Obesity affects over 650 million adults globally, yet laparoscopic bariatric surgery, despite 60%-80% excess weight loss and <1% adoption, remains underutilized. Endobariatric therapies, including endoscopic sleeve gastroplasty (ESG), intragastric balloons, and transoral outlet reduction (TORe), expand treatment options, offering minimally invasive alternatives for patients averse to surgery’s risks or permanence. ESG achieves 15% to 20% total body weight loss (TBWL), TORe 8% to 12%, with adverse events below 2%. These tools salvage high-risk cases, revise weight regain, and manage complications, synergizing with GLP-1 agonists for enhanced outcomes (e.g. ESG plus GLP-1: 20.5% TBWL). Integration demands endoscopic expertise, amplifying bariatric practice reach and efficacy.
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