Endoscopic Sleeve Gastroplasty Leads to Sustained Weight Loss

Findings from a new study presented at Digestive Disease Week (DDW) 2019 show that endoscopic sleeve gastroplasty (ESG) can lead to significant long-term weight loss.¹

Previous studies tracked results of ESG for 1 to 2 years, and the long-term efficacy of the minimally invasive procedure had not been well-defined.

“We felt that a longer-term study was needed to make sure weight loss is sustainable with this method of treatment,” lead study author Reem Sharaiha, MD, MSc, who is an attending physician at NewYork-Presbyterian/Weill Cornell Medical Center, said in a press release.²

Dr Sharaiha discussed the study results on May 18 at DDW 2019 in San Diego, California.

Sharaiha and colleagues performed a retrospective chart review of 203 individuals with obesity who underwent ESG between August 2013 and October 2018. At baseline, BMI was 39 ± 7 kg/m².

Overall, the total body weight loss (TBWL) was 15.2% at 1 year, 14.5% at 2 years, 15.7% at 3 years, and 14.5% at 5 years. The percentage of patients who achieved a minimum TBWL of 10% was 74% at 1 year, 67% at 2 years, 67% at 3 years, and 69% at 5 years.

“This is significant because studies have shown that when people lose at least 10% of their body weight, they see improvement in blood pressure, diabetes, and heart outcomes,” Sharaiha said. “So, we hope this will persuade insurance companies that ESG is not experimental but has value over patients’ lifespan.”²

After adjustments for age, gender, and baseline BMI, multivariable regression analysis indicated that TBWL at 2, 6, and 12 months were independent predictors of TBWL at 2 years. An individual had a lower likelihood of achieving a minimum TBWL of 10% at 2 years if they did not achieve it at 3 months (odds ratio, 0.21).

The average maximum weight loss was 17.6 kg, which corresponded to a TBWL of 15.2%. Participants lost an average of 15.1 kg at the end of the follow-up period, which corresponded to a TBWL of 13.1%.

Maximum weight loss was achieved during the first 2 years after ESG. After 2 years, individuals were more likely to regain 14% of the weight they lost.

“We will continue watching this cohort to track their progress over the next 10 to 20 years,” Sharaiha said. “Additionally, we are looking at hormonal responses and comorbidities and are working to predict the best candidates who will benefit from this procedure,” adding that a randomized clinical trial is currently underway.²

—Melinda Stevens

References:

1. Hajifathalian K, Ang B, Dawod QM, et al. Long-term follow up and outcomes after endoscopic sleeve gastroplasty for treatment of obesity (5 year data). Presented at: Digestive Disease Week (DDW) 2019; May 18-21, 2019; San Diego, CA.
2. Minimally invasive procedure shows promise in combatting obesity [press release]. San Diego, CA: Digestive Disease Week; May 9, 2019. https://ddw.org/news/press-releases/minimally-invasive-procedure-shows-promise-in-combating-obesity. Accessed May 15, 2019.