| Obesity is the major underlying cause of type 2 diabetes (T2D), cardiovascular, renal , liver and many obesity related metabolic disorders. Obesity treatment is also becoming important in Medicine and Biotechnological Industry. Other than bariatric/metabolic surgery, many new interventional treatment modalities and new pharmacies had been developed. These advancements reshaped the treatment of obesity and promote a new medical division. This talk will introduce the recent advancements in obesity treatment, especially the interventional treatments. (1) Novel metabolic and bariatric surgical procedures and new guideline of indication. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed metabolic and bariatric procedures. One anastomosis gastric bypass (OAGB) was the most recently accredited metabolic and bariatric surgical procedures with better safety profile and weight loss efficacy than most of the procedures. Sleeve gastrectomy plus duodenal switch (DS) or bipartition bypass (TB) and it's variant of one anastomosis sleeve ileostomy (SASI) are also the novel procedures. A new worldwide guideline was recently launched and the indication for metabolic and bariatric surgery was lowered BMI 27.5 Kg/m2 for Asian. (2) Novel obesity treatment modalities. Endoscopic obesity treatment had a major progress in the success of endoscopic gastroplasty (ESG) by endoscopic suturing designs. The weight loss result is durable up to 5 years with a mean weight loss of 15%. Endoscopic treatment is also recommended for weight regain after bariatric surgery, especially RYGB. The proposed treatment including Argon beam ablation, endoscopic suture, or rubber band mucosa ligation. (3) Combination treatment. Recently, new drugs for obesity and diabetes treatment also had great progress recently. After the success of weekly injection GLP-1 alone drug, new drugs with combination of 2 and 3 gut hormones increased the 48 weeks weight loss from 15% to 24%, mimicking the effect of bariatric surgery. These new pharmacies not only recruit more patients willing to receive obesity, but also improve the efficacy of interventional treatment of obesity and treatment of obesity recurrence after bariatric/metabolic surgery. |
