In this article we’ll examine the role of endoscopy in weight management and how to provide insights and strategies for working with patients on weight-related health issues. As a seasoned board-certified, family medicine physician, industry thought leader and creator of my own science-driven approach to sustainable weight management (called MELTOFF.Health), I’ve seen firsthand the importance and efficacy of minimally invasive to noninvasive practices that help aid in weight management.
Endoscopy, in regard to weight management, is minimally invasive and one the best diagnostic tools we have to get to the root cause of weight gain (or loss) from a biological standpoint. As readers of this magazine are well aware, endoscopes are used to examine internal systems, organs, obstructions and structures. Endoscopes are also a valuable tool for initial assessment and are also used in treatment procedures for overweight patients who struggle with obesity despite their best weight-loss efforts.
When used holistically with a focus on the mental health and emotional components of the individual patient in addition to the use of medical procedures, weight-loss results improve and sustained management can be achieved.
When used diagnostically, procedures such as colonoscopy or upper gastrointestinal endoscopy are often performed if there is concern that the patient’s weight loss or gain could be caused by a physical condition or disease that can be discovered, assessed and observed internally using the flexible tube, light and camera of the endoscope. This window into the human body provides tremendous insight and better diagnostic ability than ever before, resulting in a much more accurate diagnosis and treatment plan for the patient. Once the diagnosis has been made, the use of this technology continues as a means of treatment for obesity.
When used for gastric bypass or sleeve gastrectomy, an endoscopic procedure (versus an open procedure) has many benefits, the most valuable being a shortened recovery timeline and limiting hospital stays due to the lack of incision. One of the most common weight-loss procedures, endoscopic sleeve gastroplasty (or ESG), is performed less invasively through the mouth.
This treatment uses sutures to minimize the size of the stomach, resulting in a significantly quicker satiated state and decreased ability for food intake, ultimately resulting in weight loss. Unlike gastric sleeve surgery, ESG is much less invasive as it does not remove any part of the stomach.
It is important to understand that weight management, whether the underlying focus is gain or loss, is not limited to just diet, exercise or medical action. More often than not, the root of obesity can be an emotional one that is not often addressed along with lifestyle changes, pharmaceuticals or medical procedures.
Without a broader assessment that takes into consideration the patient’s mental health and lifestyle habits, the results from more extreme medical measures—however less invasive—can prove to be ineffective. Putting into practice mindful and more emotionally aware eating habits on their own can prove beneficial, and when used in combination with guided goals and a health plan from a physician, the results can be much more positive. Body positivity is top of mind currently in society and the media, but it is not so easily achieved. Emotional trauma and conditioning around a negative body image are deeply rooted and enforced by our culture and society.
It is imperative that, as medical professionals who are being sought out by our patients for support of weight management, we acknowledge, address and aid in recognizing and rehabilitating these intertwined beliefs. An endoscopic procedure is absolutely not a simple, quick fix to years of emotional neglect and a deeply ingrained, negative body image.
Though less invasive, endoscopic procedures are not at all without risk, and results will absolutely vary from person to person. Similar risks to traditional surgeries—such as infection, bleeding and a negative reaction to anesthesia—can occur.
Focusing on lifelong well-being and accountability from a holistic viewpoint is often overlooked in lieu of a physical procedure that doesn’t necessarily get to the root of the problem for the diagnosis. Understanding that the physical practices and procedures are equally important as the psychological, mental and emotional health of the patient is a proven, unparalleled approach to success.
The best weight-management program that leads to sustained weight loss is a process best undertaken alongside a medical professional’s guidance and care.
