8th Annual Association for Bariatric Endoscopy (ABE) Meeting: Practical Approaches to Treating Obesity and Related Comorbidities| May 2023 ABEANN2023-Imagineering the Future of EBTs-GastricandSmall Bowel Therapies

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In this document, Dr. Vivek Kumbhari discusses the future of gastric and small bowel therapies for weight loss and metabolic improvements. The current goals of available endoscopic bariatric therapies (EBTs) include being safe, suitable for individuals with a BMI over 30, and achieving 10% or more total body weight loss (TBWL) at 12 months. However, Dr. Kumbhari questions whether these benchmarks from 10 years ago are still appropriate, given emerging evidence that the risk-benefit profile for surgical interventions is favorable for individuals with a BMI between 30-40 and even 25-30 in patients with diabetes.<br /><br />Dr. Kumbhari discusses various EBTs such as pharmaceutical therapy, intragastric balloons, endoscopic sleeve gastroplasty (ESG), duodenal-jejunal bypass liner (DJBL), and other procedures like EndoSleeve and endoscopic magnetic appetite control system. He presents the outcomes and efficacy of these therapies, including weight loss percentages and improvements in metabolic profiles.<br /><br />The document also highlights the need to appreciate the mechanisms of bariatric surgery and identify cellular and molecular alterations after surgery to develop techniques that are well tolerated, effective, safe, and appealing to patients. The ultimate goals of EBTs are to achieve efficacy similar to bariatric surgery, be safer, and more cost-effective.<br /><br />Dr. Kumbhari mentions several emerging technologies and approaches such as Gelesis100, Jellynov, Glyscend Technology, and the endoscopic magnetic appetite control system. These technologies offer alternatives to traditional bariatric surgery and aim to provide personalized approaches for weight loss and metabolic improvements.<br /><br />In summary, the document discusses the current goals and limitations of available EBTs and explores the emerging technologies and approaches in the field. The ultimate aim is to develop therapies that are safe, effective, appealing to patients, and provide long-term improvements in metabolic outcomes.

Asset Subtitle

Vivek Kumbhari, MD

Keywords

gastric and small bowel therapies

weight loss

metabolic improvements

endoscopic bariatric therapies

total body weight loss

surgical interventions

bariatric surgery mechanisms

emerging technologies

personalized approaches

long-term improvements