Agrawal A, Cadillo Arbaiza A, Blanco Montecino R, Almandoz JP, Messiah SE, Mathew M, Tavakkoli A. Quality of life, dumping symptoms, and weight bias internalization after endoscopic bariatric revisional therapies. World J Gastrointest Endosc 2025; 17(12): 113467 [DOI: 10.4253/wjge.v17.i12.113467]
Corresponding Author of This Article
Anna Tavakkoli, Associate Professor, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6011 Harry Hines Boulevard, Suite V8.106A, Dallas, TX 75390, United States. anna.tavakkoli@utsouthwestern.edu
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Gastroenterology & Hepatology
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Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 16, 2025 (publication date) through Dec 19, 2025
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World Journal of Gastrointestinal Endoscopy
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1948-5190
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Agrawal A, Cadillo Arbaiza A, Blanco Montecino R, Almandoz JP, Messiah SE, Mathew M, Tavakkoli A. Quality of life, dumping symptoms, and weight bias internalization after endoscopic bariatric revisional therapies. World J Gastrointest Endosc 2025; 17(12): 113467 [DOI: 10.4253/wjge.v17.i12.113467]
World J Gastrointest Endosc. Dec 16, 2025; 17(12): 113467 Published online Dec 16, 2025. doi: 10.4253/wjge.v17.i12.113467
Quality of life, dumping symptoms, and weight bias internalization after endoscopic bariatric revisional therapies
Amulya Agrawal, Alvaro Cadillo Arbaiza, Ronald Blanco Montecino, Jaime P Almandoz, Sarah E Messiah, Matthew Mathew, Anna Tavakkoli
Amulya Agrawal, Department of Internal Medicine, Emory University, Atlanta, GA 30322, United States
Alvaro Cadillo Arbaiza, Jaime P Almandoz, Anna Tavakkoli, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
Ronald Blanco Montecino, Department of Medicine, St. Barnabas Hospital, Bronx, NY 10457, United States
Sarah E Messiah, Matthew Mathew, Department of Epidemiology, Peter O’Donnell Jr. School of Public Health, Dallas, TX 75390, United States
Author contributions: Agrawal A and Tavakkoli A designed research study, performed the research and statistical analyses; Cadillo Arbaiza A and Blanco Montecino R contributed to data abstraction; Cadillo Arbaiza A, Blanco Montecino R, Almandoz JP, Messiah SE, and Mathew M contributed to critical review and revision of the manuscript. All authors approved the final version to publish.
Institutional review board statement: This study is approved by the Institutional Review Board of University of Texas Southwestern Medical Center.
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The raw data supporting the conclusions of this article cannot be made publicly available due to privacy and confidentiality restrictions under the Health Insurance Portability and Accountability Act and institutional review board requirements for the protection of human subjects. The dataset contains protected health information that could potentially identify individual participants, even with standard de-identification procedures. However, in the interest of research transparency and reproducibility, all statistical analysis code used in this study is available upon reasonable request to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Tavakkoli, Associate Professor, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6011 Harry Hines Boulevard, Suite V8.106A, Dallas, TX 75390, United States. anna.tavakkoli@utsouthwestern.edu
Received: August 26, 2025 Revised: September 2, 2025 Accepted: October 15, 2025 Published online: December 16, 2025 Processing time: 112 Days and 6.9 Hours
Abstract
BACKGROUND
Endoscopic bariatric therapies (EBT) have been developed as an adjunctive therapy to treat persistent obesity and recurrent weight gain and dumping symptoms after metabolic and bariatric surgery (MBS). While the efficacy of revisional EBTs has been documented, no studies to date have examined how these procedures impact quality of life (QOL) and internalized weight bias (IWB).
AIM
To understand how endoscopic revisional therapies impact QOL, IWB, and dumping syndrome.
METHODS
Analysis included 19 participants treated for post-MBS recurrent weight gain and/or dumping syndrome. The short-form 36 survey, weight bias internalization scale, and the Sigstad scoring system were used to measure QOL, IWB, and dumping syndrome pre- and ≥ 4 weeks post-EBT.
RESULTS
At 6-months, total body weight loss was 8.6% ± 7.15% (n = 16), at 12-months was 13.4% ± 7.46% (n = 16). Short-form 36 scores for all 8 scales significantly increased from pre- to post-procedure with the greatest improvement in the scales related to emotional (mean improvement = 59.6, P < 0.05) and physical health (mean improvement = 31.1, P < 0.05). Both total Sigstad score (mean difference = 4.947, P < 0.05) and total weight bias internalization score (mean difference = 0.761, P < 0.05) significantly decreased from pre- to post-procedure.
CONCLUSION
Findings suggest that revisional EBT may improve post-MBS QOL across a broad spectrum of outcomes beyond optimizing body weight. As early EBT results indicate positive mental and physical health outcomes, further research is needed to evaluate the relationship between these improvements, body weight and interdisciplinary post-MBS care.
Core Tip: Endoscopic bariatric therapies are an important adjunctive therapy for weight recurrence and dumping symptoms after metabolic and bariatric surgery. Our study aimed to understand how endoscopic bariatric therapies impact quality of life, weight bias internalization scores, and dumping symptoms as measured by the Sigstad scale. We found that quality of life improved across all scales that were measured, with the greatest improvement in emotional and physical healthy. There was also improvement in weight bias internalization scores and dumping symptoms. Patients also experience sustained weight-loss over the study period.
