Endoscopic Sleeve Gastroplasty in Those with a BMI of 27-30

Background

Endoscopic gastroplasty (ESG) is safe and effective in patients with a body mass index (BMI) more than 30, with few cases reported in patients with overweight (BMI 27-30) . However, evidence is lacking in the overweight group as the procedure is not currently performed routinely for such patients. In this study, we aim to evaluate the safety and efficacy of ESG in patients with a BMI between 27 and 30 who failed other weight loss modalities and/or had weight-related comorbidities.

Methods

This was a subgroup analysis of data pertaining to adults with a BMI between 27 and 30 who underwent ESG as a primary weight loss intervention. Data were abstracted from our longitudinal, prospective single-center registry. We analyzed weight loss, comorbidity resolution, adverse events, revisions, and quality of life using Bariatric Analysis and Reporting Outcome System (BAROS)

Results

Out of 3,797 ESG procedures, 656 patients (17%) had a BMI of 27-30. Mean age was 33 ± 9 years and women comprised 94% (n=616) of the sample. Mean %TWL at 6, 12, 24, and 36 months after ESG was 11.0 ± 7.2, 15.5 ± 6.3, 15.1 ± 8.3%, and 13.3 ± 9.9%, respectively.

Eight of 22 patients with diabetes (36%) and 9 of 51 (18%) patients with hypertension experienced complete remission. Two patients were hospitalized with bleeding. Twenty-three (3.5%) patients underwent revision to LSG or repeat ESG. Six more patients underwent suture removal. A total of 214 of 261 patients (82%) rated quality of life after ESG as good or better.

Conclusions

ESG appears to be well tolerated, safe, and effective in patients with a BMI of 27 to 30.