Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 7/2018

01-07-2018 | Mentored Reviews

Endoscopic Interventions in the Treatment of Obesity and Diabetes

Authors: A. Ruban, A. Uthayakumar, H. Ashrafian, J. P. Teare

Published in: Digestive Diseases and Sciences | Issue 7/2018

Login to get access

Abstract

Obesity is a global health problem which is on the rise and is strongly associated with the development of type 2 diabetes and other comorbidities. Bariatric surgery is now an established treatment for both these conditions, leading to impressive results in weight loss and glycemic control. More recently, we have seen the development of various endoscopic devices as potential alternatives or adjuncts to bariatric surgery. In this state-of-the-art review, we outline the current landscape of endoscopic treatments available for the management of both obesity and diabetes, including the clinical evidence supporting their use, efficacy, safety, and potential mechanisms of action.
Literature
1.
WHO. Obesity and overweight. Factsheet No. 31; 2015.
2.
The Organisation for Economic Co-operation and Development. Obesity update; 2017.
3.
International Diabetes Federation, Atlas, 7th ed. 2015.
4.
Buchwald H, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122:248–256.CrossRefPubMed
5.
Ashrafian H, et al. Effects of bariatric surgery on cardiovascular function. Circulation. 2008;118:2091–2102.CrossRefPubMed
6.
Ashrafian H, et al. Bariatric surgery or non-surgical weight loss for obstructive sleep apnoea? A systematic review and comparison of meta-analyses. Obes Surg. 2015;25:1239–1250.CrossRefPubMed
7.
Cohen RV, et al. The Diabetes Surgery Summit II guidelines: a disease-based clinical recommendation. Obes Surg. 2016;26:1989–1991.CrossRefPubMed
8.
9.
Muller-Stich BP, et al. Surgical versus medical treatment of type 2 diabetes mellitus in nonseverely obese patients: a systematic review and meta-analysis. Ann Surg. 2015;261:421–429.CrossRefPubMed
10.
Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291:335–342.CrossRefPubMed
11.
Nathan H, et al. Strategies for reducing population surgical costs in medicare: local referrals to low-cost hospitals. Ann Surg. 2018;267:878–885.CrossRefPubMed
12.
13.
Nunes GC, et al. Assessment of weight loss with the intragastric balloon in patients with different degrees of obesity. Surg Laparosc Endosc Percutan Tech. 2017;27:e83–e86.CrossRefPubMed
14.
Imaz I, et al. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18:841–846.CrossRefPubMed
15.
Brooks J, Srivastava ED, Mathus-Vliegen EM. One-year adjustable intragastric balloons: results in 73 consecutive patients in the U.K. Obes Surg. 2014;24:813–819.CrossRefPubMed
16.
Ponce J, Quebbemann BB, Patterson EJ. Prospective, randomized, multicenter study evaluating safety and efficacy of intragastric dual-balloon in obesity. Surg Obes Relat Dis. 2013;9:290–295.CrossRefPubMed
17.
Machytka E, et al. Elipse, the first procedureless gastric balloon for weight loss: a prospective, observational, open-label, multicenter study. Endoscopy. 2017;49:154–160.PubMed
18.
Mion F, et al. Swallowable Obalon(R) gastric balloons as an aid for weight loss: a pilot feasibility study. Obes Surg. 2013;23:730–733.CrossRefPubMed
19.
Trande P, et al. Efficacy, tolerance and safety of new intragastric air-filled balloon (Heliosphere BAG) for obesity: the experience of 17 cases. Obes Surg. 2010;20:1227–1230.CrossRefPubMed
20.
Gaggiotti G, et al. Adjustable totally implantable intragastric prosthesis (ATIIP)-Endogast for treatment of morbid obesity: one-year follow-up of a multicenter prospective clinical survey. Obes Surg. 2007;17:949–956.CrossRefPubMed
21.
22.
Giardiello C, et al. Air-filled vs water-filled intragastric balloon: a prospective randomized study. Obes Surg. 2012;22:1916–1919.CrossRefPubMed
23.
Bernante P, et al. Green urine after intragastric balloon placement for the treatment of morbid obesity. Obes Surg. 2003;13:951–953.CrossRefPubMed
24.
Galloro G, et al. New technique for endoscopic removal of intragastric balloon placed for treatment of morbid obesity. Obes Surg. 2007;17:658–662.CrossRefPubMed
25.
Abu Dayyeh BK, et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82:425–438.CrossRefPubMed
26.
Dumonceau JM. Evidence-based review of the Bioenterics intragastric balloon for weight loss. Obes Surg. 2008;18:1611–1617.CrossRefPubMed
27.
28.
Gaur S, et al. Balancing risk and reward: a critical review of the intragastric balloon for weight loss. Gastrointest Endosc. 2015;81:1330–1336.CrossRefPubMed
29.
Kotzampassi K, et al. 500 intragastric balloons: what happens 5 years thereafter? Obes Surg. 2012;22:896–903.CrossRefPubMed
30.
Mathus-Vliegen EMH, Tytgat GNJ. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc. 2005;61:19–27.CrossRefPubMed
31.
32.
Popov VB, et al. The impact of intragastric balloons on obesity-related co-morbidities: a systematic review and meta-analysis. Am J Gastroenterol. 2017;112:429–439.CrossRefPubMed
33.
Chan AO, et al. The effect of intragastric balloon placement on weight loss and type 2 diabetes control. Aliment Pharmacol Ther. 2008;28:162–164. (author reply 164-5).CrossRefPubMed
34.
Crea N, et al. Improvement of metabolic syndrome following intragastric balloon: 1 year follow-up analysis. Obes Surg. 2009;19:1084–1088.CrossRefPubMed
35.
Su HJ, et al. Effect of intragastric balloon on gastric emptying time in humans for weight control. Clin Nucl Med. 2013;38:863–868.CrossRefPubMed
36.
Gomez V, Woodman G, Abu BK. Dayyeh, Delayed gastric emptying as a proposed mechanism of action during intragastric balloon therapy: results of a prospective study. Obesity (Silver Spring). 2016;24:1849–1853.CrossRef
37.
Ladabaum U, et al. Differential symptomatic and electrogastrographic effects of distal and proximal human gastric distension. Am J Physiol. 1998;275:G418–G424.PubMed
38.
Mathus-Vliegen EM, de Groot GH. Fasting and meal-induced CCK and PP secretion following intragastric balloon treatment for obesity. Obes Surg. 2013;23:622–633.CrossRefPubMed
39.
Feinle C, et al. Effects of duodenal fat, protein or mixed-nutrient infusions on epigastric sensations during sustained gastric distension in healthy humans. Neurogastroenterol Motil. 2002;14:205–213.CrossRefPubMed
40.
Konopko-Zubrzycka M, et al. The effect of intragastric balloon on plasma ghrelin, leptin, and adiponectin levels in patients with morbid obesity. J Clin Endocrinol Metab. 2009;94:1644–1649.CrossRefPubMed
41.
Fuller NR, et al. An intragastric balloon produces large weight losses in the absence of a change in ghrelin or peptide YY. Clin Obes. 2013;3:172–179.CrossRefPubMed
42.
43.
Forssell H, Noren E. A novel endoscopic weight loss therapy using gastric aspiration: results after 6 months. Endoscopy. 2015;47:68–71.CrossRefPubMed
44.
Thompson CC, et al. Percutaneous gastrostomy device for the treatment of class II and class III obesity: results of a randomized controlled trial. Am J Gastroenterol. 2017;112:447–457.CrossRefPubMed
45.
James AN, Ryan JP, Parkman HP. Inhibitory effects of botulinum toxin on pyloric and antral smooth muscle. Am J Physiol Gastrointest Liver Physiol. 2003;285:G291–G297.CrossRefPubMed
46.
Foschi D, et al. Effects of intramural administration of Botulinum Toxin A on gastric emptying and eating capacity in obese patients. Dig Liver Dis. 2008;40:667–672.CrossRefPubMed
47.
Garcia-Compean D, Maldonado Garza H. Intragastric injection of botulinum toxin for the treatment of obesity. Where are we? World J Gastroenterol. 2008;14:1805–1809.CrossRefPubMedPubMedCentral
48.
Bang CS, et al. Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression. Gastroenterology. 2015;148:670.CrossRef
49.
Fogel R, et al. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc. 2008;68:51–58.CrossRefPubMed
50.
Kumar N, Thompson CC. Transoral outlet reduction for weight regain after gastric bypass: long-term follow-up. Gastrointest Endosc. 2016;83:776–779.CrossRefPubMed
51.
Brethauer SA, et al. Transoral gastric volume reduction as intervention for weight management: 12-month follow-up of TRIM trial. Surg Obes Relat Dis. 2012;8:296–303.CrossRefPubMed
52.
Familiari P, et al. Transoral gastroplasty for morbid obesity: a multicenter trial with a 1-year outcome. Gastrointest Endosc. 2011;74:1248–1258.CrossRefPubMed
53.
Sharaiha RZ, et al. Initial experience with endoscopic sleeve gastroplasty: technical success and reproducibility in the bariatric population. Endoscopy. 2015;47:164–166.PubMed
54.
Abu Dayyeh BK, et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol. 2017;15:37–43.CrossRefPubMed
55.
van Wezenbeek MR, et al. Long-term results of primary vertical banded gastroplasty. Obes Surg. 2015;25:1425–1430.CrossRefPubMed
56.
Colquitt JL, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:Cd003641.
57.
Lopez-Nava G, et al. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg. 2017;27:2649–2655.CrossRefPubMed
58.
Sullivan S, et al. 100 12 month randomized sham controlled trial evaluating the safety and efficacy of targeted use of endoscopic suture anchors for primary obesity: the ESSENTIAL study. Gastroenterology. 2016;150:S25–S26.CrossRef
59.
Espinos JC, et al. Gastrointestinal physiological changes and their relationship to weight loss following the POSE procedure. Obes Surg. 2016;26:1081–1089.CrossRefPubMed
60.
Marinos G, et al. Weight loss and improved quality of life with a nonsurgical endoscopic treatment for obesity: clinical results from a 3- and 6-month study. Surg Obes Relat Dis. 2014;10:929–934.CrossRefPubMed
61.
Ashrafian H, et al. Diabetes resolution and hyperinsulinaemia after metabolic Roux-en-Y gastric bypass. Obes Rev. 2011;12:e257–e272.CrossRefPubMed
62.
Sandler BJ, et al. Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve. Surg Endosc. 2011;25:3028–3033.CrossRefPubMed
63.
Sandler BJ, et al. One-year human experience with a novel endoluminal, endoscopic gastric bypass sleeve for morbid obesity. Surg Endosc. 2015;29:3298–3303.CrossRefPubMed
64.
Garvey WT. Ablation of the duodenal mucosa as a strategy for glycemic control in type 2 diabetes: role of nutrient signaling or simple weight loss. Diabetes Care. 2016;39:2108–2110.CrossRefPubMedPubMedCentral
65.
Cherrington AD, et al. Hydrothermal duodenal mucosal resurfacing: role in the treatment of metabolic disease. Gastrointest Endosc Clin N Am. 2017;27:299–311.CrossRefPubMed
66.
Ashrafian H, et al. Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer. 2011;117:1788–1799.CrossRefPubMed
67.
Rajagopalan H, et al. Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes: 6-month interim analysis from the first-in-human proof-of-concept study. Diabetes Care. 2016;39:2254–2261.CrossRefPubMed
68.
Theodorakis MJ, et al. Human duodenal enteroendocrine cells: source of both incretin peptides, GLP-1 and GIP. Am J Physiol Endocrinol Metab. 2006;290:E550–E559.CrossRefPubMed
69.
Salinari S, et al. Nutrient infusion bypassing duodenum–jejunum improves insulin sensitivity in glucose-tolerant and diabetic obese subjects. Am J Physiol Endocrinol Metab. 2013;305:E59–E66.CrossRefPubMed
70.
Betzel B, et al. Weight reduction and improvement in diabetes by the duodenal–jejunal bypass liner: a 198 patient cohort study. Surg Endosc. 2017;31:2881–2891.CrossRefPubMed
71.
de Jonge C, et al. Endoscopic duodenal–jejunal bypass liner rapidly improves type 2 diabetes. Obes Surg. 2013;23:1354–1360.CrossRefPubMed
72.
de Moura EG, et al. Effects of duodenal–jejunal bypass liner (EndoBarrier(R)) on gastric emptying in obese and type 2 diabetic patients. Obes Surg. 2015;25:1618–1625.CrossRefPubMed
73.
Sauer N, et al. A new endoscopically implantable device (SatiSphere) for treatment of obesity–efficacy, safety, and metabolic effects on glucose, insulin, and GLP-1 levels. Obes Surg. 2013;23:1727–1733.CrossRefPubMed
74.
Machytka E, et al. Sa1596 endoscopically-placed, Satisphere; duodenal insert for treatment of obesity—pilot trial with second generation device. Gastrointest Endosc. 2014;79:268.CrossRef
75.
Machytka E, et al. Partial jejunal diversion using an incisionless magnetic anastomosis system: 1-year interim results in patients with obesity and diabetes. Gastrointest Endosc. 2017;86:904–912.CrossRefPubMed
76.
Welbourn R, et al. First registry report to March 2010: Henly-on-Thames: the United Kingdom National Bariatric Surgery Registry. Oxfordshire: Dendritic Clinical Systems; 2011.
77.
Chang SH, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149:275–287.CrossRefPubMedPubMedCentral
78.
Monkhouse SJ, Morgan JD, Norton SA. Complications of bariatric surgery: presentation and emergency management—a review. Ann R Coll Surg Engl. 2009;91:280–286.CrossRefPubMedPubMedCentral
Metadata
Title
Endoscopic Interventions in the Treatment of Obesity and Diabetes
Authors
A. Ruban
A. Uthayakumar
H. Ashrafian
J. P. Teare
Publication date
01-07-2018
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 7/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5117-1

Other articles of this Issue 7/2018

Digestive Diseases and Sciences 7/2018 Go to the issue

Original Article

Painful or Mild-Pain Constipation? A Clinically Useful Alternative to Classification as Irritable Bowel Syndrome with Constipation Versus Functional Constipation

Original Article

Rates of Prevalent Colorectal Cancer Occurrence in Persons 75 Years of Age and Older: A Population-Based National Study

Original Article

Anti-fibrogenic Potential of Mesenchymal Stromal Cells in Treating Fibrosis in Crohn’s Disease

Original Article

Systemic Inflammatory Responses in Ulcerative Colitis Patients and Clostridium difficile Infection

Original Article

Antenatal Management for Women with Inflammatory Bowel Disease: Experience from Our ‘IBD MOM’ Clinic

Profiles and Perspectives

Competence, Confidence, and Certification: Observations from Both Sides of the Aisle

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits