Mayo Clinic as designed an Endoscopic Pneumatic Assist Device (EPAD) to help patients with weight loss and maintenance. The EPAD technology induces weight loss by creating a physical/obstructive barrier to the passage of nutrients through the pylorus. Additionally, the device induces malabsorption due to the attached optioal malbsorptive sleeve in the proximal small bowel.Finally, the use of a second EPAD placed within an endoscopically or surgically creates gastrojejunal and duodenojejunal anastomosis, which bypasses portions of the intestinal tract.