽

Short Term ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty

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Fad Diets: Dietary Dilemmas, Predicaments, and Recommendations for its Use

Current Nutrition & Food Science ◽

10.2174/1573401316999200407092922 ◽

2020 ◽

Vol 16 (9) ◽

pp. 1362-1380

Author(s):

Jyoti Singh ◽

Prasad Rasane ◽

Vidisha Tomer ◽

Sawinder Kaur ◽

Yogesh Gat ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Health Care Expenditures ◽

Overweight And Obesity ◽

Lifestyle Changes ◽

Health Issues ◽

Lifestyle Modifications ◽

Treatment Measures ◽

Long Time ◽

Extra Weight

The health issues, mainly overweight and obesity are the growing concerns nowadays due to the associated factors and lifestyle changes which significantly have increased the individual’s health care expenditures. Fad diets are promoted as the easiest and simplest way of shedding the extra weight despite the availability of several treatments available. The prevention and treatment measures, including modification in lifestyle, dietary pattern, and physical activity, are the foundation of weight loss. However, the standard treatment measures are not effective for certain populations as they require long time adherence, which leads to the search for other approaches like fad diet. We steered a comprehensive literature review to present the facts related to fad diets to their efficacy and sustainability. Although fad diets have yielded tremendous positive results in weight loss and cardiovascular risk prevention, the studies reported death in long-term interventions and the results and some of them show side effects too. Randomized controlled trials have significantly reported weight loss in comparison with the popular fad diets; however, persisting on the same diet has also reported kidney problems, ketosis, and other metabolic related problems. The conclusion of this critical review reported that gradual weight loss could be attained by the combination of lifestyle modifications, physical activity, and recommended dietary approaches.

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Quality of Life, Mental Health, and Weight Loss Outcomes Following Endoscopic Sleeve Gastroplasty

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-021-05137-4 ◽

2021 ◽

Author(s):

Amit Mehta ◽

Kaveh Hajifathalian ◽

Shawn L. Shah ◽

SriHari Mahadev ◽

Kartik Sampath ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Weight Loss ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty ◽

Weight Loss Outcomes

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Short Term Outcomes of Endoscopic Sleeve Gastroplasty in Class III Obese Patients: A Clinical, Retrospective, Single Center Study

10.1055/s-0041-1724305 ◽

2021 ◽

Author(s):

V Pontecorvi ◽

V Bove ◽

C Gallo ◽

G Carlino ◽

L Laterza ◽

...

Keyword(s):

Obese Patients ◽

Class Iii ◽

Single Center ◽

Short Term ◽

Endoscopic Sleeve Gastroplasty ◽

Single Center Study ◽

Sleeve Gastroplasty ◽

Center Study

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Abstract TMP81: Regional, Race-Ethnic and Sex Disparities in Lifestyle Interventions: Data from the Florida Puerto Rico Collaboration to Reduce Stroke Disparities (FL-PR CReSD) Study - the NINDS Stroke Prevention Intervention Research Program

Stroke ◽

10.1161/str.48.suppl_1.tmp81 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Maria A Ciliberti-Vargas ◽

Kefeng Wang ◽

Sofia Oluwole ◽

Erika Marulanda-Londoño ◽

Maranatha Ayodele ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Modification ◽

Lifestyle Changes ◽

Lifestyle Interventions ◽

Lifestyle Modifications ◽

Sodium Diet ◽

Low Sodium Diet ◽

Low Sodium ◽

Diet Counseling ◽

To Receive

Background: As key components of the AHA Life’s Simple 7 campaign, lifestyle modifications play an integral role in the prevention of vascular disease. Little is known about the prevalence of lifestyle modification counseling in patients with acute ischemic stroke (AIS). We sought to investigate disparities in the delivery of lifestyle interventions to AIS patients in the large NINDS-funded FL-PR CReSD Registry of Get With The Guidelines-Stroke (GWTG-S) data. Methods: GWTG-S collects data on the provision of several lifestyle interventions including counseling on exercise/weight loss, Therapeutic Lifestyle Changes (TLC) diet, diabetes (DM) education and antihypertensive (low sodium) diet. 80,598 AIS cases were prospectively included from 82 sites (69 FL; 13 PR) from 2010-2016. Multilevel logistic regression models adjusted for age, race, and aphasia were used to evaluate differences in the provision of lifestyle interventions as indicated for patients prior to hospital discharge. Results: Among AIS cases, 51% were men, 62% non-Hispanic White (NHW), 18% NH-Black (NHB), 13% FL-Hispanic (FLH), and 6% PR-Hispanic (PRH). Mean age was 71±14 years. The highest mean BMI was in PRH (29±7 kg/m 2 ), with the lowest in NHW (27±6 kg/m 2 ) and FLH (28±6 kg/m 2 ). Despite this, PRH were less likely to receive exercise/weight loss counseling compared to NHW (OR 0.43, 95% CI 0.20-0.90) and FLH (OR 0.46, 95% CI 0.22-0.97). PRH also had lower odds of receiving TLC diet counseling compared to NHW and FLH (OR 0.32, 95% CI 0.15-0.68). Though NHB presented with higher rates of DM compared to NHW (38% vs. 25%), they were less likely to receive DM education (OR 0.95, 95% CI 0.91-0.99). Women were less likely to receive TLC diet counseling (OR 0.94, 95% CI 0.90-0.98) and DM education (OR 0.94, CI 0.92-0.97) compared to men. Despite higher HTN frequency in women and NHB (67% and 69%), both were less likely to receive low sodium diet recommendations as compared to men (OR 0.94, 95% CI 0.92-0.97) and NHW (OR 0.95, 95% CI 0.91-0.99). Conclusion: Overall, disparities were identified in the provision of several lifestyle interventions in AIS patients. These interventions can benefit all and providers should continue counseling patients regarding modifiable risk factors to prevent future stroke.

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