Abstract Background Obesity is a long-term condition and one of the major risk factors for increased cardiovascular and metabolic diseases; Type 2 diabetes, hypertension, and obstructive sleep apnea are some associated comorbidities. Endoscopic gastroplasty (EG) is a novel obesity treatment that replicates gastric sleeve surgery by working solely through the endoscope to reduce stomach volume with respect to promoting satiety. Objective To investigate the effectiveness, safety, and cost-effectiveness of endoscopic gastroplasty in comparison with isolated lifestyle interventions (LI) in managing grade I and II obesity. Methods Database searching was performed using the PRISMA protocol through PubMed, Cochrane, EMBASE/OVID, and LILACS. Studies involving adults aged 18 years or older that compared EG with LI were included. No comparator group, surgical bariatric procedure, duplicates were excluded. Primarily, the %EWL and %TWL of the patients were anayzed, and secondarily, the clinical improvement of comorbidities, complications, total costs, QALY, and ICER. We used SPSS for statistical analysis. Results Seven studies were included, with 951 participants (494 EG and 457 LI). The average BMI was 35. 9 kg/m2. Endoscopic gastroplasty showed a superior weight loss: %TWL of 12. 75% versus 5. 85% and %EWL of 45. 75% versus 23. 4% (EG versus LI). An improvement in comorbidities was observed after 2 years in 80% of the patients who underwent EG, compared to 28% in the LI group. The most frequent complication with EG was abdominal pain (9. 6%), and severe complications were rare (≤3 cases). The average cost of EG was 53 845, while in the LI group it was 36 430. The average difference in QALY was 1. 28 for the EG group, with an ICER of 8461. 8/QALY. Conclusion Endoscopic gastroplasty proved to be superior to isolated lifestyle intervention in weight loss effectiveness, improvement of comorbidities, and presented a favorable safety profile and acceptable cost-effectiveness, making it a promising alternative for the treatment of moderate obesity.
Lisboa et al. (Thu,) studied this question.