The document discusses bariatric surgery and new endoscopic solutions for weight regain after surgery. It describes an endoluminal gastric pouch reduction procedure called StomaphyX that uses fasteners to reduce the size of the gastric pouch endoscopically. Data from 26 patients who underwent the procedure at Ohio State University showed significant weight loss and improvement in comorbidities. The mechanism of weight loss is thought to be reducing the size of the gastric pouch and slowing gastric emptying.