Quality of bowel preparation for colonoscopy in patients on glucagon-like peptide-1 receptor agonists.

Background And Aims: We aimed to assess the quality of bowel preparation in a matched cohort of patients actively using and not using GLP-1 RAs in a large health system in the United States.

Methods: We performed a retrospective review of adult patients undergoing colonoscopy in 22 endoscopy units across 18 sites in the US.

Results: Our cohort comprised 6235 patients (3344 cases and 2891 controls).

Impact of Leptin-Melanocortin Pathway Genetic Variants on Weight Loss Outcomes After Endoscopic Transoral Outlet Reduction.

Purpose: Variants in the leptin-melanocortin pathway (LMP) are associated with severe obesity. We evaluated weight loss of patients with or without heterozygous LMP variants, with weight recurrence after Roux-en-Y gastric bypass, who underwent endoscopic transoral outlet reduction (TORe).

Materials And Methods: We retrospectively reviewed patients genotyped for an LMP who had undergone TORe, classified as "carriers" or "non-carriers" of genetic variants.

Corrigendum to "Outcomes of concomitant antiobesity medication use with endoscopic sleeve gastroplasty in clinical US settings" [Obes. Pillars, Volume 11, September 2024, 100112].

[This corrects the article DOI: 10.1016/j.obpill.

Precision Medicine in Bariatric Procedures.

Obesity is a multi-factorial disease that is influenced by genetic, epigenetic, and environmental factors. Precision medicine is a practice wherein prevention and treatment strategies take individual variability into account. It involves using a variety of factors including deep phenotyping using clinical, physiologic, and behavioral characteristics, 'omics assays (eg, genomics, epigenomics, transcriptomics, and microbiomics among others), and environmental factors to devise practices that are individualized to subsets of patients.

Novel Devices for Endoscopic Suturing: Past, Present, and Future.

Endoscopic suturing has been described in many applications, including the approximation of tissue defects, anchoring stents, hemostasis, and primary and secondary bariatric interventions. Primary endobariatric procedures use endoscopic suturing for gastric remodeling with the intention of weight loss. Currently, the only commercially available device in the United States is the OverStitch endoscopic suturing system (Apollo Endosurgery).

Outcomes of concomitant antiobesity medication use with endoscopic sleeve gastroplasty in clinical US settings.

Background: To evaluate the weight loss outcomes of the large US cohort of patients undergoing endoscopic sleeve gastroplasty (ESG) with or without concomitant anti-obesity (AOM) use.

Methods: We performed a retrospective analysis of adult patients who underwent ESG from seven different sites, from January 1, 2020 to November 30, 2022. Percent total body weight loss (%TBWL) and %excess weight loss (%EWL) were calculated based on baseline weight at the procedure.

Assessing ChatGPT vs. Standard Medical Resources for Endoscopic Sleeve Gastroplasty Education: A Medical Professional Evaluation Study.

Background And Aims: The Chat Generative Pre-Trained Transformer (ChatGPT) represents a significant advancement in artificial intelligence (AI) chatbot technology. While ChatGPT offers promising capabilities, concerns remain about its reliability and accuracy. This study aims to evaluate ChatGPT's responses to patients' frequently asked questions about Endoscopic Sleeve Gastroplasty (ESG).

Weight loss outcomes with semaglutide based on diabetes severity using the individualized metabolic surgery score.

Background: Semaglutide demonstrated inferior weight loss responses in patients with type 2 diabetes (T2D) compared to patients with obesity without T2D. The individualized metabolic surgery (IMS) score was validated to predict T2D remission after bariatric surgery. The parameters of the IMS are HbA1c (<7%), insulin use, T2D medications and T2D duration.

Applicability of individualized metabolic surgery score for prediction of diabetes remission after endoscopic sleeve gastroplasty.

Background: Endoscopic sleeve gastroplasty (ESG) is a safe and effective obesity treatment. The individualized metabolic score (IMS) is a validated score that uses preoperative variables predicting T2D remission (DR) in bariatric surgery.

Objectives: We evaluated the applicability of using the IMS score to predict DR in patients after ESG.

Gut motility and hormone changes after bariatric procedures.

Purpose Of Review: Metabolic and bariatric surgery (MBS) and endoscopic bariatric therapies (EBT) are being increasingly utilized for the management of obesity. They work through multiple mechanisms, including restriction, malabsorption, and changes in the gastrointestinal hormonal and motility.

Recent Findings: Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) cause decrease in leptin, increase in GLP-1 and PYY, and variable changes in ghrelin (generally thought to decrease).

The association between previous use of anti-obesity medication and semaglutide weight loss outcomes.

Aims: To compare weight loss outcomes between patients starting semaglutide who had previously been on another anti-obesity medication (AOM) compared to those who were AOM-naïve.

Materials And Methods: We performed a retrospective study in patients with overweight or obesity taking semaglutide for weight loss for a duration of 3 to 12 months. Our primary endpoint was assessment of percentage of total body weight loss (TBWL) in patients who started semaglutide as their first AOM (AOM-naïve) compared to those who started semaglutide and had previously taken another AOM (non-AOM-naïve).

Cumulative effect of obesity phenotypes on body weight and body mass index.

Background: Obesity originates from an imbalance between energy intake and expenditure. Changes in energy intake components (satiation, postprandial satiety, emotional eating) and energy expenditure have been linked to obesity and are referred to as obesity phenotypes. We aim to study if these obesity phenotypes have a cumulative effect on body weight and body mass index (BMI).

Practice patterns and outcomes of endoscopic sleeve gastroplasty based on provider specialty.

Endoscopic sleeve gastroplasty (ESG) is performed in clinical practice by gastroenterologists and bariatric surgeons. Given the increasing regulatory approval and global adoption, we aimed to evaluate real-world outcomes in multidisciplinary practices involving bariatric surgeons and gastroenterologists across the United States. We included adult patients with obesity who underwent ESG from January 2013 to August 2022 in seven academic and private centers in the United States.

Weight loss and cardiovascular disease risk outcomes of semaglutide: a one-year multicentered study.

Background/objective: There are limited real-world studies assessing semaglutide weight loss and associated comorbidity and metabolic outcomes over periods ≥ 6 months. We aim to assess weight loss, metabolic, and cardiovascular outcomes of 12 months of semaglutide.

Subject/methods: We conducted a multicentered retrospective cohort study on semaglutide use.

Applicant-Fellow Virtual Sessions in Recruitment for Gastroenterology Fellowship.

Background: Since the COVID-19 pandemic in 2020, virtual interviews have become a norm for gastroenterology (GI) fellowship recruitment. Most interviews hold a session for applicant and current fellow interaction. There is wide variability of the sessions across programs.

Efficacy of Antiobesity Medications in Patients With Celiac Disease on a Gluten-free Diet: A Retrospective Matched Cohort Study.

Goals: We aim to describe the weight loss outcomes of patients with celiac disease (CeD) taking antiobesity medications (AOMs) and compare it with the weight loss outcomes of patients without CeD taking AOMs.

Background: Increasing rates of obesity and obesity-associated comorbidities have been previously reported in patients with CeD on a gluten-free diet. The effectiveness of AOMs in this population has not been previously described.

Correlation Between Gastrojejunal Anastomosis Diameter, Distensibility Index, and Weight Regain After Roux-en-Y Gastric Bypass.

Introduction: Gastrojejunal anastomosis (GJA) dilation is an independent predictor of weight regain (WR) after Roux-en-Y gastric bypass (RYGB). However, the role of planimetric measurements in this context remains unknown.

Methods: This is a retrospective cohort study including adult RYGB patients who underwent a diagnostic endoscopy with Endoflip assessment of the GJA.

Endoscopic Management of Surgical Complications of Bariatric Surgery.

Bariatric surgery, although highly effective, may lead to several surgical complications like ulceration, strictures, leaks, and fistulas. Newer endoscopic tools have emerged as safe and effective therapeutic options for these conditions. This article reviews post-bariatric surgery complications and the role of endoscopy in their management.

Effect of Glucagon-Like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy.

Introduction: Inadequate bowel preparation can result in decreased diagnostic accuracy and therapeutic safety of colonoscopy for colon cancer screening. The Boston Bowel Preparation Scale (BBPS) has been used to assess the quality of bowel preparation. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are commonly used medications for diabetes mellitus and obesity that are known to delay gastrointestinal motility.

Implementation and Evaluation of a Curriculum for Ergonomics Training During GI Fellowship.

Background And Aims: Training in ergonomics is either fragmented or lacking in most GI programs. There are limited real-world data on fellows' perceptions and change in practice after the delivery of a curriculum for ergonomics. We aim to implement a curriculum for endoscopy for our GI fellows and evaluate their response to the same.

Type 2 Diabetes Remission in Patients with Heterozygous Variants in the Leptin-Melanocortin Pathway after Roux-en-Y Gastric Bypass: A Matched Case-Control Study.

Background: Roux-en-Y gastric bypass (RYGB) is associated with a high rate of type 2 diabetes (T2D) remission. Carriers of heterozygous variants in the leptin-melanocortin pathway (LMP) are more likely to experience weight recurrence after RYGB. Our aim was to investigate if carrier status and associated weight regain affects the rate of T2D remission after RYGB.

Demographic Disparities in Recruitment for Clinical Trials Focused on Endoscopic Bariatric Therapies.

Background And Aims: Studies have shown that there are multiple disparities in the recruitment for clinical trials across medical specialties, which makes it challenging to translate research findings to the real world. We performed a systematic review of RCTs focused on EBTs and examined the sex, racial, and ethnic background and age of participants.

Methods: A systematic search of trials pertaining to EBTs was performed.

Performance of Endoscopic Sleeve Gastroplasty by Obesity Class in the United States Clinical Setting.

Introduction: Endoscopic sleeve gastroplasty (ESG) has gained popularity over the past decade and has been adopted in both academic and private institutions globally. We present outcomes of the largest cohort of patients from the United States undergoing ESG and evaluate these according to obesity class.

Methods: We performed a retrospective analysis of adult patients who underwent ESG.