Quality of Life, Mental Health, and Weight Loss Outcomes Following Endoscopic Sleeve Gastroplasty

Mehta, Amit; Hajifathalian, Kaveh; Shah, Shawn L.; Mahadev, Sri Hari; Sampath, Kartik; Carr‐Locke, David L.; Sharaiha, Reem Z.

doi:10.1007/s11605-021-05137-4

“…A metanalysis by Gadd et al including studies on several bariatric endoscopic techniques showed that they may improve short-term quality of life and mental health alongside weight loss [ 22 ]. With a specific view on ESG, Mehta et al showed a continuous positive association between the maximum weight loss achieved after ESG and the improvement in quality of life assessed with several validated questionnaires [ 23 ]. Further, Fiorillo et al evaluated the Gastrointestinal Quality of Life index in a matched cohort study comparing ESG and laparoscopic sleeve gastrectomy (LSG), showing that despite the inferior weight loss (%EWL 39.9% ESG vs. 54.9% LSG, p = 0.01), ESG was associated with better quality of life compared with LSG, with definite advantage for the gastrointestinal symptoms [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…A metanalysis by Gadd et al including studies on several bariatric endoscopic techniques showed that they may improve short-term quality of life and mental health alongside weight loss [22]. With a specific view on ESG, Mehta et al showed a continuous positive association between the maximum weight loss achieved after ESG and the improvement in quality of life assessed with several validated questionnaires [23]. Further, Fiorillo Fig.…”

Section: Discussionmentioning

confidence: 99%

Success Predictors of Endoscopic Sleeve Gastroplasty

Matteo,

Bove,

Ciasca

et al. 2024

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Objective Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure that proved to be safe and effective in obesity treatment. However, not all subjects respond to treatment in the same way, and, with a view to personalized care, it is essential to identify predictors of success or failure. Methods A retrospective 2-year followed-up cohort of ESG subjects was analyzed to investigate the presence of any baseline or early indicators of long-term optimal or suboptimal ESG outcomes. Results A total of 315 subjects (73% women) were included, with 73% of patients exhibiting an Excess weight loss percentage (%EWL) >25% at the 24 months. Neither demographic parameters (age and sex), smoking habits, and menopause in women nor the presence of comorbidities proved potential predictive value. Interestingly, the %EWL at 1 month after ESG was the strongest predictor of 24-month therapeutic success. Subsequently, we estimated an “early threshold for success” for 1 month-%EWL by employing Youden’s index method. Conclusions ESG is a safe and effective bariatric treatment that can be offered to a wide range of subjects. Early weight loss seems to impact long-term ESG results significantly and may allow proper early post-operative care optimization. Graphical Abstract

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“…Unlike IGB, these findings sustained over a 2 year follow-up period [56]. In another retrospective study, QoL and mental health outcomes were significantly improved after ESG [57]. Lopez-Nava et al [58] performed redo ESG in 7% of their ESG patients for weight loss failure (WF), weight regain (WR), or weight plateau (WP).…”

Section: Recent Data On Endoscopic Sleeve Gastroplasty Safety and Eff...mentioning

confidence: 98%

Endobariatrics: well past infancy and maturing rapidly

Shrestha

¹

,

Shrestha

²

,

Shah

³

2022

Current Opinion in Gastroenterology

0

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Purpose of reviewThis review summarizes the key developments with regard to FDA-approved endoscopic bariatric metabolic therapies (EBMTs) in the last 2 years.Recent findingsThe prevalence of obesity has increased during the coronavirus disease 2019 (COVID-19) pandemic, and obesity worsens COVID-19 related outcomes. Several studies have confirmed the safety and short-term efficacy of intragastric balloons (IGBs). In the short-term IGBs may improve steatosis and fibrosis in nonalcoholic fatty liver disease and improve quality of life and mental health. Unfortunately weight loss from these temporarily placed devices is not sustained long-term. Endoscopic sleeve gastroplasty (ESG) may be more effective and durable than IGBs, and result in fewer adverse events compared to bariatric surgery. The recently completed MERIT trial may catapult ESG as a first-line EBMT. Aspiration therapy meets safety and effectiveness thresholds for incorporation into routine practice, but overall acceptance has been lower than other FDA-approved EBMTs.SummaryThe field of endobariatrics is rapidly maturing. Significant knowledge gaps remain with regards to combining EBMTs with pharmacologic therapy to improve durability of weight loss. The rapid expansion in the literature supporting safety and long-term efficacy ESG may prompt revision of existing guidelines.

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IFSO Bariatric Endoscopy Committee Evidence-Based Review and Position Statement on Endoscopic Sleeve Gastroplasty for Obesity Management

Dayyeh,

Stier,

Alqahtani

et al. 2024

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Background Obesity is a significant global health issue. Metabolic and bariatric surgery (MBS) is the gold standard in the treatment of obesity due to its proven effectiveness and safety in the short and long term. However, MBS is not suitable for all patients. Some individuals are at high surgical risk or refuse surgical treatment, while others do not meet the criteria for MBS despite having obesity-related comorbidities. This gap has driven the development of endoscopic solutions like endoscopic sleeve gastroplasty (ESG), which offers a less invasive alternative that preserves organ function and reduces risks. A recent IFSO International Delphi consensus study highlighted that multidisciplinary experts agree on the utility of ESG for managing obesity in patients with class I and II obesity and for those with class III obesity who do not wish to pursue or qualify for MBS. This IFSO Bariatric Endoscopy Committee position statement aims to augment these consensus statements by providing a comprehensive systematic review of the evidence and delivering an evidence-based position on the value of ESG within the spectrum of obesity management. Methods A comprehensive systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Cochrane guidelines. Results Systematic Review: The systematic review included 44 articles encompassing 15,714 patients receiving ESG. The studies varied from large case series to cohort studies and a randomized controlled trial (RCT). The mean baseline BMI was 37.56 kg/m2. The review focused on weight loss outcomes and safety data. Meta-analysis: Time point Mean %EWL Mean%TBWL 6 months 48.04 15.66 12 months 53.09 17.56 18 months 57.98 16.25 24 months 46.57 15.2 36 months 53.18 14.07 60 months 45.3 15.9 These results demonstrate significant weight loss following ESG. Safety: The pooled serious adverse event (SAE) rate was 1.25%. This low rate of SAEs indicates that ESG is a relatively safe procedure. Quality of Evidence: The quality of evidence from the included observational studies was assessed as very low, primarily due to the inherent limitations associated with observational study designs, such as potential biases and lack of randomization. In contrast, the quality of evidence from the single randomized controlled trial was rated as MODERATE, reflecting a more robust study design that provides a higher level of evidence despite some limitations. Conclusions The IFSO Bariatric Endoscopy Committee, after conducting a comprehensive systematic review and meta-analysis, endorses endoscopic sleeve gastroplasty (ESG) as an effective and valuable treatment for obesity. ESG is particularly beneficial for patients with class I and II obesity, as well as for those with class III obesity who are not suitable candidates for metabolic bariatric surgery. ESG provides significant weight loss outcomes and demonstrates a favorable safety profile with a low rate of serious adverse events. Despite the limitations of the included observational studies, the randomized controlled trial included in the analysis reinforces the efficacy and safety of ESG and provides an evidence-based foundation for the position statement. Thus, the IFSO position statement supports and provides an evidence base for the role of ESG within the broader spectrum of obesity management.

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Quality of Life, Mental Health, and Weight Loss Outcomes Following Endoscopic Sleeve Gastroplasty

Cited by 4 publications

References 6 publications

Success Predictors of Endoscopic Sleeve Gastroplasty

Success Predictors of Endoscopic Sleeve Gastroplasty

Endobariatrics: well past infancy and maturing rapidly

IFSO Bariatric Endoscopy Committee Evidence-Based Review and Position Statement on Endoscopic Sleeve Gastroplasty for Obesity Management

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