CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(09): E1185-E1193
DOI: 10.1055/a-1198-4598
Review

Building an endobariatric program: lessons learned

Dilhana Badurdeen
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Abdellah Hedjoudje
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
2   Hôpital Beaujon – Département d'endoscopie digestive, Clichy, France
,
Mohamad Itani
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Lea Fayad
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Jad Farha
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Margo Dunlap
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Lawrence Cheskin
3   Johns Hopkins University Bloomberg School of Public Health – Weight Management Center, Baltimore, Maryland, United States
,
Michael Schweitzer
4   Johns Hopkins Medicine – Department of Surgery, Baltimore, Maryland, United States
,
Kristen Koller
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Christian Hartman
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Andreas Oberbach
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Mouen A. Kashab
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Anthony Kalloo
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
,
Vivek Kumbhari
1   Johns Hopkins Medical Institutions – Division of Gastroenterology and Hepatology, Baltimore, Maryland, United States
› Author Affiliations

Abstract

The emphasis on treating obesity has never been more critical, yet the complexity of delivering care has become more intricate due to new procedures, variable insurance coverage, and inconsistent reimbursement. This is our experience building an endobariatric program and treating overweight and obese patients with endobariatric therapies (EBTs) over 3 years. The primary intention of this manuscript was to educate the reader on how to build an endobariatric program, identify barriers, and provide succinct solutions to establish a successful program. The secondary aim was weight loss outcomes of procedures offered at our institution. We compiled a list of lessons learned, based on the difficulties we experienced to make it easy for others embarking on this journey. Herein, we present a business development strategy to overcome impediments, whilst offering high quality service.

The high cost and lack of insurance coverage are significant barriers. Marketing can be costly and is often a factor that is ignored particularly early on, when finances are limited. However, it is an integral component of growing the program. The percentage total body weight loss (%TBWL) at 6 and 12 months post ESG was 17.8 ± 6.48 and 20.6 ± 8.3 (P < 0.001), respectively. The %TBWL at 6 months post IGB was 14.9 ± 9.8 for the Orbera IGB and 12.6 ± 7.4 for the Reshape IGB. There was a trend of preference for ESG compared to IGB placement over the 3 years.

The key to building a successful endobariatric program is a motivated physician leader, collaborative bariatric surgeons, institutional support, and marketing. Insurance coverage will likely occur in the near future and programs must be prepared to manage the massive influx of patients that will likely request these procedures.



Publication History

Received: 28 February 2020

Accepted: 22 May 2020

Article published online:
31 August 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 
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