Endoscopic Treatment of Obesity and Nutritional Aspects of Bariatric Endoscopy

Obesity is a significant problem worldwide. Several serious diseases that decrease patient quality of life and increase mortality (high blood pressure, dyslipidaemia, type 2 diabetes etc.) are associated with obesity. Obesity treatment is a multidisciplinary and complex process that requires maximum patient compliance. Change of lifestyle is fundamental in the treatment of obesity. While pharmacotherapeutic options are available, their efficacy is limited. Surgical treatment though highly effective, carries the risk of complications and is thus indicated mostly in advanced stages of obesity. Endoscopic treatments of obesity are less invasive than surgical options, and are associated with fewer complications and nutritional deficits. Currently, there is a large spectrum of endoscopic methods based on the principles of gastric volume reduction, size restriction and gastric or small bowel bypass being explored with only few available in routine practice. The aim of this publication is to present an up-to-date summary of available endoscopic methods for the treatment of obesity focusing on their efficacy, safety and nutritional aspects.

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Gastric Sensory and Motor Functions and Energy Intake in Health and Obesity—Therapeutic Implications

Nutrients ◽

10.3390/nu13041158 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1158

Author(s):

Lizeth Cifuentes ◽

Michael Camilleri ◽

Andres Acosta

Keyword(s):

Energy Consumption ◽

Gastric Emptying ◽

Food Intake ◽

Gastric Volume ◽

Obesity Management ◽

Bariatric Endoscopy ◽

Motor Functions ◽

Therapeutic Implications ◽

Intestinal Functions

Sensory and motor functions of the stomach, including gastric emptying and accommodation, have significant effects on energy consumption and appetite. Obesity is characterized by energy imbalance; altered gastric functions, such as rapid gastric emptying and large fasting gastric volume in obesity, may result in increased food intake prior to reaching usual fullness and increased appetite. Thus, many different interventions for obesity, including different diets, anti-obesity medications, bariatric endoscopy, and surgery, alter gastric functions and gastrointestinal motility. In this review, we focus on the role of the gastric and intestinal functions in food intake, pathophysiology of obesity, and obesity management.

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362 Endoscopic Gastric Volume Reduction Created by an Articulating Stapler for the Treatment of Obesity - Initial Results

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.04.069 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB148 ◽

Cited By ~ 1

Author(s):

Tessa Verlaan ◽

Givan F. Paulus ◽

Elisabeth M. Mathus-Vliegen ◽

Elisabeth Veldhuyzen ◽

Jan H. Eshuis ◽

...

Keyword(s):

Gastric Volume ◽

Volume Reduction ◽

Treatment Of Obesity ◽

Initial Results

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Obesity and psychopathology. A study of psychiatric comorbidity among patients attending a specialist obesity unit

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00001007 ◽

2009 ◽

Vol 18 (2) ◽

pp. 119-127 ◽

Cited By ~ 15

Author(s):

Bernardo Carpiniello ◽

Federica Pinna ◽

Gianluca Pillai ◽

Valentina Nonnoi ◽

Enrica Pisano ◽

...

Keyword(s):

Mental Health ◽

Major Depression ◽

Mood Disorders ◽

Clinical Sample ◽

Psychiatric Evaluation ◽

Routine Practice ◽

Obese Patients ◽

High Prevalence ◽

Axis I ◽

Treatment Of Obesity

SummaryAims – The study aims to evaluate the frequency of association between Axis I and II disorders according to DSMIVTR criteria and obesity, and use of mental health services in a clinical sample of patients attending a centre for the diagnosis and treatment of Obesity. Methods – 150 consecutive patients (32 Males, 118 females, mean age 44.614.3 yrs; mean BMI 35.46.2) were interviewed by means of SCID I and SCID II. Results – Lifetime Prevalence of Axis I disorders was 58% (males 50%; females 61%); the highest prevalence rate was found for Anxiety Disorders (approx 35%), whilst 30% of subjects were affected by Mood disorders, chiefly Major Depression (20%), and 18% by Eating Disorders. 28% of obese patients presented a Personality Disorder, 23% of patients being affected both by an Axis I and Axis II disorder. Mood Disorders, in particular Major Depression, were significantly prevalent among female obese. 50% of females and approx 37% males included in the sample had contacted mental health units for treatment. Conclusion – Data obtained in the present study confirm the high prevalence rates of mental disorders in obese patients seeking treatment. Specialist units should therefore include thorough psychiatric evaluation of patients as a routine practice.Declaration of Interest: The study was supported by a research grant by University of Cagliari (ex 60% funding, financial year 2006); the authors declare no conflict of interest.

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Outcomes, controversies and gastric volume after laparoscopic sleeve gastrectomy in the treatment of obesity

Cirugía y Cirujanos (English Edition) ◽

10.1016/j.circen.2016.08.008 ◽

2016 ◽

Vol 84 (5) ◽

pp. 369-375

Author(s):

Juan José García-Díaz ◽

Manuel Ferrer-Márquez ◽

Almudena Moreno-Serrano ◽

Rogelio Barreto-Rios ◽

Raquel Alarcón-Rodríguez ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Gastric Volume ◽

Treatment Of Obesity

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Endoscopic Treatment of Obesity

Canadian Journal of Gastroenterology ◽

10.1155/2011/174163 ◽

2011 ◽

Vol 25 (11) ◽

pp. 627-633 ◽

Cited By ~ 20

Author(s):

Agnieszka Swidnicka-Siergiejko ◽

Eugeniusz Wróblewski ◽

Andrzej Dabrowski

Keyword(s):

Weight Loss ◽

English Language ◽

Literature Search ◽

Cochrane Library ◽

Bridge To Surgery ◽

Obesity And Overweight ◽

Potential Benefits ◽

Treatment Of Obesity ◽

Endoscopic Methods ◽

Malabsorptive Procedures

BACKGROUND: The increasing incidence of obesity and overweight among children and adolescents will be reflected by the imminent increase in the number of obese patients who require more definitive methods of treatment. There is great interest in new, safe, simple, nonsurgical procedures for weight loss.OBJECTIVE: To provide an overview of new endoscopic methods for the treatment of obesity.METHODS: An English-language literature search on endoscopic interventions, endoscopically placed devices and patient safety was performed in the MEDLINE and Cochrane Library databases.RESULTS: The literature search yielded the following weight loss methods: space-occupying devices (widely used), gastric capacity reduction, modifying gastric motor function and malabsorptive procedures. A commercially available intragastric balloon was the most commonly used device for weight loss. In specific subgroups of patients, it improved quality of life, decreased comorbidities and served as a bridge to surgery. More evidence regarding the potential benefits and safety of other commercially available intragastric balloons is needed to clarify whether they are superior to the most commonly used one. Moreover, early experiences with transoral gastroplasty, the duodenaljejunal bypass sleeve and an adjustable, totally implantable intragastric prosthesis, indicate that they may be viable options for obesity treatment. Other agents, such as botulinum toxin and a device known as the ‘butterfly’, are currently at the experimental stage.CONCLUSION: New endoscopic methods for weight loss may be valuable in the treatment of obesity; however, more clinical experience and technical improvements are necessary before implementing their widespread use.

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Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review

ISRN Gastroenterology ◽

10.1155/2013/434706 ◽

2013 ◽

Vol 2013 ◽

pp. 1-15 ◽

Cited By ~ 5

Author(s):

Martin P. Mintchev

Keyword(s):

Electrical Stimulation ◽

Gastric Volume ◽

Point Of View ◽

Gastric Electrical Stimulation ◽

Obesity Epidemic ◽

Surgical Methods ◽

Treatment Of Obesity ◽

The One ◽

Invasive Techniques

Growing worldwide obesity epidemic has prompted the development of two main treatment streams: (a) conservative approaches and (b) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of minimally invasive gastric manipulation methods featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries. This antiobesity approach is based on placing external devices in the stomach ranging from electrodes for gastric electrical stimulation to temporary intraluminal bezoars for gastric volume displacement for a predetermined amount of time. The present paper examines the evolution of these techniques from invasively implantable units to completely noninvasive patient-controllable implements, from a functional, rather than from the traditional, parametric point of view. Comparative discussion over the available pilot and clinical studies related to gastric electrical stimulation outlines the promises and the fallacies of this concept as a reliable alternative anti-obesity strategy.

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Current Patterns of Management of Advanced Prostate Cancer in Routine Clinical Practice in Spain

Prostate Cancer ◽

10.1155/2015/186740 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Maria José Ribal ◽

Juan Ignacio Martínez-Salamanca ◽

Camilo García Freire

Keyword(s):

Prostate Cancer ◽

Advanced Prostate Cancer ◽

Progressive Disease ◽

Hormonal Treatment ◽

Dominant Strategy ◽

Routine Practice ◽

Experienced Pain ◽

Medical Oncologists ◽

Advanced Stages

Objective. To describe urologists’ practice patterns when managing patients with advanced prostate cancer (PCa) in Spain.Methods. This was an observational study conducted by 120 urologists using retrospective data of advanced PCa patients attending hospitals and outpatient centers.Results. Urologists evaluated a total of 375 patients (mean age: 75 years; ECOG 0-1: 77%; mean serum PSA levels at study entry: 50.5 ng/Ml). Approximately 50% of patients had bone metastases, and 60.6% experienced pain as the main symptom of progressive disease. Primary androgen deprivation therapy (ADT) use was 99.7%, with continuous ADT as the dominant strategy (91.9%). After failure of initial ADT, antiandrogen withdrawal was the next method most commonly used in 57% of patients. Choice of secondary hormonal treatment was made mostly by urologists (96%), who continued to monitor patients. Patient follow-up after chemotherapy and supportive care were mainly done in urology units, although responsibility was shared with medical oncologists and radiologists.Conclusion. The urologists’ attitudes towards management of PCa in the routine practice in Spain show the urologist as an integral component even when patients progress to advanced stages of the disease.

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Ultrasound Lipolysis and Suction Lipectomy for Treatment of Obesity

The American Journal of Cosmetic Surgery ◽

10.1177/074880689701400310 ◽

1997 ◽

Vol 14 (3) ◽

pp. 289-296 ◽

Cited By ~ 13

Author(s):

Beniamino Palmieri ◽

Pierangelo Bosio ◽

Gaspare Palmieri ◽

Glauco Gozzi

Keyword(s):

Surgical Treatment ◽

Weight Control ◽

Laparoscopic Gastric Banding ◽

Subcutaneous Fat ◽

Control Program ◽

Gastric Volume ◽

Excess Body Weight ◽

Intracellular Lipids ◽

Treatment Of Obesity ◽

Weight Control Program

Surgical treatment of obesity is a challenging problem. In one approach, miniinvasive laparoscopic gastric banding has been attempted to reversibly reduce gastric volume and, thus, food intake. That, as well as other more aggressive interventions on the gastrointestinal tract, is quite effective, but several side effects and appreciable morbidity and mortality have been reported. The aesthetic outcome of weight loss after these procedures is relatively poor. Two hundred five obese patients with 30–60% excess body weight had surgical treatment combining ultrasound lipolysis and liposuction of subcutaneous fat. Large amounts of intracellular lipids were extracted, after subdermal infiltration of saline solution containing vasoactive agents, with combined ultrasound lipolysis and liposuction. The slimming achieved has been satisfactory, and the metabolic repercussions of the procedure are promising. Moreover, cosmetic improvements strongly motivate the patient to undertake a strict weight control program.

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Current Treatments for Obesity: An Update

10.53350/pjmhs211561132 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1132-1135

Author(s):

Z. Safdar ◽

R. Fatima ◽

A. Bajwa

Keyword(s):

Heart Disease ◽

Review Paper ◽

Sleep Apnoea ◽

Disease Type ◽

Morbidity Rate ◽

Mortality And Morbidity ◽

Keywords Obesity ◽

Surgical Options ◽

Treatment Of Obesity

Obesity is one of the biggest health problems in the world. It is not only a key developer of various dangerous diseases like coronary heart disease, type 2 diabetes mellitus, and sleep apnoea, but is also associated with high mortality and morbidity rate. In recent years, doctors have shifted their attention towards the prevention and treatment of obesity rather than letting the person move towards different diseases and then curing those multiple disorders. One of those strategies for obesity treatment includes bariatric surgery. This review paper encapsulates multiple other strategies like dietary, pharmaceutical, and surgical options available at present for the treatment of obesity. Keywords: Obesity, weight, diabetes, heart disease.

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