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Endoscopic sleeve gastroplasty plus semaglutide increases weight loss

Combining minimally invasive endoscopic sleeve gastroplasty (ESG) with semaglutide can provide additional significant weight loss for patients who are not candidates for invasive weight-loss surgery, according to research presented at Digestive Disease Week (DDW) 2021.

"As the worldwide obesity rate continues to climb, so do the number of people seeking bariatric surgery to treat their condition," said Dr Anna Carolina Hoff, MD, lead researcher on the study and founder and clinical director of Angioskope Brazil, São José dos Campos. "Surgical procedures are some of the most successful ways to help patients lose weight, but they can eventually come with complications. Our study shows that patients may not have to undergo invasive surgery to get similar results."

In a double-blind study, researchers randomised 61 patients undergoing ESG into two groups with one group of 29 patients receiving semaglutide, the injectable glucagon-like peptide-1 receptor that has been known to stimulate weight loss, beginning one month after the procedure. Another group of 29 patients received a placebo administered with look-alike injector pens. Three patients were lost to follow-up. Participants were monitored each month for body weight and body composition, and blood panels were taken every three months.

Patients who received semaglutide lost on average 26.7 percent of their total body weight compared to the control group, which on average lost 19.6 percent of total body weight. The semaglutide group lost 86.3 percent of their excess weight - the amount of weight the patients needed to lose to reach ‘normal’ BMI - compared to 60.4 percent for the control group. The semaglutide group also lost 12.7 percent of their body fat by weight compared to 9 percent for the control group. Finally, glycated haemoglobin (Hb1Ac) levels fell 0.95 for the semaglutide group and 0.61 for the controls.

"ESG has been available to patients for years, but it has not always been as successful as surgical options in helping patients lose weight," said Hoff. "We now have a minimally invasive procedure that can be just as successful when combined with semaglutide and can be made available to even more people looking to lose a significant amount of weight."

The researchers caution that long term durability of the treatment still needs to be determined.


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