Abstract

Obesity, a multifactorial chronic disease, requires a multimodal and individualized approach. Although Metabolic and Bariatric Surgery (MBS) is effective in the treatment of obesity because of its effectiveness and safety in the short and long term, MBS is not suitable for Some patients who are at high surgical risk or refuse surgical treatment and generally not the primary treatment option for patients with class I/II obesity. Lifestyle modifications, incretin-based pharmacotherapy, or endoscopic interventions alone may not sufficiently overcome this gap. Recently, combining lifestyle modifications, incretin-based pharmacotherapy, and endoscopic interventions has emerged as a promising cocktail strategy. This review presents the rationale, supporting evidence, and possible synergistic benefits of this integrative approach, with emphasis on weight reduction, metabolic improvement, and safety considerations.

Keywords:Obesity; Incretin; GLP-1; ESG; Lifestyle modification; Combination therapy

Abbreviations: GLP-1: Glucagon-Like Peptide-1; GIP: Gastric Inhibitory Polypeptide; ESG: Endoscopic Sleeve Gastroplasty; T2D: Type 2 Diabetes; BMI: Body Mass Index