Endoscopic Sleeve Gastroplasty for Mild-to-Moderate Obesity

Endoscopic sleeve gastroplasty (ESG) is an endoluminal treatment that has been used to successfully treat patients with obesity. In ESG, the endoscopist places transmural gastric sutures that restrict gastric volume and delay gastric emptying; the procedure is reversible, and because it is endoscopic, it potentially avoids some of the complications of more-invasive procedures.

In this multicenter U.S. study, investigators randomized 209 patients with class 1 or 2 obesity (body-mass index [BMI], 30–40 kg/m²) to either ESG or lifestyle modification alone; both groups received the same behavioral and dietary recommendations. At 1 year, the mean percentage of total body-weight loss was significantly higher among ESG recipients than controls (14%…