ASGE Obesity Policy Statement

Obesity stands as a formidable public health challenge with far-reaching implications, necessitating urgent attention and comprehensive action. By 2030, it is estimated that half of U.S. adults will have obesity. As a leading authority in gastrointestinal health, the American Society of Gastrointestinal Endoscopy (ASGE) recognizes the profound impact of obesity on both individual well-being and the health care system. 

In 2013, the American Medical Association recognized obesity as a disease state with
multiple pathophysiological aspects requiring a range of interventions for treatment and
prevention. Obesity not only contributes to a spectrum of gastrointestinal disorders, but it also exacerbates the burden of chronic diseases, including diabetes, cardiovascular disease, and certain cancers. The prevalence of multiple gastrointestinal and hepatic diseases escalates significantly with obesity including but not limited to metabolic dysfunction-associated steatotic liver disease (MASLD), gastroesophageal reflux disease (GERD), gallstone disease, gastrointestinal cancers, pancreatitis and Barrett’s esophagus. This underscores the interconnectedness between obesity treatment management and optimal gastrointestinal health.

The ASGE supports a multi-pronged approach to combat obesity. This entails implementing evidence-based interventions spanning prevention, diagnosis, and treatment. It is important to integrate all available obesity treatment options for optimal patient care. The ASGE supports a full range of treatments and interventions to treat obesity, which include lifestyle modification, anti-obesity medications, endoscopic metabolic and bariatric therapy, and bariatric surgery. We must also ensure that healthcare professionals are educated and trained in the proper use of these interventions, to provide patients with the best possible care.

The ASGE supports the use of endoscopic bariatric and metabolic therapies (EBMT) in clinical practice and recognizes that these therapies are not well known to patients or physicians. These are endoscopic, minimally invasive procedures such as intragastric devices and gastric remodeling procedures, and small bowel therapies. These procedures aid in weight loss and have a weight-loss dependent effect on improving obesity-related diseases. Therapies targeting the small bowel may improve glycemic control and obesity related metabolic disease independent of weight loss but are not yet approved for use in the US. EBMTs are an integral component across the spectrum of obesity treatments, and provide patients a treatment option that does not require lifelong medication use or surgery. ASGE also advocates for patients to have access to and coverage of EBMT procedures. 

In alignment with our commitment to enhancing patient care, ASGE pledges to collaborate with health care organizations, insurance companies and government entities to address the obesity crisis. We advocate for research into endoscopic approaches to obesity management, aiming to optimize patient outcomes.