Systematic Review of Endoscopic Treatments for Obesity: Their Safety and Efficacy in Weight Reduction

Abstract

Background : 

Obesity is a tremendous, increasing health problem worldwide. There are multiple endoscopic treatments for obesity. This study is a systematic review of researches on these methods and an evaluation of their safety and efficacy.

Materials and Methods :

We conducted a MEDLINE electronic research to review relevant English articles and abstracts published in the previous ten years( up to September 2012) on endoscopic treatments for human obesity.

Results : 

Overall, we found 62 articles. Of these, 42 articles (n=6406 cases) evaluated the bioenteric intragastric balloon (BIB) method. The percent of excess weight loss (EWL%) was 7.6%-62.3% and proportion of weight loss (WL) was 5.4-28.5 kg over six months. A total of five articles (n=159 cases) researched the air filled gastric balloon technique and reported a WL of approximately 10-17 kg in six months. Another five articles (n=112 cases) studied the duodeno jejuna bypass liner (DJBL) method and showed an EWL% of 11.9%-40% and WL of 8.2-16.7 kg over a 3-month period. Researchers evaluated botulinum toxin A (BTX A) injections in nine articles (n=144 cases) with a WL in two months of 0-11 kg. In three articles (n=64 cases), endoscopic suturing of the stomach was evaluated with an EWL% of 58.1 kg in six months. Another three articles (n=99 cases) evaluated transoral gastroplasty with an EWL% of 24.4%-36% and WL of 14-24 kg over six months.

Conclusion :

We have located numerous studies on the BIB procedure with lengthy (up to 5 years) monitoring of cases. According to these studies, BIB is a short-term, effective weight loss treatment. BIB may be a suitable method for preoperative weight loss in patients who are candidates for bariatric surgery to decrease the risk of surgery; in cases who are not candidates for surgery due to the risk of surgery; or in patients with moderate obesity as a primary weight loss treatment to induce changes in the patient's life style. DJBL and transoral gastroplasty sounds larger and more effects but additional long-term researches are needed to clarify the safety and efficacy of DJBL and transoral gastroplasty.