TY - JOUR
T1 - Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy
T2 - a case-matched study
AU - Cheskin, Lawrence J.
AU - Hill, Christine
AU - Adam, Atif
AU - Fayad, Lea
AU - Dunlap, Margo
AU - Badurdeen, Dilhana
AU - Koller, Kristen
AU - Bunyard, Linda
AU - Frutchey, Robin
AU - Al-Grain, Haitham
AU - Kahan, Scott
AU - Hedjoudje, Abdellah
AU - Khashab, Mouen A.
AU - Kalloo, Anthony N.
AU - Kumbhari, Vivek
N1 - Funding Information:
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: S. Kahan: Personal fees from Novo Nordisk, Biologix, and KVK Tech. M. A. Khashab: Consultant for Boston Scientific, Olympus America, and Medtronic; advisory board for Boston Scientific and Olympus; research support from Cook Medical. A. N Kalloo: Founding member, equity holder, and consultant for Apollo Endosurgery. V. Kumbhari: Consultant for Apollo Endosurgery, Boston Scientific, Medtronic, Pentax, and ReShape Life Sciences; research support from Erbe and Apollo Endosurgery. All other authors disclosed no financial relationships relevant to this publication.
Publisher Copyright:
© 2020 American Society for Gastrointestinal Endoscopy
PY - 2020/2
Y1 - 2020/2
N2 - Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG + low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss (%TBWL). Results: Mean age across both cohorts was 48.0 ± 12.1, and baseline BMI was 40.0 ± 7.7 kg/m2. In multivariable analysis controlling for age, sex, and baseline BMI, the mean %TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean %TBWL in the ESG cohort was 14.0% compared with 11.3% in the HIDLT cohort (P <.011), and at 12 months the mean %TBWL in the ESG cohort was 20.6% versus 14.3% in the HIDLT cohort (P < .001). ESG patients with baseline BMI ≤40 kg/m2 continued to show significantly greater %TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P < .001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.
AB - Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG + low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss (%TBWL). Results: Mean age across both cohorts was 48.0 ± 12.1, and baseline BMI was 40.0 ± 7.7 kg/m2. In multivariable analysis controlling for age, sex, and baseline BMI, the mean %TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean %TBWL in the ESG cohort was 14.0% compared with 11.3% in the HIDLT cohort (P <.011), and at 12 months the mean %TBWL in the ESG cohort was 20.6% versus 14.3% in the HIDLT cohort (P < .001). ESG patients with baseline BMI ≤40 kg/m2 continued to show significantly greater %TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P < .001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.
UR - http://www.scopus.com/inward/record.url?scp=85075371302&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075371302&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2019.09.029
DO - 10.1016/j.gie.2019.09.029
M3 - Article
C2 - 31568769
AN - SCOPUS:85075371302
SN - 0016-5107
VL - 91
SP - 342-349.e1
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 2
ER -