## 4 Treatment Advancements  
### Obesity Treatments  
For decades, the fight against obesity has centered on lifestyle modifications, emphasizing healthy eating habits and regular physical activity. While these remain the foundation of weight management, the field of obesity treatment is undergoing a renaissance, offering a more comprehensive and multifaceted approach. **Minimally Invasive Procedures:** The field of bariatric surgery has undergone a remarkable transformation, moving away from the historically invasive procedures that  
Figure 3: Comparison of classical and modern methods for diagnosing diabetes mellitus. relied on large abdominal incisions [41; 42]. This shift toward minimally invasive surgery (MIS) is fueled by a multitude of advantages. MIS offers patients significant improvements in their postoperative experience, including less pain, minimized scarring, and a shorter hospital stay, leading to a faster return to daily life [37; 42]. Additionally, MIS often utilizes specialized laparoscopic instruments and robotics, which can enhance a surgeon's dexterity and control during the procedure [43]. Furthermore, the landscape of bariatric procedures themselves is constantly evolving. Established procedures like sleeve gastrectomy are being refined, while entirely new approaches like the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) are emerging. After almost 16 years of accumulated experience with SADI-S, this procedure has been intensively studied in terms of its long-term impact on obesity and metabolic diseases, with recent studies still providing evidence of its significant efficacy both in maintaining a low weight [44] and offering significant decreases in blood pressure values, lipid profiles, and uric acid levels [45]. These advancements hold promise for even greater weight loss success and improved management of obesity-related comorbidities [46; 47]. However, it should also be mentioned that possible deficiencies in various nutrients and oligoelements following SADI-S surgery are often overlooked. A systematic review of 12 studies involving 581 patients who underwent a SADI-S procedure (217 males and 364 females) observed that selenium, zinc, and iron were the prevalent minerals with deficiencies in a significant number of cases (up to 50% of reported cases), followed by vitamin A deficiency in up to 53% of patients and protein deficiency in up to 34% of patients [48]. These main nutrient deficiencies after SADI-S were also recently reported by [PERSON] et al. [45]. However, there was evidence in patients who followed a strict supplementation protocol that, although they had mild to moderate vitamin deficiencies in the first 18 months (14.2% of patients included) after SADI-S, at 4 years, the cohort had zero nutritional deficiencies [49]. The spectrum of bariatric interventions is further widening with the exploration of non-surgical options. Endoscopic procedures like the placement of an adjustable gastric band or an intragastric balloon offer less invasive approaches for some patients. These devices can be inserted and adjusted through the mouth, promoting satiety and aiding in weight loss [50; 51]. The future of bariatric surgery is likely to see a continued focus on minimally invasive techniques with the further refinement of existing procedures and the development of entirely new approaches. This, coupled with the exploration of non-surgical options, offers a more comprehensive toolbox for tackling the global obesity epidemic. **Fecal Microbiota Transfer (FMT):** Another promising avenue for obesity treatment lies in manipulating the gut microbiota. Research suggests a strong link between the composition of gut bacteria and weight regulation [52; 53]. FMT is a procedure where healthy, diverse gut bacteria from a donor are transplanted into the recipient's gastrointestinal tract. The rationale behind FMT lies in the notion that a healthy gut microbiome can restore metabolic balance and promote weight loss in obese individuals.