American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity

Pichamol Jirapinyo; Alia Hadefi; Christopher C Thompson; Árpád V Patai; Rahul Pannala; Stefan K Goelder; Vladimir Kushnir; Marc Barthet; Caroline M Apovian; Ivo Boskoski; Christopher G Chapman; Paul Davidson; Gianfranco Donatelli; Vivek Kumbhari; Bu Hayee; Janelle Esker; Tomas Hucl; Aurora D Pryor; Roberta Maselli; Allison R Schulman; Francois Pattou; Shira Zelber-Sagi; Paul A Bain; Valérie Durieux; Konstantinos Triantafyllou; Nirav Thosani; Vincent Huberty; Shelby Sullivan

doi:10.1016/j.gie.2023.12.004

American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity

Gastrointest Endosc. 2024 Jun;99(6):867-885.e64. doi: 10.1016/j.gie.2023.12.004. Epub 2024 Apr 19.

Authors

Pichamol Jirapinyo¹, Alia Hadefi², Christopher C Thompson³, Árpád V Patai⁴, Rahul Pannala⁵, Stefan K Goelder⁶, Vladimir Kushnir⁷, Marc Barthet⁸, Caroline M Apovian⁹, Ivo Boskoski¹⁰, Christopher G Chapman¹¹, Paul Davidson¹², Gianfranco Donatelli¹³, Vivek Kumbhari¹⁴, Bu Hayee¹⁵, Janelle Esker¹⁶, Tomas Hucl¹⁷, Aurora D Pryor¹⁸, Roberta Maselli¹⁹, Allison R Schulman²⁰, Francois Pattou²¹, Shira Zelber-Sagi²², Paul A Bain²³, Valérie Durieux²⁴, Konstantinos Triantafyllou²⁵, Nirav Thosani²⁶, Vincent Huberty², Shelby Sullivan¹⁶

Affiliations

¹ Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: pjirapinyo@bwh.harvard.edu.
² Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Hôpital Universitaire de Bruxelles, Brussels, Belgium.
³ Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary.
⁵ Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA.
⁶ Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany.
⁷ Department of Medicine-Division of Gastroenterology, Washington University, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.
⁸ Department of Hepatogastroenterology, Faculty of Medicine, Aix-Marseille University, Chemin des Bourrely, Marseille, France.
⁹ Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹⁰ Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, and Centre for Endoscopic Research Therapeutics and Training, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
¹¹ Center for Interventional and Therapeutic Endoscopy, Division of Digestive Diseases and Nutrition, Rush University, Chicago, Illinois USA.
¹² Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹³ Unité d'Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Générale de Santé, Paris, France and Department of Clinical Medicine and Surgery, University of Naples "Federico II," Naples, Italy.
¹⁴ Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
¹⁵ Division of Gastroenterology, Kings College London, London, United Kingdom.
¹⁶ Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado, USA.
¹⁷ Department of Gastroenterology and Hepatology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
¹⁸ Department of Surgery, Long Island Jewish Medical Center, Queens, New York, USA.
¹⁹ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy and Humanitas Clinical and Research Center IRCCS, Endoscopy Unit, Rozzano, Italy.
²⁰ Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
²¹ Department of Endocrine and Metabolic Surgery, CHU Lille, University of Lille, Inserm, Institut Pasteur Lille, Lille, France.
²² School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel and Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel.
²³ Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
²⁴ Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles, Brussels, Belgium.
²⁵ Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece.
²⁶ Center for Interventional Gastroenterology at UTHealth, Division of Gastroenterology Hepatology and Nutrition, McGovern Medical School, Houston, Texas, USA.

PMID: 38639680
DOI: 10.1016/j.gie.2023.12.004

Abstract

This joint ASGE-ESGE guideline provides an evidence-based summary and recommendations regarding the role of endoscopic bariatric and metabolic therapies (EBMTs) in the management of obesity. The document was developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. It evaluates the efficacy and safety of EBMT devices and procedures that currently have CE mark or FDA-clearance/approval, or that had been approved within five years of document development. The guideline suggests the use of EBMTs plus lifestyle modification in patients with a BMI of ≥ 30 kg/m², or with a BMI of 27.0-29.9 kg/m² with at least 1 obesity-related comorbidity. Furthermore, it suggests the utilization of intragastric balloons and devices for endoscopic gastric remodeling (EGR) in conjunction with lifestyle modification for this patient population.

Copyright © 2024 American Society for Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy. Published by Elsevier Inc on behalf of American Society for Gastrointestinal Endoscopy and by Georg Thieme Verlag KG Stuttgart on behalf of European Society of Gastrointestinal Endoscopy. All rights reserved. Published by Elsevier Inc. All rights reserved.

Publication types

Practice Guideline

MeSH terms

Adult
Bariatric Surgery*
Body Mass Index
Endoscopy, Gastrointestinal* / methods
Gastric Balloon*
Humans
Obesity* / complications