In 2013, roughly a third of US men and women were obese. Obesity-related conditions include heart disease, high blood pressure, stroke, type 2 diabetes and certain types of cancer – currently some of the leading causes of preventable death. Despite a clear understanding of these risks, successful realization and continued maintenance of weight loss remains a challenge for many individuals.
Dietary and lifestyle interventions alone are often not enough to achieve and sustain a healthy weight. Although bariatric surgeries are the most successful in accomplishing weight loss and reducing associated co-morbidities, only 1 in 400 (<1%) morbidly obese individuals undergo bariatric surgery in the United States. This low number is due to many reasons, but for many patients with mild to moderate obesity, they do not qualify for bariatric surgery.
To help meet the needs of patients who either not candidates for surgery or elect not to pursue it, the University of Chicago Medicine is now offering new endoscopic methods for weight loss. Primary endoscopic bariatric therapies are incision-less procedures performed entirely through the mouth that can be repeated, are reversible, and do not permanently remove or rearrange any part of the intestinal tract. Current endoscopic bariatric procedures being offered to patients with obesity include intragastric balloon placement, endoscopic sleeve gastroplasty and aspiration therapy.
Intragastric balloons are placed with an endoscope and remain in the stomach for 6 months. The balloons take up 1/3rd of the stomach volume and delay stomach emptying, resulting in decreased appetite and prevention of excess eating. This outpatient procedure is completed in 30 minutes and patients are discharged after 2 hours. Intragastric balloons have demonstrated weight loss of average 3 times more weight loss than diet and exercise alone – with reports averaging 8 to 16 kg and 20-30 percent excess weight loss. Patients with the balloon also saw an improvement in diabetes, blood pressure, dyslipidemia and depression.
In an effort to mimic the creation of a surgical laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty utilizes the Overstitch™ device to perform endoscopic suturing for gastric volume reduction. The preliminary results from a multicenter registry, identified a total body weight loss of 19.8 percent at 18 months post ESG. This procedure takes 1 to 2 hours, and most patients are still discharged home the same day. The Overstitch™ device can also be used to reduce the size of a Roux-en-Y gastric bypass outlet or laparoscopic sleeve in patients that have gained weight after an initial response to bariatric surgery.
Christopher Chapman, director of bariatric endoscopy at the University of Chicago Medicine, believes that “when combined with a motivated individual willing to participate in aggressive lifestyle interventions, these procedures can serve as the launching pad to achieving and sustaining a healthy weight. These endoscopic procedures can even open the door to other treatments, such as surgery, for patients who may not otherwise qualify.”
Dr. Chapman adds, “The strength of the University of Chicago Medicine program is the multidisciplinary team that provides individualized evaluations to determine the ideal treatment strategy. When a patient is deciding on bariatric surgery or an endoscopic bariatric procedure, our bariatric surgeons, gastroenterologists, nutritionists, dieticians, psychologists, exercise therapists and endocrinologists collaborate closely together to create a plan that meets each patient's health and lifestyle needs.”
To refer a patient for a primary endoscopic bariatric procedure or to be considered for endoscopic management of bariatric complications or weight regain, call (773) 702-4921. The clinics are located at the University of Chicago Medicine Huron clinic, 150 E. Huron Street, Suite 900 and the Duchossois Center for Advanced Medicine, 5758 S. Maryland Avenue, Suite 6B.