Advances and future directions in endoscopic bariatric therapies

Obesity is a chronic, multifactorial disease closely linked to a spectrum of cardiometabolic disorders, with its global prevalence rising at an alarming rate. In recent years, minimally invasive, safe, and effective endoscopic bariatric therapies have gained significant attention as alternatives to conventional surgical interventions. This review provides a comprehensive overview of various endoscopic weight-loss procedures, evaluating their advantages and limitations in comparison to surgical approaches to assist clinicians in optimizing patient-specific treatment strategies. Endoscopic bariatric therapies, including intragastric balloons, duodenal-jejunal bypass sleeves, endoscopic sleeve gastroplasty, gastric remodeling procedures, and interventions aimed at delaying gastric emptying are systematically reviewed. The efficacy, safety profiles, and clinical applicability are all synthesized. Endoscopic bariatric therapies exhibit distinct advantages and limitations, with varying indications and contraindications. As part of a multidisciplinary approach to obesity management, these procedures should be integrated with lifestyle modifications and nutritional counseling to maximize therapeutic benefits. Future research should focus on the long-term efficacy, safety, and patient-reported outcomes to refine clinical practice and optimize the role of endoscopic interventions in obesity treatment.