Performance of Endoscopic Sleeve Gastroplasty by Obesity Class in the Clinical United States Setting.

Endoscopic sleeve gastroplasty (ESG) has gained popularity over the past decade and has been adopted in both academic and private institutions globally. We present outcomes of the largest cohort of patients from the United States undergoing ESG and evaluate these according to obesity class. We performed a retrospective analysis of adult patients who underwent ESG. Medical information was abstracted from the electronic record with weight records up to two years after ESG. Percent total body weight loss (%TBWL) at 6, 12, 18, and 24 months were calculated based on baseline weight at procedure. SPSS (version 29.0) was used for all statistical analyses. A total of 1506 patients from 7 sites were included (501 Class I obesity, 546 Class II and 459 with Class III). Baseline demographics differed according to obesity class due to differences in age, BMI, height, sex distribution, and race. As early as 6 months post ESG, mean BMI for each class dropped to the next lower class and remained there through 2 years. %TWBL achieved in the Class III group was significantly greater when compared with other classes at all time points. At 12 months, 83.2% and 60.9% of patients had ≥10% and ≥ 15% TBWL for all classes. There were no differences in adverse events between classes. Real world data from a large cohort of patients of all BMI classes across the US shows significant and sustained weight loss with ESG. ESG is safe to perform in a higher obesity class with acceptable mid-term efficacy.

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Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.