Obesity is a chronic,progressive,and relapsing disease of excess adiposity that contributes to more than two hundred medical conditions and is projected to affect more than half the adult population of the United Stat...Obesity is a chronic,progressive,and relapsing disease of excess adiposity that contributes to more than two hundred medical conditions and is projected to affect more than half the adult population of the United States by the year 2030.Given the limited penetrance of traditional bariatric surgery,as well as the cost and adherence barriers to anti-obesity medications,there is growing interest in the rapidly evolving field of endoscopic bariatric therapies(EBTs).EBTs are minimally invasive,same-day,per-oral endoscopic procedures and include endoscopic sleeve gastroplasty,intragastric balloons,and endoscopic bariatric revisional procedures.This field represents an exciting and innovative subspe-cialty within gastroenterology.However,building a successful endoscopic bariatric practice requires intentional,coordinated,and sustained efforts to overcome the numerous obstacles to entry.Common barriers include acquisition of the technical and cognitive skillset,practice limitations including the availability of nutrition counseling,facility capabilities,direct-to-consumer marketing,and financial pressures such as facility and anesthesia fees.As the highest-volume center for metabolic and bariatric endoscopy in the United States,we provide insights into successfully establishing an endoscopic bariatric program.展开更多
The obesity epidemic in the USA and worldwide is well documented and continues to grow.Endoscopic metabolic and bariatric therapies may offer a less invasive approach than surgical intervention.This article will revie...The obesity epidemic in the USA and worldwide is well documented and continues to grow.Endoscopic metabolic and bariatric therapies may offer a less invasive approach than surgical intervention.This article will review advances in endobariatrics over the last several decades,addressing the past and current state of bariatric and metabolic endoscopy.Food and Drug Administration-cleared devices and interventions currently under investigation are described including gastric devices,gastric remodeling procedures,small-bowel devices,duodenal ablation,as well as procedures to address weight regain after bariatric surgery.Future studies evaluating gastric and duodenal combination therapy,adjunctive pharmacotherapy,as well as individualized precision-health algorithms are underway.展开更多
文摘Obesity is a chronic,progressive,and relapsing disease of excess adiposity that contributes to more than two hundred medical conditions and is projected to affect more than half the adult population of the United States by the year 2030.Given the limited penetrance of traditional bariatric surgery,as well as the cost and adherence barriers to anti-obesity medications,there is growing interest in the rapidly evolving field of endoscopic bariatric therapies(EBTs).EBTs are minimally invasive,same-day,per-oral endoscopic procedures and include endoscopic sleeve gastroplasty,intragastric balloons,and endoscopic bariatric revisional procedures.This field represents an exciting and innovative subspe-cialty within gastroenterology.However,building a successful endoscopic bariatric practice requires intentional,coordinated,and sustained efforts to overcome the numerous obstacles to entry.Common barriers include acquisition of the technical and cognitive skillset,practice limitations including the availability of nutrition counseling,facility capabilities,direct-to-consumer marketing,and financial pressures such as facility and anesthesia fees.As the highest-volume center for metabolic and bariatric endoscopy in the United States,we provide insights into successfully establishing an endoscopic bariatric program.
文摘The obesity epidemic in the USA and worldwide is well documented and continues to grow.Endoscopic metabolic and bariatric therapies may offer a less invasive approach than surgical intervention.This article will review advances in endobariatrics over the last several decades,addressing the past and current state of bariatric and metabolic endoscopy.Food and Drug Administration-cleared devices and interventions currently under investigation are described including gastric devices,gastric remodeling procedures,small-bowel devices,duodenal ablation,as well as procedures to address weight regain after bariatric surgery.Future studies evaluating gastric and duodenal combination therapy,adjunctive pharmacotherapy,as well as individualized precision-health algorithms are underway.