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Abstract

Introduction: For a long time, obesity has been known as a risk factor for cardiovascular disease, which is one of the main causes of death. Resistance to insulin and consequent compensatory hyperinsulinemia significantly increase the risk of death due to cardiovascular diseases. Endoscopic weight loss therapies may provide some of the benefits of weight loss surgery while being reversible, with a lower risk profile, and being available to patients who do not qualify for surgery. Those endoscopic solutions for weight loss are also applicable as metabolic procedures to address comorbidities as type 2 diabetes, dyslipidemia and nonalcoholic fatty liver disease. Metabolic Improvements with the Intragastric Balloon: The intragastric balloon is a spherical silicone balloon that is resistant to degradation by gastric acid for approximately 6 months. It can be placed endoscopically and filled with 400 to 700 ml of saline. A meta-analysis by Imaz et al. of 15 studies comprising 3698 patients estimated 14.7 kg weight loss, 32.1% excess weight loss (EWL), and 5.7 kg/m2 decrease in BMI after 6 months. A prospective study, evaluating the effect of the balloon on weight, insulin resistance, and liver steatosis in obese patients showed that 76% of the patients had a BMI decrease of 3.5 Kg/m2 or more. The mean (SD) weight loss with respect to baseline values was 16.4 (8.2) kg with a corresponding mean (SD) BMI reduction of 6.4 (3.2) kg/m2. The absolute percentage of participants with glycemia levels of 100 mg/dL or higher decreased from 50% to 12%, those with triglyceridemia 150 mg/dL or higher from 58% to 19%, and those with abnormal ALT level from 38% to 7% [23]. Conclusion: The intragastric balloon and the Duodenojejunal bypass liner (DJBL) are tools with promising results in the endoscopic treatment of obesity. They are still subjects of research with a great potential for improvement. Although outcomes from the use of the intragastric balloon and the DJBL are not comparable to those of surgery with regard to weight loss and late results, these new techniques have showed an excellent result in ameliorating health status, in the control of the metabolic syndrome as well as improving the quality of life for a well selected group of patients.

Biography

Email: eduardoghdemoura@gmail.com