The different types of bariatric surgery (gastric bypass, gastric sleeve…) are the only therapies with proven results and are suitable in the treatment of morbid obesity. But they have a significant degree of morbidity, death and alteration of the quality of life, and they are not exempt from the possibility of recovering the lost weight.

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The endoscopy techniques nowadays cannot compete with the results obtained by bariatric surgery when reducing the weight of morbid obesity cases, but they do represent a solution or treatment in the other obesity cases, as well as assistance in the morbid cases.

The endoscopy treatment of obesity is indicated in 4 cases:

1. As primary treatment, reducing the EWL (Excess Weight Loss) more than 25% with a low index of complications.

2. As early treatment to avoid reaching morbid obesity.

3. As a preventive measure to then have surgery in order to limit the risks (not only bariatric surgery, but any surgery)

4. As treatment of metabolic disorder. In the last three cases the endoscopy technique should reduce more than 5% of the EWL (Excess Weight Loss), it is very safe and does not change the anatomy in case bariatric surgery is to be performed later on.

The endoscopy treatments to treat obesity are not only recommendable considering weight and contraindications but they also make the patients adopt the necessary changes in the eating habits in order to maintain weight loss.

It is important to select the patients (they should be motivated and ready to follow a diet and change their eating habits and lifestyle) and the medical team (professional, expert in endoscopy treatments, multidisciplinary) so the techniques included in the Bariatric Endoscopy concept, that is to say, Intragastric Balloon, P.O.S.E. procedure, Endobarrier, Aspire Assist) achieve good results.

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