Episode 191 - Endobariatrics with Dr Matthew Peverelle
In the preceding episode with Dr Peverelle, we reviewed pharmacologic approaches to obesity management. In this episode, we review an alternative approach to bariatric surgery referred to as Endobariatrics. These are endoscopic interventions sitting between lifestyle-pharmacotherapy and bariatric surgery and are suited for patients with BMI’s between 30-40 kg/m2 who don’t want surgery or are not surgical candidates.
The main interventions include:
Intragastric balloons, which are temporary devices associated with 10-15% weight loss.
Endoscopic sleeve gastroplasty, reducing gastric volume with 15-20% efficacy and currently the preferred Endo Bariatrics technique.
Duodenal mucosal resurfacing and duodenal-jejunal bypass liners.
To discuss these options with us in more detail, please welcome back Dr Matthew Peverelle. Matthew is a gastroenterologist who completed his advanced training in gastroenterology at Monash Health and Austin Health, including the Victorian Liver Transplant Unit. Matthew went on to complete a hepatology fellowship at the prestigious Kings College Hospital in London and has developed a strong interest in both hepatology, luminal gastroenterology and Endo Bariatrics. Thank you for joining us as he brings his expertise to the podcast.
References:
Endoscopic Weight Loss Options, Danse & Jirapinyo. Endocrinol Metab Clin N Am 54 (2025) 149-162: https://pubmed.ncbi.nlm.nih.gov/39919871/
Endoscopic Bariatrics: Current Therapies and Future Directions. Reja et al. Transl Gastroenterol Hepatol. 2022 Apr 25; 7: 21. pmc.ncbi.nih.gov
Outcomes of Endoscopic Sleeve Gastroplasty: A Systematic Review. Vargas et al. Medicina. 2025 Oct 11; 61(10): 1821 https://www.mdpi.com/1648-9144/61/10/1821