#USA #Milan #Semaglutide #weight loss #endoscopic sleeve gastroplasty

Endoscopic Sleeve Gastroplasty vs. Oral Semaglutide: A Definitive Study

In the recent ESGE Days 2026 conference, researchers unveiled results from a significant comparative study that highlights the effectiveness of endoscopic sleeve gastroplasty (ESG) over oral semaglutide for weight loss in adults suffering from obesity. Conducted with a cohort of 150 patients, this retrospective study presents findings that could reshape treatment options and inform clinical decisions regarding obesity management.

Significant Findings

The study's results indicate that patients who underwent ESG experienced an average total body weight loss of 12.7% at six months, contrasting sharply with the 8.7% mean weight loss reported in those receiving oral semaglutide at a dose of 14 mg. This striking difference of around 4% was confirmed to be statistically significant (p = 0.0001), maintaining its relevance even after adjustments for various baseline characteristics, such as age, sex, body mass index (BMI), and diabetes status.

The implications are profound, as ESG not only demonstrates a higher average percentage of weight loss but also greater short-term effectiveness compared to a commonly used weight loss medication. Additionally, at the six-month mark, a remarkable 70% of patients in the ESG group achieved at least a 10% loss of total body weight, significantly exceeding the 43% success rate seen in the semaglutide group. Furthermore, 36% of ESG patients reached a weight loss of at least 15%, unlike a mere 7% in the semaglutide cohort.

Safety Profile

Critically, the safety profiles of both procedures were promising, with adverse event rates being comparable across both groups, primarily consisting of mild gastrointestinal symptoms. Notably, there were no reports of severe complications or mortality, underscoring ESG's safety as a minimally invasive procedure.

Expert Insights

Dr. Nitin G. Jagtap, the study's lead author, emphasized the importance of these findings in a real-world clinical context. He noted that patients frequently inquire about whether they should opt for surgical intervention or pharmacological treatment for weight loss, yet data to assist in making such decisions are often scarce. According to Dr. Jagtap, “We concentrated on oral semaglutide due to its availability during the study period, reflecting a genuine clinical choice rather than an artificial comparison.”

He added that the weight loss difference of approximately 4% with ESG is notable enough to potentially improve the management of obesity-related conditions, such as diabetes and fatty liver disease.

Individualized Treatment Approaches

As the discussion around obesity treatments advances, Dr. Jagtap reinforced the necessity for personalized treatment plans that consider patient preferences, accessibility, and long-term adherence. He explained that while daily oral medications require ongoing commitment, ESG offers a one-time intervention linked with the promise of faster weight loss.

He concluded, “These treatment options should not be viewed as mutually exclusive. The future of healthcare lies in identifying the most suitable treatment for each patient, refining our approach to care tailored specifically to individual needs.”

Conclusion

The study presented at ESGE Days 2026 is a vital contribution to the body of research comparing procedural and pharmacological methods for long-term obesity management. With the evidence favoring ESG, healthcare professionals may need to revise their strategies, integrating ESG into their recommendations alongside pharmacological alternatives like semaglutide. As the obesity epidemic continues globally, innovative and effective solutions for weight management are more important than ever.