Endoscopic Weight Loss Treatment: Shrinking the Stomach Without Surgery
Update Date：2025/05/05，
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Weight Loss Metabolic Surgery and Weight Management Center
Dr. Hsuan-Wei Chen/ Director Dr. Kuo-Feng Hsu
In modern society, obesity has become a global health issue that not only affects physical appearance but is also closely related to various chronic diseases. Traditional weight loss methods, such as dietary control and exercise, may be ineffective for some individuals. While surgical options can provide significant results, they come with higher risks and complications. In recent years, with advancements in medical technology, endoscopic weight loss treatments, as a non-invasive, minimally traumatic, and quick-recovery alternative, have gained increasing attention, offering a new option for obese patients.
1. Advantages of Endoscopic Weight Loss Treatment
Compared to traditional weight loss surgery, endoscopic weight loss treatment offers the following advantages:
• No Surgery, Minimal Trauma: All procedures are performed through an endoscope inserted via the mouth into the digestive tract, with no external incisions, thus avoiding surgical trauma and related complications.
• Quick Recovery and Short Hospital Stay: Most patients require only 1-2 days of hospitalization and can return to normal eating and activities after the procedure.
• High Safety, Fewer Complications: The risk of complications and adverse events is significantly lower compared to traditional surgery.
• Reversibility: Some endoscopic weight loss treatments are reversible, allowing adjustments or removal based on the patient's condition.
• Wide Applicability: Ideal for patients with a BMI between 27.5 and 35 who have been unable to lose weight through diet and exercise alone.
2. Common Endoscopic Weight Loss Treatments
Currently, the most commonly used endoscopic weight loss treatments include:
• Intragastric Balloon (IGB):
o Principle: A silicone balloon filled with saline is placed in the stomach, taking up space and reducing food intake, resulting in a feeling of fullness.
o Features: The procedure is simple and highly effective, but the balloon must be removed after 6 months.
• Endoscopic Botulinum Toxin Injection:
o Principle: Botulinum toxin is injected into the gastric antrum to inhibit gastric smooth muscle contractions, delay gastric emptying, and increase satiety.
o Features: The procedure is easy to perform, but the effects are temporary and require repeated injections.
• Endoscopic Sleeve Gastroplasty (ESG):
o Principle: Using endoscopic suturing techniques, the greater curvature of the stomach is stitched to reduce its volume and limit food intake.
o Features: This method offers significant and lasting weight loss, but requires advanced technical skills.
• POSE 2.0 (Primary Obesity Surgery Endoluminal 2.0):
o Principle: Performed using the Incisionless Operating Platform (IOP), the procedure involves endoscopic suturing of the stomach to achieve weight loss.
o Features: It can reduce stomach volume by up to 78%, resulting in an overall weight loss of 20.3% after one year. It also significantly improves blood pressure, insulin resistance, and liver function.
3. Indications and Contraindications for Endoscopic Weight Loss Treatment
• Indications:
o BMI ≥ 27 kg/m² with obesity-related complications such as diabetes, hypertension, and sleep apnea.
o BMI ≥ 32.5 kg/m², even without complications, may be considered for endoscopic weight loss treatment.
o Patients who are unable to lose weight through traditional methods (diet, exercise, etc.).
o Patients who are unwilling or unsuitable for surgical weight loss procedures.
• Contraindications:
o Severe cardiopulmonary insufficiency, coagulation disorders, severe gastroesophageal reflux disease (GERD), pregnant or breastfeeding women, or individuals with psychiatric conditions.
4. Important Considerations for Endoscopic Weight Loss Treatment
• Preoperative Assessment: Before undergoing endoscopic weight loss treatment, patients should undergo a thorough medical evaluation, including BMI, obesity-related complications, and psychological assessment, to determine suitability for the procedure.
• Postoperative Diet: Strict adherence to the physician's dietary guidelines is essential, starting with liquid foods and gradually transitioning to normal foods while maintaining healthy eating habits.
• Lifestyle Changes: Endoscopic weight loss treatment is not a permanent solution. Patients must continue to control their diet, exercise, and adjust their lifestyle to maintain long-term weight loss.
• Regular Follow-up: Post-treatment follow-ups are necessary to monitor weight changes, nutritional status, and any potential complications.
5. Outlook
Endoscopic weight loss treatment, as an emerging approach, offers advantages such as minimal trauma, quick recovery, and high safety, providing a new option for obese patients. As the technology continues to advance, the indications for endoscopic treatments will expand, and the results will become even more significant. In the future, endoscopic weight loss treatments are expected to play an increasingly important role in obesity management, helping more patients regain their health.
It is important to note that endoscopic weight loss treatments may not be suitable for all obese patients, and the treatment plan should be personalized by a professional physician based on the individual’s condition.