Understanding Hunger Physiology for Clinical Management of Bariatric Embolization

Introduction: Obesity has become a global epidemic with limited successful medical therapy. Bariatric surgical interventions have demonstrated the best sustained weight loss, but risk of significant morbidities should complications arise. Animal and human models have demonstrated that left gastric artery embolization has similar disruptions to appetite hormones to surgery. While this offers a promising noninvasive therapeutic angle in managing obesity, the pathology is multifactorial as are its treatments. Successful management of patients will rely on detailed pathophysiologic understanding of obesity. This exhibit will discuss the neuroendocrine axis of hunger physiology, obesity pathophysiology, the mechanism of action of available therapies, and clinical applications of physiology as it relates to bariatric embolization.

Content Organization:

Neuroendocrine regulation of hunger and satiety

• Physiologic derangements of obesity

• Medication mechanism of action

• Anatomic and physiologic consequences of surgical/interventional therapies

• Clinical considerations of bariatric embolization

Learning Points: Obesity is a growing epidemic with multifactorial pathologic etiologies, which require multidisciplinary and multimodality treatment. As interventional radiology moves to a clinical specialty, it is incumbent to understand the physiology of hunger, and understand bariatric embolization’s role in therapy.