Obesity: An Overview for the Interventional Radiologist

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.

Publikationsverlauf

Artikel online veröffentlicht:
10. Juli 2024

• References

• 1 DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med 2007; 356 (21) 2176-2183
• 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
• 3 Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med 2017; 5 (07) 161
• 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
• 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
• 6 Harris E. US obesity prevalence surged over the past decade. JAMA 2023; 330 (16) 1515-1515
• 7 Wing RR. The challenge of defining the optimal lifestyle weight loss intervention for real-world settings. JAMA 2022; 328 (22) 2213-2214
• 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
• 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
• 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
• 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
• 12 Butryn ML, Webb V, Wadden TA. Behavioral treatment of obesity. Psychiatr Clin North Am 2011; 34 (04) 841-859
• 13 Wadden TA, Tronieri JS, Butryn ML. Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol 2020; 75 (02) 235-251
• 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
• 15 Buchwald H, Avidor Y, Braunwald E. et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292 (14) 1724-1737
• 16 Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroenterology 2007; 132 (06) 2226-2238
• 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
• 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
• 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
• 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
• 21 Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ 2014; 349: g3961
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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