ArticleSurgical endoscopy2026
Long-term outcomes after endoscopic sleeve gastroplasty: impact of clinician follow-up and lifestyle engagement.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundBariatric interventions rely on lifestyle changes that benefit from long-term follow-up and patient engagement. Mid- and long-term outcomes following endoscopic sleeve gastroplasty (ESG) are heterogeneous and likely multifactorial. While the literature has explored patient demographic and anthropometric influence, as well as procedural technique, on post-ESG weight loss, there are knowledge gaps about the influence of aftercare programs. We hypothesize that clinician follow-up intensity and exercise participation correlate with weight loss after ESG.
methodsWe conducted a retrospective cohort study of adults who underwent ESG at a tertiary academic center with expertise in bariatric endoscopy. Patients with at least two years of follow-up and complete weight and behavioral data were included. Follow-up intensity was defined by the number of post-ESG physician or advanced practice clinician visits and categorized as close (≥ 5 visits) or limited (< 5 visits). The primary outcome was total body weight loss (TBWL%) at the most recent follow-up visit; the secondary outcome was the association between exercise participation and TBWL%.
resultsA total of 56 individuals met inclusion criteria (mean age 49.6 years, 82.2% female). The mean duration of follow-up was 29.0 months. Baseline demographic and clinical characteristics were similar between groups. Patients with close clinician follow-up achieved significantly greater TBWL compared with those with limited follow-up (- 13.7 ± 11.2% vs. - 6.7 ± 8.2%, p = 0.01). In categorical analyses, a higher proportion of the close follow-up group achieved ≥ 10, ≥ 15, and ≥ 20% TBWL. Exercise participation was reported by 69.7% of participants and was associated with numerically higher but nonsignificant TBWL (p = 0.55).
conclusionsHeightened clinician follow-up after ESG was associated with approximately twice the magnitude of long-term weight loss. These findings emphasize that structured, ongoing engagement from clinical team members, as opposed to solely nutritional team members, is a critical determinant of durable success after ESG.
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