Endoscopic Sleeve Gastroplasty Versus Lifestyle Modification: A Review of a Promising Treatment for Obesity

Presented in 15th World Gastroenterology, IBD & Hepatology Conference from December 17-19, 2025, in Dubai, UAE & Online. 

Speaker Name: Dr. Ahmed Khalid Sharafeldin  
Location: UK
Research interest: Advanced Endoscopic Techniques, Gastroenterology, Upper Gastrointestinal Bleeding, Pancreatic Cancer
Category: (Poster Presentation )

Biography: Dr. Ahmed Sharafeldin has completed his medical degree from the Royal College of Surgeons in Ireland – Bahrain University and was ranked amongst the top 10 medical students based on GPA. He is currently working as a junior doctor at Noble’s Hospital in the Isle of Man and is an aspiring gastroenterologist.

Global Journal of Gastroenterology & Hepatology Research [GJGHR]
Visit Poster Presenter page: https://gastroenterology.utilitarianconferences.com/speaker/dr-ahmed-sharafeldin

Introduction: Obesity affects approximately 890 million individuals worldwide and is linked to several comorbidities such as type 2 diabetes and cardiovascular disease, contributing to 2.8 million deaths every year. While lifestyle modification remains the primary approach for managing obesity, Endoscopic Sleeve Gastroplasty (ESG) has emerged as a promising, minimally invasive alternative for patients with obesity refractory to lifestyle modification.

Keywords: “Obesity”, “treatment”, “endoscopic sleeve gastroplasty”, “clinical trial”

Results: [1, 2, 3, 4]

Figure 1: Key clinical outcomes and findings of ESG.

      Complications: As with all endoscopic procedures, there is a possibility of intraoperative infection, bleeding, perforation and adverse anesthetic events, however the rate is considerably low (around 1%) [2]. Three out of the 131 participants in the aforementioned study regarding efficacy had serious ESG-related adverse events but there were no deaths, and no intensive care or surgery was needed [1]. In a paper assessing the technical feasibility of ESG, Barham Abu Dayyeh et al. made mention of some post-procedural adverse events such as abdominal pain, nausea and acid reflux [5]. Out of the three subjects that had post-procedural abdominal pain and nausea, only one required a longer hospital stay (72 hours) whilst the others were managed with a short course of oral pain medication and antiemetics in the outpatient setting. The patient with the newly found acid reflux was managed with proton pump inhibitors which lead to a gradual resolution of symptoms. On the other hand, this paper had a very small sample size (only four subjects) and thus, the topic of post-ESG complications must be studied further.

      References: [1] Abu Dayyeh BK, Bazerbachi F, Vargas EJ, Sharaiha RZ, Thompson CC, Thaemert BC, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet (London, England) 2022;400:441–51. https://doi.org/10.1016/S0140-6736(22)01280-6.

[2] Vargas EJ, Rizk M, Gomez-Villa J, Edwards PK, Jaruvongvanich V, Storm AC, et al. Effect of endoscopic sleeve gastroplasty on gastric emptying, motility and hormones: a comparative prospective study. Gut 2022:gutjnl–2022-327816. https://doi.org/10.1136/gutjnl-2022-327816.

[3] Kelly J, Menon V, O’Neill FJ, Elliot L, Combe E, Drinkwater W, et al. UK cost-effectiveness analysis of endoscopic sleeve gastroplasty versus lifestyle modification alone for adults with class II obesity. International Journal of Obesity 2023;47:1161–70. https://doi.org/10.1038/s41366-023-01374-6.

[4] Sharaiha RZ, Wilson EB, Zundel N, Ujiki MB, Dayyeh BKA. Randomized Controlled Trial Based US Commercial Payor Cost-Effectiveness Analysis of Endoscopic Sleeve Gastroplasty Versus Lifestyle Modification Alone for Adults With Class I/II Obesity. Obesity Surgery 2024;34:3275–84. https://doi.org/10.1007/s11695-024-07324-z.

[5] Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointestinal Endoscopy 2013;78:530–5. https://doi.org/10.1016/j.gie.2013.04.197.

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