Endoscopic sleeve gastroplasty bests diet, lifestyle changes for weight loss
Patients who underwent endoscopic sleeve gastroplasty achieved greater weight loss than patients who made diet and lifestyle changes alone, according to study results.
“Though now gaining traction worldwide, much is left to learn when comparing this procedure to other weight control strategies,” Vivek Kumbhari, MD, director of bariatric endoscopy at Johns Hopkins Medical Institutions, and colleagues wrote. “Most notably, ESG has not been directly compared with the current first-line treatment for obesity, described by the U.S. Department of Health and Human Services as the combination of low-calorie diet, increased physical activity and behavioral therapy.”
Researchers conducted a case-matched study comprising 105 patients who underwent ESG, as well as a low-intensity diet and lifestyle therapy and compared percentage of total body weight loss (%TBWL) with 281 patients who underwent high-intensity diet and lifestyle therapy (HIDLT). They evaluated patient weight at 1, 3, 6 and 12 months after beginning HIDLT or after ESG.
After controlling for age, sex and baseline BMI, Kumbhari and colleagues found that the patients who underwent ESG had higher %TBWL at each weight evaluation compared with patients who underwent HIDLT.
At 3 months, mean TBWL in the ESG group was 14% compared with 11.3% in the HIDLT group (P < .011). At 12 months, the mean TBWL was 20.6% in the ESG and 14.3% in the HIDLT group (P < .001).
The benefit of ESG largely driven by results in the group of patients who had a BMI of 40 kg/m² or lower at baseline. Those patients continued to show greater %TBWL at 1, 3, 6 and 12 months than patients in the same BMI group who underwent HIDLT.
“The adverse event rate associated with ESG may be acceptable to many patients in light of the superior weight loss as compared with HIDLT,” Kumbhari and colleagues wrote. “Future work is needed to assess ESG outcomes in a larger, prospective multicenter study, with longer follow-up.”– by Alex Young
Disclosure s: Kumbhari reports consulting for Apollo Endosurgery, Boston Scientific, Medtronic, Pentax and ReShape Life Sciences. He also reports receiving research support from Apollo Endosurgery and Erbe.