Endoscopic Bariatric and Metabolic Therapies: Surgical Analogues and Mechanisms of Action

Clin Gastroenterol Hepatol. 2017 May;15(5):619-630. doi: 10.1016/j.cgh.2016.10.021. Epub 2016 Oct 28.


Obesity is a worsening pandemic with numerous related comorbid illnesses. Conservative management including lifestyle modification and medications have limited efficacy. In contradistinction, bariatric surgery is effective, however, with substantial cost and non-negligible morbidity and mortality. As such, a small percentage of eligible patients undergo surgery. Over the past decade, endoscopic bariatric and metabolic therapies have been introduced as a less invasive option for the treatment of obesity and its related comorbid illnesses. This article reviews major endoscopic bariatric and metabolic therapies, their surgical analogues, and proposed mechanisms of action. Clinical trial data for each device also are discussed.

Keywords: Aspire; Bariatric; Diabetes; Duo; EBMT; EBT; ESG; EndoBarrier; Endoscopic Sleeve Gastroplasty; Endoscopy; GLP-1; Gastric Balloon; Ghrelin; IMAS; Incretin; Magnetic; Metabolic; Obalon; Obesity; Orbera; POSE; PYY.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery / methods*
  • Endoscopy / methods*
  • Humans
  • Obesity / surgery*