Minimally invasive procedure shows promise for facilitating weight loss.
A new weight loss procedure that reduces the size of the stomach without the need for surgery known as endoscopic sleeve gastroplasty (ESG) is safe and effective way for the treatment obesity and obesity–related comorbidities such as diabetes, high blood pressure and fatty liver, according to a new study by NewYork–Presbyterian and Weill Cornell Medicine researchers.

ESG is an incisionless, same–day outpatient procedure performed using an endoscope, a flexible instrument with an attached camera that allows the physician to visualize the stomach from outside the body. The goal of ESG is to reduce the length and width of the stomach to facilitate weight loss. NewYork–Presbyterian is currently the leading institution and the first in New York to offer this innovative treatment, and its physicians have performed the most procedures in the country.

The study will be published in the spring 2017 journal of Clinical Gastroenterology and Hepatology and is published online.

“Obesity is a significant health concern that affects millions of people across the country, but until now there hasn’t been an effective minimally invasive treatment we could offer patients,” said Dr. Reem Sharaiha, director of bariatric endoscopy and associate director of the Pancreas Program at NewYork–Presbyterian/Weill Cornell Medical Center and an assistant professor of medicine at Weill Cornell Medicine. “With ESG, we’re giving patients who are not eligible for surgery, or deemed to be too high risk for surgery a new option for their care.”

The study followed 91 patients who underwent ESG from August 2013 through March 2016. All patients were clinically obese with a body mass index (BMI) greater than 30 kg/m² and had failed non–invasive weight–loss measures, or had a BMI greater than 40 kg/m² and were not considered as surgical candidates or had refused surgery. At six months, patients in the study had lost 14.4 percent of their total body weight, 17.6 percent at 12 months and 20.9 percent loss at 24 months. In addition to sustained total body weight loss up to 24 months, ESG reduced key indicators of hypertension, diabetes and hypertriglyceridemia, a high level of a certain type of triglycerides in the blood that can predispose patients to cardiovascular disease.

Obesity is a significant public health challenge, affecting more than one–third of adults in the United States. The estimated annual health care costs of obesity–related illnesses are $190.2 billion, nearly 21 percent of annual medical spending in the U.S. It is strongly associated with an increase in mortality in both men and women of all ages and ethnicities. “It will soon rival tobacco as the leading cause of preventable premature deaths,” said Dr. Sharaiha.

A new randomized control study which will compare ESG to diet and exercise has been approved and is now recruiting patients.