An increasing number of physicians and patients are recognizing the positive impact of the Endoscopic Sleeve Gastroplasty (ESG) procedure on weight loss and metabolic health. The procedure is endoscopic (meaning scar-less), minimally-invasive, safe, well-tolerated, and effective. Nonetheless, many remain uncertain or unconvinced about the benefits of ESG for various reasons. One of the most common questions I receive is “how long does it last?” This is a fair question, considering that a percentage of patients undergoing weight loss operations such as the gastric bypass and laparoscopic sleeve gastrectomy can suffer from weight regain over time with the return of obesity-related diseases (high blood pressure, diabetes, etc). [Link to revision page]
While we have seen data demonstrating the durability of ESG to at least two years, a recently presented study has pushed this boundary even farther! The study included 203 patients with obesity (BMI > 30 mg/kg2) who had undergone the ESG procedure at a single center. The patients were followed over time and their health data recorded. What’s remarkable about the study is that they were able to follow patients for up to 5 years. Here’s what the data show:
- At 1 year of follow-up, patients lost an average of 15.2% of their body weight which translates to 18.1 kg for this group;
- At 2 years, patients lost an average of 14.5% of their total body weight (TBW);
- At 3 years %TBW loss was 15.7%;
- At 5 years they lost an average of 14.5% of their weight. Importantly, 89% of patients who had undergone the ESG procedure who were followed to 5 years were captured for follow up, which limits bias somewhat (those that follow up may have greater weight loss, those that don’t may have experienced less).
Additional key details were also found. A particularly important finding was that failure to lose ≥10 % of body weight within the first 3 months after endoscopic sleeve gastroplasty decreased the chance of subsequent significant weight loss by 80%. In other words, early success predicted later success. In addition, the complication rate was < 1%.
It’s important to remember that this was a single center study and therefore the results may not be translatable to others. However, we already have data showing that the results are consistent around the world, provided the procedure is performed in an expert center and the physician is properly trained. In addition, these patients were enrolled in a comprehensive weight management program for at least one year after their ESG procedure. Studies show that the more contacts a patient has with his/her weight loss team, the better the results. Therefore, there are important patient-related factors such as continued participation that are critical to achieving the best results.
This is a landmark study showing that ESG results in consistent, sustained weight loss to at least 5 years. This adds to the growing literature demonstrating that ESG is a powerful tool for those looking to lose weight and improve their metabolic health.
The San Francisco Institute for Weight Loss, founded by world-renowned gastroenterologist Kenneth F. Binmoeller, M.D., is dedicated to providing the highest quality care for patients in the Bay Area. Rabindra R. Watson, M.D., heads up the weight loss branch and performs all weight loss procedures. In this video, Dr. Watson explains the Gastric Sleeve Revision procedure performed for weight loss. Give us a call at 415.215.1633 to schedule a consultation.