Globesity: the silent pandemic of the 21st century. Multidisciplinary and new incisionless endoscopic technique may be an effective solution for adult patients.

pharmafile | March 3, 2023 | News story | Business Services  

London, 03/03/2023– Ahmed is 45 years old and weighed 120 kg. He was always very tired, and would even fall asleep while working.  He suffered severe sleep apnoea.  He was stressed and bloated.  His blood pressure was dangerously high, and he was diagnosed with type 2 diabetes. Today, 2 weeks after his Endoscopic Sleeve Gastroplasty (ESG) procedure, he has lost 13 kg.

“I can’t believe the difference just losing that much in two weeks has made to my health,” said Ahmed. “My life has totally changed: I am sleeping better, my blood sugar and blood pressure have gone down. I have less pain. I honestly feel like I was 18 years old again: full of energy, I can fit into my old clothes again and I am still losing weight”.

Stories like Ahmed’s are told among the millions of people suffering from obesity and severe obesity (defined as BMI>35 with a comorbidity or BMI>40, respectively).  According to the World Health Organization (WHO), obesity is much more than a pandemic. This a disease that has been plaguing the planet for over forty years and shows no signs of decreasing. In Europe, it affects 59% of the adult population and is associated with 1.2 million deaths/year1.  The situation in the United Kingdom is similar; 66% of adults present with overweight or obesity, with a clear male prevalence1.

 “We are seeing a massive increase in the number of people living with obesity. We need better access to a range of treatment options. There needs to be education about the bias and stigma that people living with obesity face.” – said Ken Clare Director of Bariatric and Metabolic Surgery Services, Obesity UK.

Obesity is not the result of poor management of one’s diet and/or incorrect lifestyle.  Rather, it is a chronic, multifactorial condition defined by excessive adiposity.  Obesity is associated with numerous other chronic diseases (e.g. diabetes, heart failure, hypertension). There are also important psychological consequences, such as loss of self-esteem and confidence, self-isolation, stigma and, in severe cases, depression.

Comprehensive patient care, tailored to the needs of the individual, is needed to improve the quality of life of these patients. Treatment consists of body weight reduction, typically under strict medical supervision, and requires the patient’s commitment to a proper diet and regular physical activity. For certain individuals, endoscopic procedures or surgery may be recommended.  Despite the urgency of the obesity pandemic, only about 1% of the patients who are eligible to receive bariatric surgery, actually have surgery.   Patients give reasons such as fear of the surgery and resulting scars, the post-operative process, and costs, as factors that adversely affect their desire to pursue surgery. Endoscopic procedures are often more attractive to patients.  ESG enables patients to feel fuller longer, with less food, and facilitates clinically meaningful weight loss.

 “ESG is a very exciting new, safe and extremely effective way of achieving significant long-term weight loss, which is done without the need for surgery- declared Dr. Devinder Bansi Gastroenterologist at Cromwell Hospital in London –  The stomach is stitched from the inside whilst the patient is totally asleep (under general anaesthetic ) and this reduces its volume by up to 70-80%, thereby creating a feeling of fullness or satiety with much less intake. There are no scars, patients are discharged the following day and return to work very quickly without the need to take long-term dietary supplements”.

The OverStitch™ Endoscopic Suturing System recently received CE Mark under the European Medical Device Regulation, specifically identifying Endoscopic Sleeve Gastroplasty in the intended use statement.  It is the first and only device to be CE Marked for this use.  Clinical trial results from a randomized study comparing ESG to lifestyle modification were published in The Lancet in July 2022.

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