A retrospective study at ESGE Days 2026 finds endoscopic sleeve gastroplasty (ESG) leads to greater weight loss than oral semaglutide in patients with obesity, highlighting the procedure's effectiveness.

A comparative study presented at ESGE Days 2026 has found that endoscopic sleeve gastroplasty (ESG), a minimally invasive endoscopic procedure, is associated with significantly greater short-term weight loss compared to oral semaglutide. The retrospective cohort study included 150 patients treated in routine clinical practice and evaluated outcomes at six months.

Patients undergoing ESG achieved a mean total body weight loss of 12.7%, while those receiving 14mg of oral semaglutide experienced an average weight loss of 8.7%. This difference was statistically significant, with a mean difference of approximately 4.0% (p=0.0001), and remained consistent even after adjusting for baseline characteristics such as age, sex, body mass index, and diabetes status.

The study also patients undergoing ESG were more likely to achieve clinically meaningful weight loss at six months. Specifically, 70% of the ESG group achieved at least a 10% total body weight loss compared to 43% in the semaglutide group, while 36% reached at least a 15% weight loss compared to 7% for those on semaglutide.

Adverse event rates were comparable between groups and primarily consisted of mild gastrointestinal symptoms. No serious complications or mortality was reported during the study period.

Dr. Nitin G. Jagtap, lead author of the study, emphasized that while ESG offers a rapid weight loss benefit, treatment choice should remain individualized based on patient preference, access to care, and adherence to long-term therapy. "A daily oral therapy requires sustained commitment," he noted, "whereas ESG is a one-time intervention associated with more rapid weight loss."

Dr. Jagtap concluded that the findings suggest ESG should be considered alongside pharmacological therapies as a mainstream option in obesity management. He added, "The future of care lies in personalized treatment selection—matching the right approach to the right patient."

The study highlights the potential advantages of endoscopic procedures over oral medications for short-term weight loss outcomes, particularly among patients with obesity who are seeking effective and rapid intervention options.

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Key Medical Concepts Semaglutide: A glucagon-like peptide-1 receptor agonist that promotes weight loss. Endoscopic Sleeve Gastroplasty (ESG): A minimally invasive endoscopic procedure reducing gastric volume. Non-Alcoholic Fatty Liver Disease (NAFLD): An obesity-related condition influenced by treatment outcomes.

Clinical Categories Weight Management: Focus on managing obesity and its associated conditions such as diabetes and NAFLD. Gastroenterology: Treatment approaches for gastrointestinal issues, including weight loss interventions.

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Who's Behind This Story? Sadie Harley: BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Robert Egan: Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language.

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Citation Endoscopic Procedure Outperforms Oral Semaglutide for Short-Term Weight Loss (2026, May 14). Retrieved from https://medicalxpress.com/news/2026-05-endoscopic-procedure-greater-short-term.html

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