ARTICLE SUMMARY:
At the recent Digestive Disease Week, GI endoscopists paraded data showing that interventional weight loss procedures are still more cost-effective by a wide margin than semaglutide and with more durable effects. The meeting also highlighted duodenal mucosal resurfacing, a new type of metabolic surgery with the potential to put type 2 diabetes into remission.
Because they dominate gastrointestinal endoscopy, gastroenterologists are well positioned to address diseases of the gut, the body’s largest endocrine organ and its largest nervous system outside of the brain. Their purview includes two of most costly and potentially longevity-shortening diseases. The first is obesity, of which there are 109 million Americans, who with a body mass index (BMI) greater than 30 kg/m2 need to be treated to avoid a host of cardiac, metabolic, hepatic, and renal morbidities. The second is type 2 diabetes, for which obesity is the largest risk factor, affecting 34 million in the US. Obesity also increases the risk of MASLD or MASH (metabolic dysfunction associated steatotic liver disease, which was formerly known as nonalcoholic fatty liver disease or NASH).
Not a day goes by that one doesn’t come across a headline having to do with the new GLP-1 receptor agonist (GLP-1RA) class of weight-loss drugs for obesity; they’ve been so successful that their manufacturers can’t keep up with demand. But that is only one tool in the toolbox, and the recent Digestive Disease Week meeting (DDW 2024), held in Washington, DC, at the end of May, hosted many presentations on the efficacy, durability, and cost-effectiveness of endoscopic procedures for the gut, or endobariatric interventions.
