There are scarless treatment options for obesity that are performed by only a select group of experts. Read further to discover more about these innovative approaches.
Due to urbanization in India, lifestyle disorders such as obesity have surged among the population due to significant changes in lifestyle and dietary habits. Obesity carries various health consequences, including reduced physical strength, negative impacts on mental health, and increased susceptibility to other diseases such as diabetes mellitus, hypertension, dyslipidemia, cardiovascular issues, fatty liver disease, sleep apnea, cirrhosis, and cancer in various organs.
Recent statistics and data in India regarding obesity and its detrimental effects on overall health are concerning. According to the National Family Health Survey (NFHS-4A), a government health survey, the prevalence of overweight men in the country has doubled over the past decade. Additionally, one in every five women is now affected by obesity. While morbid obesity cases were predominantly found among urban upper- and middle-class families, the rural population also contributed significantly, with 15% of total obesity cases.
The editorial team at Onlymyhealth consulted Dr. Vikas Singla, Director & Head of Gastroenterology at Max Super Speciality Hospital in Saket, New Delhi, regarding scarless treatment options for obesity.
The development of endoscopic treatment and the emergence of endoscopic weight loss procedures
The primary objective of treating obesity is to achieve physical well-being and mitigate obesity-related complications. Research indicates that a ten percent reduction in total body weight (e.g., 10 kg in a person weighing 100 kg) is correlated with improvements in conditions such as diabetes, hypertension, and lipid levels. Further reductions in excess body weight can lead to additional improvements in obesity-related complications. A multidisciplinary team consisting of a nutritionist, psychologist, endoscopist, and surgeon collaborates to support obese individuals in attaining a healthier lifestyle. While physical activity and dietary modifications are typically recommended as initial interventions for obesity, their limited effectiveness and poor adherence necessitate alternative treatment options.
Endoscopic Scarless Solutions for Treating Obesity
Treatment options for obesity through endoscopic scarless procedures encompass:
1. Bariatric surgery
Bariatric surgery has demonstrated its effectiveness in achieving and sustaining long-term weight loss, as well as in resolving obesity-related comorbidities such as diabetes and hypertension. However, despite its effectiveness, only 1% of eligible patients undergo this procedure. Consequently, there remains an unmet need for an efficacious treatment option with broader acceptability. In the interim, other endoscopic procedures have made advancements in the treatment of obesity and may offer a promising alternative to bridge this gap.
2. Intragastric Ballooning (IGB)
The intragastric balloon (IGB) stands out as one of the most effective methods for reducing excess body weight. It is primarily a non-surgical procedure conducted under anesthesia. Using an endoscopic camera called a gastroscope inserted through the mouth into the stomach, a balloon is placed. Once the camera is in position, the balloon is filled with a sterile saline solution, typically ranging from 500 to 750 ml, through a small tube attached to the balloon. Subsequently, the tube is gently detached. Once in the stomach, the balloon induces early satiety and reduces calorie intake due to its weight.
Generally, intragastric ballooning facilitates a weight loss of around 10% of total body weight. Many patients find they can better manage insulin levels and reduce oral medications for blood sugar, blood pressure, and lipid control. The entire procedure, including balloon insertion and adjustment, typically lasts 25-30 minutes, and patients are often discharged either the same day or the following day.
This procedure is highly effective and beneficial with minimal major side effects. The intragastric balloon should remain in the stomach for a duration of 6-12 months before being removed endoscopically. For removal, the catheter attached to the balloon is pulled out, the balloon is deflated, grasped, and extracted through the mouth.
3. Endoscopic Sleeve Gastroplasty (ESG)
Endoscopic Sleeve Gastroplasty (ESG) is an innovative technique effective in managing body weight by reducing stomach size. Unlike traditional surgical methods, ESG is performed under anesthesia and requires no skin incisions. During the procedure, a scope is inserted through the throat into the stomach, where sutures are applied to decrease stomach size and restrict food intake. Post-procedure, patients experience early satiety due to the reduced stomach size, resulting in decreased calorie consumption and significant weight loss. ESG has shown positive outcomes in treating comorbid health conditions and reducing excess body weight.
This minimally invasive procedure is not only safe but also highly effective for weight reduction. Hospital admission typically lasts 48 hours, after which patients are discharged. Extensive studies have confirmed the safety and efficacy of ESG, with an expected weight loss of around 20% of total body weight. This leads to improved control and reduction of obesity-related comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and osteoarthritis.
To ensure safety and optimal outcomes, ESG should be performed on carefully selected individuals in specialized centers equipped to care for obese patients, within a multidisciplinary setting offering comprehensive post-procedure care. Advances in endoscopic solutions have expanded options for managing obesity, aligning with the primary goal of medical science and practitioners.