Emerging Endoscopic Strategies in Obesity Management Innovations and Future Perspectives

Emerging endoscopic strategies are revolutionizing the treatment of obesity by offering a less invasive alternative to traditional bariatric surgery. Conventional approaches, including lifestyle modifications and pharmacotherapy, often result in only moderate weight loss, while surgical interventions, despite their high efficacy, carry a significant risk of short- and long-term complications. This paper provides a comprehensive overview of current endoscopic modalities, such as various intragastric balloons (Orbera, ReShape, Obalon, Spatz3, Ellipse, Heliosphere), endoscopic sleeve gastroplasty, aspiration therapies, and duodenal–jejunal bypass sleeves. These techniques work by reducing gastric volume, modulating gut hormone secretion, and delaying gastric emptying, thereby enhancing satiety and promoting sustained weight loss. The review emphasizes that while early results are promising, demonstrating significant weight reduction and metabolic improvements with lower complication rates than surgical methods, further long-term studies are required to fully establish their efficacy and safety profile. Endoscopic bariatric interventions are positioned as a valuable addition to the obesity treatment armamentarium, particularly for patients who are not ideal candidates for surgery or who seek reversible treatment options.