Obesity is a major public health concern that leads to numerous metabolic, mechanical and psychological complications. Although lifestyle interventions are the cornerstone of obesity management, subsequent physiological neurohormonal adaptations limit weight loss, strongly favour weight regain and counteract sustained weight loss. A range of effective therapies are therefore needed to manage this chronic relapsing disease. Bariatric surgery delivers substantial, durable weight loss but limited access to care, perceived high risks and costs restrict uptake. Medical devices are uniquely positioned to bridge the gap between more conservative lifestyle intervention and weight-loss pharmacotherapy and more disruptive bariatric surgery. In this Review, we examine the range of gastrointestinal medical devices that are available in clinical practice to treat obesity, as well as those that are in advanced stages of development. We focus on the mechanisms of action as well as the efficacy and safety profiles of these devices. Many of these devices are placed endoscopically, which provides gastroenterologists with exciting opportunities for treatment.

肥胖是主要的公共健康问题，导致许多新陈代谢，机械和心理并发症。尽管生活方式干预是肥胖管理的基石，但随后的生理神经激素适应限制了体重减轻，强烈支持体重恢复并抵消了持续的体重减轻。因此，需要一系列有效的疗法来控制这种慢性复发性疾病。减肥手术可带来持久的减肥效果，但是获得护理的机会有限，人们认为高风险和高成本限制了摄取。医疗设备的独特定位是弥合更加保守的生活方式干预与减肥药物治疗和更具破坏性的减肥手术之间的鸿沟。在这篇评论中，我们研究了临床上可用于治疗肥胖症的胃肠道医疗器械的范围，以及处于发展中的晚期阶段的胃肠道医疗器械的范围。我们专注于这些设备的作用机理以及功效和安全性概况。这些设备中有许多是通过内窥镜放置的，这为肠胃科医生提供了令人兴奋的治疗机会。