Download PDF
Semin intervent Radiol 2024; 41(02): 233-238
DOI: 10.1055/s-0044-1786709
Trainee Corner

Obesity: An Overview for the Interventional Radiologist

Sean Lee
1   Touro College of Osteopathic Medicine, New York City, New York
,
Abheek Ghosh
2   University of Maryland School of Medicine, Baltimore, Maryland
,
Ashley Lamba
3   Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
,
Christina Lim
4   Creighton University School of Medicine, Omaha, Nebraska
,
Shamar Young
5   Division of Interventional Radiology, Department of Medical Imaging, University of Arizona, Tucson, Arizona
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Obesity has become a global epidemic, affecting millions of people worldwide. It is a multifactorial condition characterized by excessive body fat accumulation, which can have serious health consequences. Obesity is associated with an increased susceptibility to hypertension, diabetes, hyperlipidemia, sleep apnea, coronary heart disease, and stroke.[1] The well-established link between obesity and adverse cardiometabolic effects necessitates a comprehensive approach to management.[2] As a result, individuals with obesity have an increased risk of both morbidity and mortality.[2] [3] While lifestyle modifications stand as the primary strategy for addressing obesity, they frequently fall short in achieving weight loss objectives.[4] This article will offer insight into the epidemiology of obesity, review current treatment standards, and detail the mechanisms, efficacy, and safety profiles of innovative interventional techniques.



Publication History

Article published online:
10 July 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med 2007; 356 (21) 2176-2183
    CrossrefPubMedGoogle Scholar
  • 2 Montan PD, Sourlas A, Olivero J, Silverio D, Guzman E, Kosmas CE. Pharmacologic therapy of obesity: mechanisms of action and cardiometabolic effects. Ann Transl Med 2019; 7 (16) 393
    CrossrefPubMedGoogle Scholar
  • 3 Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med 2017; 5 (07) 161
    CrossrefPubMedGoogle Scholar
  • 4 Wadden TA, Webb VL, Moran CH, Bailer BA. Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy. Circulation 2012; 125 (09) 1157-1170
    CrossrefPubMedGoogle Scholar
  • 5 DeJesus RS, Croghan IT, Jacobson DJ, Fan C, St Sauver J. Incidence of obesity at 1 and 3 years among community dwelling adults: a population-based study. J Prim Care Community Health 2022; 13: 21 501319211068632
    CrossrefPubMedGoogle Scholar
  • 6 Harris E. US obesity prevalence surged over the past decade. JAMA 2023; 330 (16) 1515-1515
    CrossrefPubMedGoogle Scholar
  • 7 Wing RR. The challenge of defining the optimal lifestyle weight loss intervention for real-world settings. JAMA 2022; 328 (22) 2213-2214
    CrossrefPubMedGoogle Scholar
  • 8 Hoerster KD, Hunter-Merrill R, Nguyen T. et al. Effect of a remotely delivered self-directed behavioral intervention on body weight and physical health status among adults with obesity: the D-ELITE randomized clinical trial. JAMA 2022; 328 (22) 2230-2241
    CrossrefPubMedGoogle Scholar
  • 9 Yuan F, Latif MA, Shafaat O. et al. Interventional radiology obesity therapeutics: proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel. J Vasc Interv Radiol 2021; 32 (09) 1388.e1-1388.e14
    CrossrefPubMedGoogle Scholar
  • 10 Ward ZJ, Bleich SN, Cradock AL. et al. Projected U.S. state-level prevalence of adult obesity and severe obesity. N Engl J Med 2019; 381 (25) 2440-2450
    CrossrefPubMedGoogle Scholar
  • 11 Mokdad AH, Ford ES, Bowman BA. et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289 (01) 76-79
    CrossrefPubMedGoogle Scholar
  • 12 Butryn ML, Webb V, Wadden TA. Behavioral treatment of obesity. Psychiatr Clin North Am 2011; 34 (04) 841-859
    CrossrefPubMedGoogle Scholar
  • 13 Wadden TA, Tronieri JS, Butryn ML. Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol 2020; 75 (02) 235-251
    CrossrefPubMedGoogle Scholar
  • 14 Jensen MD, Ryan DH, Apovian CM. et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Society. American college of cardiology/American heart association task force on practice guidelines; obesity society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American college of cardiology/American heart association task force on practice guidelines and the obesity society. Circulation 2014; 129 (25, Suppl 2): S102-S138
    CrossrefPubMedGoogle Scholar
  • 15 Buchwald H, Avidor Y, Braunwald E. et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292 (14) 1724-1737
    CrossrefPubMedGoogle Scholar
  • 16 Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroenterology 2007; 132 (06) 2226-2238
    CrossrefPubMedGoogle Scholar
  • 17 Rössner S, Sjöström L, Noack R, Meinders AE, Noseda G. European Orlistat Obesity Study Group. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. Obes Res 2000; 8 (01) 49-61
    CrossrefPubMedGoogle Scholar
  • 18 Mok J, Adeleke MO, Brown A. et al. Safety and efficacy of Liraglutide, 3.0 mg, once daily vs placebo in patients with poor weight loss following metabolic surgery: the BARI-OPTIMISE randomized clinical trial. JAMA Surg 2023; 158 (10) 1003-1011
    CrossrefPubMedGoogle Scholar
  • 19 Frühbeck G, Diez-Caballero A, Gil MJ. et al. The decrease in plasma ghrelin concentrations following bariatric surgery depends on the functional integrity of the fundus. Obes Surg 2004; 14 (05) 606-612
    CrossrefPubMedGoogle Scholar
  • 20 Kauppila JH, Markar S, Santoni G, Holmberg D, Lagergren J. Temporal changes in obesity-related medication after bariatric surgery vs no surgery for obesity. JAMA Surg 2023; 158 (08) 817-823
    CrossrefPubMedGoogle Scholar
  • 21 Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ 2014; 349: g3961
    CrossrefPubMedGoogle Scholar
  • 22 Madsbad S, Dirksen C, Holst JJ. Mechanisms of changes in glucose metabolism and bodyweight after bariatric surgery. Lancet Diabetes Endocrinol 2014; 2 (02) 152-164
    CrossrefPubMedGoogle Scholar
  • 23 Weiss CR, Gunn AJ, Kim CY, Paxton BE, Kraitchman DL, Arepally A. Bariatric embolization of the gastric arteries for the treatment of obesity. J Vasc Interv Radiol 2015; 26 (05) 613-624
    CrossrefPubMedGoogle Scholar
  • 24 Wang Z, Zhu DQ, Zhu XY. et al. Interventional metabology: a review of bariatric arterial embolization and endovascular denervation for treating metabolic disorders. J Diabetes 2023; 15 (08) 665-673
    CrossrefPubMedGoogle Scholar
  • 25 Syed MI, Morar K, Shaikh A. et al. Gastric Artery Embolization Trial for the Lessening of Appetite Nonsurgically (GET LEAN): six-month preliminary data. J Vasc Interv Radiol 2016; 27 (10) 1502-1508
    CrossrefPubMedGoogle Scholar
  • 26 Weiss CR, Abiola GO, Fischman AM. et al. Bariatric Embolization of Arteries for the Treatment of Obesity (BEAT Obesity) trial: results at 1 year. Radiology 2019; 291 (03) 792-800
    CrossrefPubMedGoogle Scholar
  • 27 Biederman DM, Marinelli B, O'Connor PJ. et al. Transradial access for visceral endovascular interventions in morbidly obese patients: safety and feasibility. J Vasc Access 2016; 17 (03) 256-260
    CrossrefPubMedGoogle Scholar
  • 28 Hafezi-Nejad N, Bailey CR, Weiss CR. Bariatric embolization: a narrative review of clinical data from human trials. Tech Vasc Interv Radiol 2020; 23 (01) 100658
    CrossrefPubMedGoogle Scholar
  • 29 Paxton BE, Kim CY, Alley CL. et al. Bariatric embolization for suppression of the hunger hormone ghrelin in a porcine model. Radiology 2013; 266 (02) 471-479
    CrossrefPubMedGoogle Scholar
  • 30 Elens S, Roger T, Elens M. et al. Gastric embolization as treatment for overweight patients; efficacy and safety. Cardiovasc Intervent Radiol 2019; 42 (04) 513-519
    CrossrefPubMedGoogle Scholar
  • 31 Kipshidze N, Archvadze A, Bertog S, Leon MB, Sievert H. Endovascular bariatrics: first in humans study of gastric artery embolization for weight loss. JACC Cardiovasc Interv 2015; 8 (12) 1641-1644
    CrossrefPubMedGoogle Scholar
  • 32 Bai Z-B, Qin YL, Deng G, Zhao GF, Zhong BY, Teng GJ. Bariatric embolization of the left gastric arteries for the treatment of obesity: 9-month data in 5 patients. Obes Surg 2018; 28 (04) 907-915
    CrossrefPubMedGoogle Scholar
  • 33 Pirlet C, Ruzsa Z, Costerousse O. et al. Transradial left gastric artery embolization to treat severe obesity: a pilot study. Catheter Cardiovasc Interv 2019; 93 (03) 365-370
    CrossrefPubMedGoogle Scholar