ESG Alone Offers Lasting Benefits for Obesity Comorbidities

TOPLINE:

Endoscopic sleeve gastroplasty (ESG) as a standalone treatment is a safe and effective minimally invasive therapy that could help achieve significant long-term weight loss and sustained improvements in obesity-related comorbidities.

METHODOLOGY:

• Researchers conducted a 5-year prospective cohort study to evaluate the long-term effects of ESG as monotherapy on obesity-related comorbidities in 404 adult patients (mean age, 45 years; 76.2% women) with a body mass index ≥ 30 or ≥ 27 with comorbidities who underwent the procedure between August 2013 and July 2024.
• Participants had failed prior nonsurgical weight loss attempts or chose not to undergo surgery despite being eligible for it.
• The primary outcomes were the effects of ESG on obesity-related comorbidities, including improvement in diabetes (A1c), hyperlipidemia (low-density lipoprotein [LDL]), metabolic dysfunction–associated steatotic liver disease (alanine aminotransferase test [ALT]), and hypertension (systolic blood pressure) at 1, 3, and 5 years.

TAKEAWAY:

• Between baseline and 5-year follow-up:
  • Mean A1c levels were reduced from 5.80% to 5.63% (P P
  • LDL-C levels decreased significantly in patients with LDL-C > 100 mg/dL (P = .038).
  • ALT levels improved by 31% in men (P = .0144) and 20% in women (P = .0032).
  • Mean systolic blood pressure decreased from 129.3 mm Hg to 125.2 mm Hg (P = .0071), with 51.7% of patients achieving resolution of hypertension.
  • Mean percent total body weight loss was 11.8% (P
• Three moderate adverse events were noted (0.7%).

IN PRACTICE:

“Substantial evidence shows that obesity management and modest weight loss significantly improve glycemic control, delay diabetes progression, and can even reverse diabetic status in some individuals,” the authors wrote. “Our findings corroborate and extend these observations, demonstrating that the glycemic benefits of ESG only are maintained for up to 5 years postprocedure.” 

SOURCE:

The study, led by Ali Lahooti, Weill Cornell Medicine, New York, was published online in Gastrointestinal Endoscopy.

LIMITATIONS:

The generalizability of the study was limited by its single-center design and all procedures being performed by one experienced endoscopist. The lack of a control group made it difficult to conclusively determine whether the improvements noted were due to the ESG procedure or other factors, such as lifestyle changes or natural disease progression. Follow-up rates were impacted by the COVID-19 pandemic, potentially affecting the findings.

DISCLOSURES:

No funding source of the study was reported. Some authors reported receiving research grants and support, serving on scientific advisory boards, and/or being paid consultants and speakers for several pharmaceutical and other companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.