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It was an honor to be chosen to deliver the 2014 J. Edward Berk Endowed Lecture. Dr. Berk was a gifted physician and teacher who made monumental contributions to medicine. He was also an insightful leader in the field of gastroenterology during a critical formative period. I am humbled to have joined distinguished past recipients of this lectureship, including Prateek Sharma, Kenneth Chang, Robert Hawes, Robert Schoen, Glenn Eisen, Douglas Rex, and Paul Fockens. I am also delighted to have been asked to speak about bariatric endoscopy.
Obesity and its associated metabolic comorbidities represent a pandemic that requires a multidisciplinary approach, to which gastroenterologists are integral. More than one third of U.S. adults are obese, accounting for over 85 million people. This contrasts with the 1.4 million Americans with inflammatory bowel disease, or the 500,000 patients that require ERCP each year, conditions for which fellows commonly seek additional years of training. Unfortunately, although nutrition is briefly covered in most gastroenterology fellowship programs, little time is devoted to obesity or the complications of bariatric surgery.
Obesity has been formally recognized as a disease by the American Medical Association and was recently the focus of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases. Obesity is now considered the fifth leading risk for global deaths and is causally related to diabetes, ischemic heart disease, esophageal reflux, liver disease, and certain orthopedic and cancer burdens. Nevertheless, less than 2% of obese patients seek surgical treatment for a variety of reasons, including fear of complications.
Several less invasive endoscopic devices are available for the treatment of obesity, outside of the US. These devices include a variety of balloons, gastric remodeling platforms, endoluminal sleeves, and anastomotic devices. These devices focus on different mechanisms of action and offer a range of therapeutic benefits. The Food and Drug Administration has recently taken the position that risk-benefit ratio is an important concept in the treatment of obesity, allowing therapies with different risk profiles distinct therapeutic goals. As a result, many of these technologies are now being investigated in formal U.S. clinical trials.
Endoscopy currently offers solutions to many patients with complications of bariatric surgery. Additionally, there are several endoscopic devices that show promise and may be of help to this struggling patient population. This lecture focuses on these newer technologies and the current state of U.S. clinical trials.
Dr. Christopher C. Thompson, FASGE, FACG, is director of therapeutic endoscopy at Brigham and Women’s Hospital, and associate professor of medicine, Harvard Medical School, Boston. His comments were made during the ASGE and AGA joint Presidential Plenary at the annual Digestive Disease Week.
It was an honor to be chosen to deliver the 2014 J. Edward Berk Endowed Lecture. Dr. Berk was a gifted physician and teacher who made monumental contributions to medicine. He was also an insightful leader in the field of gastroenterology during a critical formative period. I am humbled to have joined distinguished past recipients of this lectureship, including Prateek Sharma, Kenneth Chang, Robert Hawes, Robert Schoen, Glenn Eisen, Douglas Rex, and Paul Fockens. I am also delighted to have been asked to speak about bariatric endoscopy.
Obesity and its associated metabolic comorbidities represent a pandemic that requires a multidisciplinary approach, to which gastroenterologists are integral. More than one third of U.S. adults are obese, accounting for over 85 million people. This contrasts with the 1.4 million Americans with inflammatory bowel disease, or the 500,000 patients that require ERCP each year, conditions for which fellows commonly seek additional years of training. Unfortunately, although nutrition is briefly covered in most gastroenterology fellowship programs, little time is devoted to obesity or the complications of bariatric surgery.
Obesity has been formally recognized as a disease by the American Medical Association and was recently the focus of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases. Obesity is now considered the fifth leading risk for global deaths and is causally related to diabetes, ischemic heart disease, esophageal reflux, liver disease, and certain orthopedic and cancer burdens. Nevertheless, less than 2% of obese patients seek surgical treatment for a variety of reasons, including fear of complications.
Several less invasive endoscopic devices are available for the treatment of obesity, outside of the US. These devices include a variety of balloons, gastric remodeling platforms, endoluminal sleeves, and anastomotic devices. These devices focus on different mechanisms of action and offer a range of therapeutic benefits. The Food and Drug Administration has recently taken the position that risk-benefit ratio is an important concept in the treatment of obesity, allowing therapies with different risk profiles distinct therapeutic goals. As a result, many of these technologies are now being investigated in formal U.S. clinical trials.
Endoscopy currently offers solutions to many patients with complications of bariatric surgery. Additionally, there are several endoscopic devices that show promise and may be of help to this struggling patient population. This lecture focuses on these newer technologies and the current state of U.S. clinical trials.
Dr. Christopher C. Thompson, FASGE, FACG, is director of therapeutic endoscopy at Brigham and Women’s Hospital, and associate professor of medicine, Harvard Medical School, Boston. His comments were made during the ASGE and AGA joint Presidential Plenary at the annual Digestive Disease Week.
It was an honor to be chosen to deliver the 2014 J. Edward Berk Endowed Lecture. Dr. Berk was a gifted physician and teacher who made monumental contributions to medicine. He was also an insightful leader in the field of gastroenterology during a critical formative period. I am humbled to have joined distinguished past recipients of this lectureship, including Prateek Sharma, Kenneth Chang, Robert Hawes, Robert Schoen, Glenn Eisen, Douglas Rex, and Paul Fockens. I am also delighted to have been asked to speak about bariatric endoscopy.
Obesity and its associated metabolic comorbidities represent a pandemic that requires a multidisciplinary approach, to which gastroenterologists are integral. More than one third of U.S. adults are obese, accounting for over 85 million people. This contrasts with the 1.4 million Americans with inflammatory bowel disease, or the 500,000 patients that require ERCP each year, conditions for which fellows commonly seek additional years of training. Unfortunately, although nutrition is briefly covered in most gastroenterology fellowship programs, little time is devoted to obesity or the complications of bariatric surgery.
Obesity has been formally recognized as a disease by the American Medical Association and was recently the focus of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases. Obesity is now considered the fifth leading risk for global deaths and is causally related to diabetes, ischemic heart disease, esophageal reflux, liver disease, and certain orthopedic and cancer burdens. Nevertheless, less than 2% of obese patients seek surgical treatment for a variety of reasons, including fear of complications.
Several less invasive endoscopic devices are available for the treatment of obesity, outside of the US. These devices include a variety of balloons, gastric remodeling platforms, endoluminal sleeves, and anastomotic devices. These devices focus on different mechanisms of action and offer a range of therapeutic benefits. The Food and Drug Administration has recently taken the position that risk-benefit ratio is an important concept in the treatment of obesity, allowing therapies with different risk profiles distinct therapeutic goals. As a result, many of these technologies are now being investigated in formal U.S. clinical trials.
Endoscopy currently offers solutions to many patients with complications of bariatric surgery. Additionally, there are several endoscopic devices that show promise and may be of help to this struggling patient population. This lecture focuses on these newer technologies and the current state of U.S. clinical trials.
Dr. Christopher C. Thompson, FASGE, FACG, is director of therapeutic endoscopy at Brigham and Women’s Hospital, and associate professor of medicine, Harvard Medical School, Boston. His comments were made during the ASGE and AGA joint Presidential Plenary at the annual Digestive Disease Week.