Device manufacturers are developing several next-generation devices for the minimally invasive treatment of obesity. Many of these emerging devices not only mimic the restriction and malabsorption mechanisms involved in bariatric surgery, but are also designed to influence the metabolic responses that are key to losing weight, improving outcomes, and impacting chronic disease.

Driven by a vast and underserved market in dire need of safer, less-invasive, more effective solutions, manufacturers are developing several next-generation devices for the minimally invasive treatment of obesity. Many of these emerging devices not only mimic the restriction and malabsorption mechanisms involved in bariatric surgery, but are also designed to influence the metabolic responses that are key to losing weight, improving outcomes, and impacting chronic disease. Indeed the obesity intervention paradigm is rapidly changing as ongoing research provides new insights into the underlying mechanisms behind obesity and bariatric surgery, heralding a new era where the primary treatment target for bariatric surgery is becoming disease specific, rather than targeted at obesity alone.

Start-ups with an array of compelling devices are seeking to provide alternatives to invasive gastric bypass surgery and laparoscopic gastric banding for the millions of morbidly and moderately obese patients – but which ones will make it through the evolving FDA clinical process? In this issue we profile three young companies that hope to succeed: Aspire Bariatrics, EndoSphere, and Vibrynt.

The market for obesity products has blockbuster potential, but it’s proven an elusive target for the medical device industry. The challenging regulatory environment, weak economy, and skittish investors have slowed the number of product launches in recent years, and there have been some high-profile setbacks for several potential weight loss therapies. But now, a "back to basics" movement, focused on understanding the physiological triggers behind obesity rather than simply restricting food intake, hopes to spur development of more effective minimally invasive weight loss solutions.