Overview on the endoscopic treatment for obesity: A review

Table 1 A summary of endoscopic procedures for reducing weight in obese patients

Method	Indication (BMI)	Duration	Efficacy	Adverse events	Limitations	Ref.
IGBs	30-40 kg/m2	6 mo	IGB therapy is a successful short-term weight loss strategy	Nausea/vomiting and stomach pain were the most common consequences, but mortality and gastric perforation were unusual. Other serious problems included dehydration, which required hospitalization, and intestinal obstruction due to balloon deflation, which required surgery	Short-term effects and weight regain	[45,48,50,54,87]
AT	35-55 kg/m2	Long term usage	AT is an implantable device that drains a portion of the stomach contents after each meal, removing up to 30% of the calories consumed	Postoperative peristomal granulation tissue and peristomal irritation, cardiac arrhythmias, hypokalemia, hypochloremic hypokalemic metabolic alkalosis, rather than gastric botox and eating problems	It cannot be used for patients with eating disorders. For this technology to be effective and long-lasting, significant patient commitment, motivation, and adherence are necessary. In addition to adhering to correct device operation, chewing food thoroughly is a significant crucial aspect in attaining successful weight reduction using this device; thus, patients who fail to stick to thoroughly chewing their meal are unlikely to get ideal outcomes	[91,94,99]
Small bowel endoscopic procedures	41.5 kg/m2	6-12 mo	10.6% TBWL and 40.2% EWL after one year	There were no AEs, and the nausea and diarrhea were self-limiting	Short-term efficacy, no small bowel EBTs are currently FDA-approved	[32,83,102,103,150]
Endoscopic sleeve gastroplasty	> 30 kg/m2	6-24 mo	%TBWL 12%-19%[150]	Leaks, perforation, hemorrhage, improved depth perception, improved visualization, severe stomach discomfort, and perigastric collection are all possible AEs	Required expertise and skills	[105,111,119,150]
Endoluminal procedures	30-40 kg/m2	6-12 mo	41.5 kg/m2, which reduced to 33.1 kg/m2	Pain, nausea, and vomiting	N/A	[129,130]
DJBS	> 35 kg/m2	6-12 mo	Effective patients lost 15% of their body weight at 12 mo, compared to 4% of controls	Nausea, vomiting, pancreatitis, GI bleeds, hepatic abscess, obstruction of the sleeve	As the common channel length shortens, so do diarrhea and severe vitamin A and D deficits	[132,135,137-139]
GJBS	30-40 kg/m2	N/A	Patients reduced 39.7% of their excess	N/A	N/A	[140,141]
Regulation gastric emptying	N/A	N/A	Weight loss was within 10% of their optimum weight	N/A	Hormonal imbalance and weight regain	[148,149]

IGBs: Intragastric balloons; AT: Aspiration therapy; TBWL: Total body weight loss; EWL: Excess weight loss; N/A: Not applicable; GJBS: Gastroduodenal jejunal bypass sleeve; DJBS: Duodenal-jejunal bypass sleeve; GI: Gastrointestinal; AEs: Adverse events; EBT: Endoscopic bariatric therapy; FDA: Food and Drug Administration; BMI: Body mass index.