TAKE HOME POINTS
1.In overweight ( BMI> 27.9kg/m2) with weight related complications or obese ( BMI> 30kg/m2) adults, consider pharmacotherapy in addition to diet and lifestyle changes for weight loss.
2.If this fails to achieve weight loss, or control weight related complications, consider endoscopic or surgical bariatric procedures.
3.Remember complications associated with these procedures, as well as post procedure nutritional deficiencies.
4.Remember to start PPI therapy in patients with intra-gastric balloons and counsel on expected post procedure symptoms and signs of balloon leakage.
REFERENCES
Acosta A, Streett S, Kroh MD, et al. White Paper AGA: POWER — Practice Guide on Obesity and Weight Management, Education and Resources. Clinical gastroenterology and hepatology. 2016;15(5):631-649.e10.
Muniraj T, Day LW, Teigen LM, et al. AGA Clinical Practice Guidelines on Intragastric Balloons in the Management of Obesity. Gastroenterology (New York, NY 1943). 2021;160(5):1799-1808.
Grunvald E, Shah R, Hernaez R, et al. AGA Clinical Practice Guideline on Pharmacological Interventions for Adults With Obesity. Gastroenterology. 2022;163(5):1198-1225.
Abu Dayyeh BK, Kumar N, Edmundowicz SA, Jonnalagadda S, Larsen M, Sullivan S, Thompson CC, Banerjee S. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82:425–438.e5
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery: A Systematic Review and Meta-analysis. JAMA : the journal of the American Medical Association. 2004;292(14):1724-1737.
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