Published online Nov 15, 2018. doi: 10.4239/wjd.v9.i11.180
Peer-review started: July 23, 2018
First decision: August 3, 2018
Revised: August 12, 2018
Accepted: October 11, 2018
Article in press: October 11, 2018
Published online: November 15, 2018
Core tip: The worldwide prevalence of obesity continues to rise. Delayed gastric emptying and impaired gastric accommodation result in upper gastrointestinal symptoms, through intrinsic nerve and pacemaker dysfunction. Glycemic control has a limited effect on gastric emptying in diabetic gastroparesis. Treatment of diabetes with pancreatic hormones and incretins inhibits gastric emptying, reduces hyperglycemia, and facilitates weight loss. Meta-analysis shows that glucagon-like peptide-1 analog, liraglutide, is one of the two most efficacious treatments of obesity. Bariatric surgery and endoscopic interventions are efficacious in diabetes and obesity, but long term follow-up is required for endoscopic interventions as well as for newer bariatric procedures. On the horizon, combination therapies directed at gastrointestinal function appear promising for these indications.