Gastroenterologists' Role Expands in Obesity Medicine, Driven by GLP-1 Therapy and Endobariatric Interventions

Obesity is a primary global driver of gastrointestinal and metabolic disease, significantly contributing to conditions like metabolic dysfunction-associated steatotic liver disease (MASLD), gastroesophageal reflux disease (GERD), Barrett's esophagus, pancreatitis, and colorectal neoplasia. Traditional gastroenterology has focused on luminal and procedural aspects, but the rising prevalence of these obesity-related disorders necessitates a broader approach. Current standard-of-care often falls short in holistic obesity management, creating a critical gap for specialists to address the underlying metabolic dysfunction.

This narrative review evaluated the evolving role of gastroenterologists in obesity medicine. Researchers conducted a focused literature review by searching PubMed and Google Scholar, prioritizing peer-reviewed publications from 2015 to 2026. Landmark earlier studies were included where relevant. Articles were selected based on their clinical relevance, methodological quality, and applicability to the expanding role of gastroenterologists in metabolic care. The review synthesized findings on the integration of pharmacologic, endoscopic, metabolic, and hepatologic approaches into modern gastrointestinal practice.

The review found that the role of gastroenterologists is significantly expanding beyond traditional luminal and procedural practice into longitudinal metabolic disease management. The emergence of GLP-1 receptor agonists and dual incretin therapies, alongside minimally invasive bariatric endoscopic interventions, has accelerated GI involvement in comprehensive obesity treatment and preventive metabolic care. This shift is reinforced by the increasing prevalence of MASLD and other obesity-related gastrointestinal disorders, underscoring the importance of multidisciplinary care. > Gastroenterologists are now positioned at the intersection of obesity medicine, hepatology, therapeutic endoscopy, nutrition, and metabolic care, redefining their scope of practice.