ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Clinical Case-Based Learning (Day Two) | March 2024-Endoscopic Bariatric Therapy Update 2024

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Endoscopic bariatric therapy is a safe and effective treatment option for obesity and metabolic diseases. Currently available procedures include the use of fluid-filled intragastric balloons and endoscopic sleeve gastroplasty. These procedures can be effective in achieving weight loss in patients who have failed lifestyle interventions. However, it is important to note that weight regain after bariatric surgery is relatively common, and endoscopic revision procedures can be a viable option for these patients. Compared to surgical revision, endoscopic revision procedures have fewer adverse events.<br /><br />Lifestyle therapy, including diet, exercise, and behavior modification, is an important aspect of weight loss and should be implemented alongside endoscopic interventions. Self-monitoring, identifying barriers, and finding solutions, avoiding triggers, recruiting social support, and practicing cognitive restructuring are some of the pillars of behavior modification.<br /><br />Pharmacotherapy can also be considered for weight loss in appropriate patients. Several medications, such as Orlistat, Phentermine-topiramate, Naltrexone-buproprion, Liraglutide, and Semaglutide, have been approved for long-term use and can be effective in achieving weight loss.<br /><br />Patient selection for endoscopic procedures should take into account factors such as BMI, willingness to participate in lifestyle therapy, and contraindications or cautions related to comorbidities or previous surgeries.<br /><br />Management of adverse events associated with endoscopic procedures involves appropriate medications, IV fluids, and diet modifications. The specific management varies depending on the procedure and the patient's symptoms.<br /><br />In conclusion, endoscopic bariatric therapy offers a less invasive alternative to surgical options for weight loss. These procedures can be effective in achieving weight loss and managing obesity-related comorbidities. Careful patient selection and post-procedure management are important for optimizing outcomes and minimizing adverse events.

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Katelyn Cookson, PA-C

Keywords

endoscopic bariatric therapy

obesity treatment

metabolic diseases

intragastric balloons

endoscopic sleeve gastroplasty

weight loss procedures

lifestyle therapy

behavior modification

pharmacotherapy for weight loss

adverse events management