Current and cutting-edge interventions for the treatment of obese patients |
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| Institution: | 1. Vascular and Interventional Radiology Center, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital/The Johns Hopkins University, 1800 Orleans Street, Baltimore, MD 21287, United States;2. Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, 550 N. Broadway, Baltimore, MD 21205, United States;3. Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital/The Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD 21287, United States;4. Division of Interventional Radiology, Piedmont Radiology, 1984 Peachtree Road, Atlanta, GA 30309, United States;1. Department of Surgery, Rijnstate Hospital, the Netherlands;2. Department of Gastroenterology, Rijnstate Hospital, the Netherlands;1. WakeMed Bariatric Specialists of NC, Cary, North Carolina;2. Bariatric Medicine Institute, South Salt Lake City, Utah;1. Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA;1. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland;4. ReShaping, KC, Lee’s Summit, Missouri;6. Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri;5. Southwest Gastroenterology, Lubbock, Texas;7. Center for Gastrointestinal Disorders, Hollywood, Florida;12. Advanced Gastroenterology and Hepatology of Greater Washington, Vienna, Virginia;8. Gastrointestinal Associates, Knoxville, Tennessee;10. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota;2. Digestive Health Center, University of Colorado Hospital, Aurora, Colorado;3. Division of Gastroenterology, Brigham and Women''s Hospital, Harvard Medical School, Boston, Massachusetts |
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| Abstract: | The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current “gold standard” therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band. Though effective, bariatric surgery can have severe short- and long-term complications. To fill the major gap in invasiveness between lifestyle modification and surgery, researchers have been developing pharmacotherapies and minimally invasive endoscopic techniques to treat obesity. Recently, interventional radiologists developed a percutaneous transarterial catheter-directed therapy targeting the hormonal function of the stomach. This review describes the current standard obesity treatments (including diet, exercise, and surgery), as well as newer endoscopic bariatric procedures and pharmacotherapies to help patients lose weight. We present data from two ongoing human trials of a new interventional radiology procedure for weight loss, bariatric embolization. |
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| Keywords: | Bariatric surgery BEAT Obesity Embolization Obesity Weight loss |
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