Endoscopic management of obesity.

MQ Endoscopic management of obesity can be grouped under the following 3 categories: primary management of obesity; management of obesity-related disorders such as diabetes mellitus and infertility; and management of postsurgical complications. Primary endoscopic management of obesity still falls within the realms of clinical trials and institutional review board–sponsored registries. Most of these studies have been performed in Europe and South America. Due to rising interest in this area, there has been a significant increase in publications over the past few years. Endoscopic management of obesity-related infertility and diabetes mellitus has been described in several case series. There have also been several reports of endoscopic management of extremely obese individuals (body mass index [BMI] >60 kg/m2) prior to performing definitive surgical procedures in order to reduce associated risks. At present, endoscopic treatment is preferred over surgery for postsurgical complications, such as bleeding, dilation of strictured anastomosis, constriction of a dilated anastomosis, and occasionally fistula formation.