What is metabolic endoscopy?

Written by: Dr Jude A. Oben
Edited by: Carlota Pano

Metabolic endoscopy is an innovate procedure in weight management that delves into the physiological processes that influence weight gain, retention, and loss.


Here, Dr Jude Oben, renowned consultant hepatologist, offers his expert insight into metabolic endoscopy and its role in long-term weight management.



What exactly is metabolic endoscopy?


Metabolic endoscopy, essentially, is a way of helping patients to reduce their weight. Presently, there are two procedures that can help patients downsize (lose weight).


  • Intra-gastric balloon


We insert a silicone balloon into the patient’s stomach, and fill it with saline and methylene blue. This balloon stays in for about six months or a year, helping the patient downsize.


In addition to inserting the balloon, we also help the patient to change the way they eat and their relationship with food. This is a fantastic modality and, last week, I had an email from one of my patients telling me that his liver function tests and his cholesterol levels were the lowest they had been in 10 years. He was completely overjoyed and of course so was I, because I was delighted that he had listened to us.


  • Endoscopic sleeve gastroplasty (ESG)


ESG is similar to a surgical sleeve gastrectomy, but it is performed endoscopically. We suture together part of the stomach, which reduces the volume of the stomach and helps the patient downsize. As a result, the patient’s propensity for metabolic syndrome and non-alcoholic fatty liver disease reduces, and liver function tests reduce as well.


Not all patients wish to have bariatric surgery, and this is why it’s important to be able to offer the possibility of metabolic endoscopy.


What is metabolic endoscopy generally used to detect?


Metabolic endoscopy is used to help the patient downsize.


However, it’s important to know that if we don’t change the patient’s relationship with food and the patient’s way of eating, then metabolic endoscopy will only be effective for a short period.


How effective is metabolic endoscopy? Is it safe?


If you want a patient’s liver to regenerate itself and lose any type of inflammation, then that patient needs to lose about 10 per cent of their weight. Metabolic endoscopy is effective because it does help patients to lose that figure of 10 per cent and more.


Consequently, metabolic endoscopy is effective not only in terms of helping to downsize, but also in terms of reducing the level of liver inflammation which has occurred as a result of being overweight.


Who is the ideal candidate?


The ideal candidate for metabolic endoscopy would have to be a patient who has obesity and who has a body mass index (BMI) greater than 30.



If you would like to schedule an appointment with Dr Jude Oben, head on over to his Top Doctors profile today.

By Dr Jude A. Oben
Hepatology (liver specialist)

Dr Jude Oben is a leading consultant hepatologist based in London who holds additional consultant appointments in gastroenterology. His areas of hepatology expertise include autoimmune liver disease, primary biliary cholangitis, primary sclerosis cholangitis, hepatocellular cancer, obesity, non-alcoholic fatty liver disease (NAFLD), abnormal liver function test and endoscopy and metabolic endoscopy (Intra-gastric balloon) for weight loss.

Dr Oben has a PhD in Pharmacology from University College London. He studied Medicine at Oxford with a period at Stanford University, Palo Alto, USA, as a research fellow in Immunology. After Oxford, his initial Postgraduate Medical training was at the Hammersmith Hospital, Imperial College London, followed by training in Ophthalmology (Eye Surgery) which he left for Hepatology (Liver Medicine). During his specialist medical registrar training, he re-oriented his research career with two years as a postdoctoral fellow at John Hopkins University, USA.

At Johns Hopkins, Dr Oben combined his previous interest in neuroscience with liver medicine, with a particular focus on obesity-related liver disease (NAFLD). After his time at John Hopkins, he was awarded a Wellcome Trust Fellowship in London to start independent research at University College London. He is currently an Associate Professor in Hepatology at University College London, Institute for Liver and Digestive Health, Royal Free Hospital, London.

Dr Oben is a co-founder and Trustee of the Obesity Action launched at the House of Lords. The primary aim of Obesity Action is to raise political and public awareness of obesity and it’s health consequences. He is an invited member of the All-Party Parliamentary Group on Obesity.

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