Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study

Lawrence J. Cheskin, Christine Hill, Atif Adam, Lea Fayad, Margo Dunlap, Dilhana Badurdeen, Kristen Koller, Linda Bunyard, Robin Frutchey, Haitham Al-Grain, Scott Kahan, Abdellah Hedjoudje, Mouen A. Khashab, Anthony N. Kalloo, Vivek Kumbhari

Research output: Contribution to journalArticle

Abstract

Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG + low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss (%TBWL). Results: Mean age across both cohorts was 48.0 ± 12.1, and baseline BMI was 40.0 ± 7.7 kg/m2. In multivariable analysis controlling for age, sex, and baseline BMI, the mean %TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean %TBWL in the ESG cohort was 14.0% compared with 11.3% in the HIDLT cohort (P <.011), and at 12 months the mean %TBWL in the ESG cohort was 20.6% versus 14.3% in the HIDLT cohort (P < .001). ESG patients with baseline BMI ≤40 kg/m2 continued to show significantly greater %TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P < .001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.

Original languageEnglish (US)
JournalGastrointestinal endoscopy
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Gastroplasty
Diet Therapy
Life Style
Body Mass Index
Weight Loss
Bariatrics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy : a case-matched study. / Cheskin, Lawrence J.; Hill, Christine; Adam, Atif; Fayad, Lea; Dunlap, Margo; Badurdeen, Dilhana; Koller, Kristen; Bunyard, Linda; Frutchey, Robin; Al-Grain, Haitham; Kahan, Scott; Hedjoudje, Abdellah; Khashab, Mouen A.; Kalloo, Anthony N.; Kumbhari, Vivek.

In: Gastrointestinal endoscopy, 01.01.2019.

Research output: Contribution to journalArticle

Cheskin, LJ, Hill, C, Adam, A, Fayad, L, Dunlap, M, Badurdeen, D, Koller, K, Bunyard, L, Frutchey, R, Al-Grain, H, Kahan, S, Hedjoudje, A, Khashab, MA, Kalloo, AN & Kumbhari, V 2019, 'Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study', Gastrointestinal endoscopy. https://doi.org/10.1016/j.gie.2019.09.029
Cheskin, Lawrence J. ; Hill, Christine ; Adam, Atif ; Fayad, Lea ; Dunlap, Margo ; Badurdeen, Dilhana ; Koller, Kristen ; Bunyard, Linda ; Frutchey, Robin ; Al-Grain, Haitham ; Kahan, Scott ; Hedjoudje, Abdellah ; Khashab, Mouen A. ; Kalloo, Anthony N. ; Kumbhari, Vivek. / Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy : a case-matched study. In: Gastrointestinal endoscopy. 2019.
@article{7732f412eead4baaae049c768ceb0d2f,
title = "Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study",
abstract = "Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG + low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss ({\%}TBWL). Results: Mean age across both cohorts was 48.0 ± 12.1, and baseline BMI was 40.0 ± 7.7 kg/m2. In multivariable analysis controlling for age, sex, and baseline BMI, the mean {\%}TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean {\%}TBWL in the ESG cohort was 14.0{\%} compared with 11.3{\%} in the HIDLT cohort (P <.011), and at 12 months the mean {\%}TBWL in the ESG cohort was 20.6{\%} versus 14.3{\%} in the HIDLT cohort (P < .001). ESG patients with baseline BMI ≤40 kg/m2 continued to show significantly greater {\%}TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P < .001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.",
author = "Cheskin, {Lawrence J.} and Christine Hill and Atif Adam and Lea Fayad and Margo Dunlap and Dilhana Badurdeen and Kristen Koller and Linda Bunyard and Robin Frutchey and Haitham Al-Grain and Scott Kahan and Abdellah Hedjoudje and Khashab, {Mouen A.} and Kalloo, {Anthony N.} and Vivek Kumbhari",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.gie.2019.09.029",
language = "English (US)",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy

T2 - a case-matched study

AU - Cheskin, Lawrence J.

AU - Hill, Christine

AU - Adam, Atif

AU - Fayad, Lea

AU - Dunlap, Margo

AU - Badurdeen, Dilhana

AU - Koller, Kristen

AU - Bunyard, Linda

AU - Frutchey, Robin

AU - Al-Grain, Haitham

AU - Kahan, Scott

AU - Hedjoudje, Abdellah

AU - Khashab, Mouen A.

AU - Kalloo, Anthony N.

AU - Kumbhari, Vivek

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG + low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss (%TBWL). Results: Mean age across both cohorts was 48.0 ± 12.1, and baseline BMI was 40.0 ± 7.7 kg/m2. In multivariable analysis controlling for age, sex, and baseline BMI, the mean %TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean %TBWL in the ESG cohort was 14.0% compared with 11.3% in the HIDLT cohort (P <.011), and at 12 months the mean %TBWL in the ESG cohort was 20.6% versus 14.3% in the HIDLT cohort (P < .001). ESG patients with baseline BMI ≤40 kg/m2 continued to show significantly greater %TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P < .001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.

AB - Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG + low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss (%TBWL). Results: Mean age across both cohorts was 48.0 ± 12.1, and baseline BMI was 40.0 ± 7.7 kg/m2. In multivariable analysis controlling for age, sex, and baseline BMI, the mean %TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean %TBWL in the ESG cohort was 14.0% compared with 11.3% in the HIDLT cohort (P <.011), and at 12 months the mean %TBWL in the ESG cohort was 20.6% versus 14.3% in the HIDLT cohort (P < .001). ESG patients with baseline BMI ≤40 kg/m2 continued to show significantly greater %TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P < .001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.

UR - http://www.scopus.com/inward/record.url?scp=85075371302&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85075371302&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2019.09.029

DO - 10.1016/j.gie.2019.09.029

M3 - Article

C2 - 31568769

AN - SCOPUS:85075371302

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

ER -