Endoscopic bariatric and metabolic therapies (EBMTs) are minimally invasive endoscopic procedures that have shown to demonstrate significant weight loss in people with obesity. While abundant data support their positive effect on weight loss, there remains a notable dearth of information regarding their effects on metabolic dysfunction-associated steatotic liver disease (MASLD). As rates of type 2 diabetes and obesity have grown worldwide, so has the rate of MASLD. Therefore, addressing these knowledge gaps is crucial in improving liver health worldwide. In this review, we aim to provide the existing evidence delineating the effects of primary and secondary endoscopic bariatric therapies on MASLD and determine knowledge gaps requiring future study. Utilizing PubMed search with relevant keywords such as "endoscopic bariatric therapies," "NAFLD" (nonalcoholic fatty liver disease), "MAFLD" (metabolic dysfunction-associated fatty liver disease), "MASLD" (metabolic dysfunction-associated steatotic liver disease), we gathered case reports, reviews, and retrospective analyses, evaluating their data and limitations. In our manuscript, we detail many primary and secondary endoscopic therapies and the literature available exploring their impact on liver health. This review demonstrates that primary EBMTs improve noninvasive liver markers, weight loss, and overall metabolic syndrome suggesting significant benefit in MASLD. There is, however, a significant lack of literature studying how primary endoscopic therapies compare amongst each other and how revisional therapies affect MASLD. We additionally offer suggestions for future research to deepen our understanding of EBMTs and their effects on MASLD.

Marginal ulcers (MUs) encompass a group of mucosal disruptions and subsequent inflammatory changes and their sequala found after Roux-en-Y gastric bypass (RYGB) oneanastomosis gastric bypass (OAGB), and, less commonly, after biliopancreatic diversion with duodenal switch (BPD/DS) or single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S). Prevalence of MU after RYGB ranges from .6%-16%. This review summarizes the current knowledge about the treatment options available for MU after MBS for providers who treat them.

Obstructive sleep apnea (OSA) is highly prevalent in patients with morbid obesity, prompting interest in bariatric surgery as a potential management strategy. Sleeve gastrectomy (SG), being the primary bariatric surgical option, offers simplicity, reduced postoperative complications, and favorable outcomes for obesity and its associated conditions.

Metabolic bariatric surgery (MBS) remains the optimal treatment for patients with severe obesity. However, concern is growing about the risk of suicide after MBS.

Bariatric surgeries are related to reduced food tolerance (FT), which may impact on nutritional status and weight loss treatment. The present study was conducted to compare the effects of gastric banding (GB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) on FT. A literature search was performed using Scopus, PubMed, Web of Science, and Google Scholar to find relevant studies published up to August 2023. The primary outcome was the postoperative overall FT score assessed by the Quality of Alimentation questionnaire. Overall, 27 studies containing 4366 adults were included in the review: 15 cohort studies, 5 interventional studies, and 7 cross-sectional studies. The quality of articles ranged between low and high. Thirteen studies evaluated the effect of SG on FT; however, 4 studies reported FT following RYGB. The postsurgery FT of GB patients was examined in 1 study. The mixture of bariatric techniques was evaluated in 9 papers. Selected studies assessed FT from 1 month to 5 years following obesity surgery. Taken together, GB patients showed the lowest level of FT. Although SG and RYGB patients had no difference in FT, RYGB ones had better tolerance to protein-rich foods such as red meat, white meat, and fish. Both SG and RYGB individuals tolerated vegetables and fish more than other food groups and could least tolerate red meat and grains. After the first postoperative year, a good level of FT was found among SG and RYGB patients.

Besides its benefits for weight loss, current findings suggest that bariatric surgery can induce remission of hypertension. Limited data report the effect of bariatric surgery on this obesity-associated comorbidity.

Whether preoperative exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) remains unclear.

More than 80% of patients seeking metabolic and bariatric surgery (MBS) report disturbance in sleep function. No studies have assessed the psychometric properties of sleep measures in MBS samples.

Early reoperation after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) is a severe adverse event that may increase the risk of perioperative mortality if there is a delay in care. However, it is unclear what proportion of reoperations occur within 24 hours of surgery and who is at greater risk, which may impact the safety of performing safe same-day surgery.

Symptoms of reflux after sleeve gastrectomy (SG) are common and may be refractory to medical treatment.

Metabolic and bariatric surgery is a safe and effective treatment strategy for severe childhood obesity, affecting 10% of US adolescents.

Marginal ulcers (MU) are a significant postoperative complication following anastomotic metabolic and bariatric surgeries including Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB), and biliopancreatic diversion with duodenal switch (BPD/DS). This review summarizes current knowledge on MU risk factors, screening, and prophylactic strategies.

Glucagon-like-peptide-1 receptor agonists (G1RA) have gained popularity as a treatment for weight loss in patients who are overweight or obese, but their utilization patterns and impact on candidates for metabolic and bariatric surgery (MBS) remain understudied.

Previous studies comparing one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) are often limited by retrospective designs, or in randomized controlled trials, by small sample sizes or limited follow-up durations.

Bariatric surgery has profound effects on weight loss, metabolic regulation, and gut hormone modulation, which make it an efficient tool for managing obesity and improving diabetes outcomes.