What question did this study set out to answer?

This study aims to evaluate the effectiveness of endoscopic sleeve gastroplasty combined with lifestyle management on weight loss and metabolic improvements.

February 27, 2026Open Access

Endoscopic sleeve gastroplasty: Prospective assessment of weight loss and metabolic impact

Key Points

This study aims to evaluate the effectiveness of endoscopic sleeve gastroplasty combined with lifestyle management on weight loss and metabolic improvements.
Conducted a prospective cohort study with 29 patients.
Performed endoscopic sleeve gastroplasty 6 months after initiating lifestyle management.
Followed patients for 1 year to assess weight and metabolic changes.
Average total body weight loss of 11.05%, with 81.2% of patients achieving over 5% weight loss.
Significant reduction in body mass index to 30.52 kg/m².
Improvements in glucose control and HbA1c levels observed at 1 year.
Decreased liver function test results and diastolic arterial pressure.
Quality of life scores improved in physical activity.

Abstract

Background and study aims: Recent international guidelines (American Society for Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy) suggest endoscopic treatment plus lifestyle management for management of obesity class I and II. The aim of this prospective study was to assess results of Endosleeve gastroplasty (ESG) plus lifestyle management (LSM). Patients and methods: Twenty-nine patients (mean age 44 years) were included in a longitudinal prospective cohort study in two experienced centers. Mean weight at inclusion was 91.13 kg (± 8.4) and mean body mass index (BMI) was 34.08 (± 2.43) kg/m². ESG was performed using Endomina (Endo Tools Therapeutics S.A., Gosselies, Belgium) 6 months after LSM and patients were followed for 1 year with continuous LSM. Results: Twenty-eight patients completed 12-month follow-up. Total body weight loss (TBWL) was 11.05% (P 5 %). EWL was significantly reached in 40.98% (P P P = 0.01 and P = 0.003). Liver function tests (gamma-glutamyl transferase, alanine aminotransferase) were significantly decreased (P = 0.006 and P = 0.009). Diastolic arterial pressure significantly decreased at 1 year (P P = 0.05). Only one adverse event was noted (sustained pain; AGREE II). No nutritional deficiency assessed by biological measurements appeared during follow-up. Conclusions: ESG combined with LSM resulted in significant improvement in TBWL, EWL, BMI, and QoL. Metabolic improvements were also observed without leading to nutritional deficiency.

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