Comparative Efficacy of Endoscopic Sleeve Gastroplasty (Esg) Versus Liraglutide in Weight Loss and Remission Of Obesity-Related Comorbidities: Twelve Months Follow-Up Results.

BACKGROUND: Endoscopic sleeve gastroplasty (ESG) has been shown to be effective for inducing weight loss. Liraglutide, a glucagon-like peptide-1 agonist, has been successfully used for weight loss and remission of comorbidities in patients with obesity. So far, there are no clinical studies comparing short-term outcomes in patients treated with ESG or Liraglutide. The aim of the study is to assess the efficacy and safety of ESG versus Liraglutide in patients with obesity over a 12 months follow-up period. METHODS: A prospective, randomized controlled, monocentric study was performed. A total of 43 patients with class I and II obesity were included in the study. Twenty-three patients underwent ESG, and 20 patients were treated with Liraglutide. All participants received standardized follow-up protocols with assessments by both surgeon and nutritionist in the bariatric ambulatory setting. Weight loss outcomes, including the percentage of excess weight loss (%EWL), total weight loss (%TWL), and resolution of obesity-related comorbidities were assessed at 3, 6, and 12 months post-intervention. RESULTS: After 3 and 6 months, %EWL and %TWL were greater in the ESG group (P = 0.001). However, at 12 months, these differences were no longer statistically significant, suggesting that the ESG group was experiencing some weight regain, while the Liraglutide group had a slower but more consistent weight loss. Regarding the resolution of comorbidities, there were no statistically significant differences at 3, 6 and 12 months between the two groups. None of the patients had major complications or significant side effects. CONCLUSIONS: Both ESG and Liraglutide guarantee weight loss and remission of comorbidities in class I and II obesity patients. However, ESG induces a more rapid weight loss in the first six months, after which two patients seem experience weight regain. Liraglutide provides a slower weight loss in terms of %EWL and %TWL but patients continue losing weight also after six months. Larger samples with a longer follow-up are needed to confirm our results.