Advances in the Endoscopic Management of Obesity

Behary, Jason; Kumbhari, Vivek

doi:10.1155/2015/757821

Cited by 22 publications

(22 citation statements)

References 70 publications

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“…Clinically relevant weight loss was reported with a fifth device (EndoBarrier, GI Dynamics, Inc., Lexington, MA, USA; Patel, Hakim, Mason, & Hakim, ); however, clinical trials were terminated in July 2015 due to concerns over bacterial infections (GI Dynamics, ). Endoscopic devices are usually less invasive and costly than traditional surgery, and can be reversed and/or repeated (Behary & Kumbhari, ). However, they are frequently performed by physicians not typically responsible for obesity management (e.g., gastroenterologists), further increasing the need for clear guidance and care pathways.…”

Section: Need For Consensus On Disease Staging Guidelines and Treatmentioning

confidence: 99%

Unmet needs in obesity management

Ritten

LaManna

2017

Journal of the American Association of Nurse Practitioners

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Despite the rather slow acceptance of obesity as a disease state, several obesity staging systems and weight‐management guidelines have been developed and are in use, along with an ever‐growing number of treatment options. Many primary care clinicians, including nurse practitioners (NPs), are at the forefront of clinical efforts to assist individuals with obesity, but face challenges due to lack of alignment and consensus among the various staging systems and guidelines. This is further complicated by shortfalls in clinical training related to obesity management and increasing complexities in reimbursement for obesity‐related services. Unmet needs in the management of obesity thus stretch from guidelines to clinic. This article examines the principal barriers to effective management of individuals with obesity and considers how concerns might be overcome, with particular emphasis on the role of the NP.

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Section: Need For Consensus On Disease Staging Guidelines and Treatmentioning

confidence: 99%

Unmet needs in obesity management

Ritten

LaManna

2017

Journal of the American Association of Nurse Practitioners

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“…Endoscopic modalities in the treatment of obesity can be categorized into the following: space-occupying devices (intragastric balloon [IGB], transpyloric shuttle), gastric restrictive methods (transoral gastroplasty, transoral endoscopic restrictive implant system), malabsorptive endoscopic procedures (duodenal-jejunal bypass liner, satiSphere), regulating gastric emptying (intragastric botulinum toxin injections, gastric electrical stimulation), and other therapies (aspiration therapy) [14][15][16]. Of these methods, the most commonly employed is IGB placement.…”

Section: Introductionmentioning

confidence: 99%

Intragastric Balloon for Obesity Treatment: Safety, Tolerance, and Efficacy

Silva¹,

Proença²,

Rodrigues³

et al. 2017

GE Port J Gastroenterol

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Background: Obesity is an increasing worldwide problem associated with a vast number of comorbidities. Decreasing body weight by only 5-10% has been shown to slow and even prevent the onset of obesity-related comorbidities. Between pharmacological therapy and bariatric surgery a great variety of endoscopic techniques are available, the most common being intragastric balloon (IGB). The purpose of this study was to assess the safety, tolerance, and kinetics of IGBs in weight loss. The kinetics of weight loss were evaluated in 2 different contexts and phases: after the IGB's removal and after follow-up that varied between 6 and 12 months. Successful weight loss was defined as ≥10% weight loss after 6-12 months. Methods: The study included 51 patients who had undergone Orbera® IGB placement between September 2014 and February 2016. Inclusion criteria were age between 18 and 65 years; body mass index (BMI) 28-35 with severe obesity-related disorders; or BMI 35-40. The IGB was removed 6 months later. All patients were followed for a minimum period of 6-12 months. Results: Of 51 patients, 16 were excluded (7 due to intolerance) and 35 patients entered the study, of which 83% were followed for more than 6-12 months. The average weight loss (WL) and % excess WL (%EWL) after 6 months of treatment were 11.94 kg and 42.16%, respectively. At 6-12 months, after removal of the IGB, the mean WL was 8.25 kg and %EWL was 30.27%. Nineteen patients attained a WL of ≥10% the baseline value at IGB removal and 12 maintained their weight below this threshold during the 6-12 following months. Conclusions: After temporary IGB implantation in overweight or obese individuals, a WL that was ≥10% of weight at baseline was achieved in 54.3% and sustained at 6-12 months in 41.4% of participants. IGBs are an attractive intermediate option between diet and exercise programs and bariatric surgery. In general, IGB placement is a safe and well-tolerated procedure.

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“…In bariatric surgery these risks mainly comprises malabsorption and surgical complications related to leakage from anastomoses or internal herniation of small bowel. In recent years new endoscopic techniques have emerged, thus providing less invasive options for treatment of obesity [15, 16]. …”

Section: Introductionmentioning

confidence: 99%

Aspiration therapy for obesity; a safe and effective treatment

Norén

Forssell

2016

BMC Obes

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BackgroundThis study evaluated the efficacy and safety of the novel AspireAssist® Aspiration Therapy System for treatment of obesity, and its effect on patient’s quality of life.MethodsA prospective observational study with 25 obese subjects, mean age 48 years (range 33–65), was performed. A custom gastrostomy tube (A-tube, Aspire Bariatrics) was percutaneously inserted during a gastroscopy performed under conscious sedation. Drainage and irrigation of the stomach were performed 3 times daily, 20 min after each meal, for 1–2 years. Efficient aspiration required thorough chewing of ingested food. Treatment included a cognitive behavioral weight loss program.ResultsMean body mass index (BMI) at inclusion was 39.8 kg/m2 (range 35–49). After 1 year mean (SD) BMI was 32.1 kg/m2 (5.4), p < 0.01, and excess weight loss was 54.4% (28.8), p < 0.01. Quality of life, as measured with EQ-5D, improved from 0.73 (0.27) to 0.88 (0.13), p < 0.01. After 2 years BMI was 31.0 kg/m2 (5.1), p < 0.01, and excess weight loss was 61.5% (28.5), p < 0.01. There were no serious adverse events or electrolyte disorders. Compliance was 80% after 1 year and 60% after 2 years.ConclusionsAspiration therapy is an efficient and safe treatment for obesity, and weight reduction improves quality of life. Excess weight was approximately halved in a year, with weight stability if treatment was continued.Trial registrationTrial Register ISRCTN 49958132. Retrospectively registered 28/02/2014.

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Advances in the Endoscopic Management of Obesity

Cited by 22 publications

References 70 publications

Unmet needs in obesity management

Unmet needs in obesity management

Intragastric Balloon for Obesity Treatment: Safety, Tolerance, and Efficacy

Aspiration therapy for obesity; a safe and effective treatment

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