systematic review of endoscopic treatments for obesity: their safety and efficacy in weight reduction

background :â  obesity is a tremendous, increasing health problem worldwide. there are multiple endoscopic treatments for obesity. this study is a systematic review of researches on these methods and an evaluation of their safety and efficacy. materials and methods : we conducted a medline electronic research to review relevant english articles and abstracts published in the previous ten years( up to september 2012) on endoscopic treatments for human obesity. results :â  overall, we found 62 articles. of these, 42 articles (n=6406 cases) evaluated the bioenteric intragastric balloon (bib) method. the percent of excess weight loss (ewl%) was 7.6%-62.3% and proportion of weight loss (wl) was 5.4-28.5 kg over six months. a total of five articles (n=159 cases) researched the air filled gastric balloon technique and reported a wl of approximately 10-17 kg in six months. another five articles (n=112 cases) studied the duodeno jejuna bypass liner (djbl) method and showed an ewl% of 11.9%-40% and wl of 8.2-16.7 kg over a 3-month period. researchers evaluated botulinum toxin a (btx a) injections in nine articles (n=144 cases) with a wl in two months of 0-11 kg. in three articles (n=64 cases), endoscopic suturing of the stomach was evaluated with an ewl% of 58.1 kg in six months. another three articles (n=99 cases) evaluated transoral gastroplasty with an ewl% of 24.4%-36% and wl of 14-24 kg over six months. conclusion : we have located numerous studies on the bib procedure with lengthy (up to 5 years) monitoring of cases. according to these studies, bib is a short-term, effective weight loss treatment. bib may be a suitable method for preoperative weight loss in patients who are candidates for bariatric surgery to decrease the risk of surgery; in cases who are not candidates for surgery due to the risk of surgery; or in patients with moderate obesity as a primary weight loss treatment to induce changes in the patient's life style. djbl and transoral gastroplasty sounds larger and more effects but additional long-term researches are needed to clarify the safety and efficacy of djbl and transoral gastroplasty. â