AIG Study Finds ESG Gives Greater Short-Term Weight Loss

Hyderabad: A study by AIG Hospitals, Hyderabad, has found that endoscopic sleeve gastroplasty (ESG) resulted in greater short-term weight loss compared with oral semaglutide among adults with obesity, even as doctors report rising demand for medical interventions in the city.

Published in the journal Endoscopy, the study compared two non-surgical obesity treatments in 150 adults treated between January 2024 and April 2025. Fifty patients underwent ESG, while 100 received oral semaglutide (14 mg). All participants were advised a calorie-deficit diet and moderate physical activity.

The findings showed ESG led to an average total body weight loss of 12.72 per cent within six months, compared with 8.67 per cent in the semaglutide group. Nearly 70 per cent of ESG patients achieved at least 10 per cent weight loss, against 43 per cent in the medication group. About 36 per cent of ESG patients lost at least 15 per cent of their body weight, compared with 7 per cent of those on semaglutide.

At 12 months, the difference narrowed, with ESG patients recording 11.92 per cent weight loss compared with 10.91 per cent in the semaglutide group, indicating both approaches can help sustain weight reduction over time. The study reported no major complications in either group, with most side effects limited to mild gastrointestinal symptoms such as nausea and vomiting. Some patients discontinued semaglutide due to side effects or cost.

Dr Nitin Jagtap, consultant gastroenterologist at AIG Hospitals and corresponding author, said, "The most important message from this study is that obesity treatment has to be individualised. ESG appears to offer a stronger early push in weight loss, especially for patients who need meaningful reduction in a short period. But the procedure is not a shortcut. It is a structured intervention that gives patients a window of opportunity to reset eating patterns, improve satiety and then build sustainable lifestyle habits."

Dr D. Nageshwar Reddy, chairman of AIG Hospitals, said, "There were more participants for semaglutide because it has been the easier option for obese patients. The study included Indian patients with Class I and Class II obesity. ESG costs more than ₹1.5 lakh, while semaglutide is becoming cheaper, but it should not be used without medical advice, neither ESG should be used. Doctors must guide patients on long-term treatment. We have followed these patients for over a year, but the real value of this study will become clearer after five years of follow-up."

He added, "ESG and medicines like semaglutide should not be seen as competing therapies. They are complementary tools. The larger goal is to help patients achieve clinically meaningful weight loss and then sustain it through long-term behavioural and metabolic care."

Obesity is identified as a chronic metabolic disease linked to conditions including diabetes, hypertension, fatty liver disease, sleep apnoea and heart disease. Doctors attribute rising obesity rates in urban India to sedentary lifestyles, unhealthy diets, stress and limited physical activity.

ESG is a minimally invasive endoscopic procedure that reduces stomach volume using internal sutures, while semaglutide, a GLP-1 receptor agonist, works by reducing appetite and increasing satiety.

Researchers noted the findings were based on a retrospective, single-centre study limited to oral semaglutide 14 mg and cautioned against extrapolating the results to higher-dose injectable GLP-1 drugs or newer therapies.