Clinical Report: Endoscopic Sleeve Gastroplasty Outcomes in Older Adults

Overview

This retrospective study evaluated the safety and efficacy of endoscopic sleeve gastroplasty (ESG) in patients aged 65 years and older with obesity. Results demonstrated significant weight loss with median excess weight loss (EWL%) of 39% at 6 months and 41% at 24 months, and total body weight loss (TBWL%) around 15%, comparable to younger patients. No peri-procedural or post-procedural adverse events were reported, indicating ESG is a safe and effective minimally invasive option for older adults.

Background

Obesity prevalence is increasing among older adults, who often face multiple comorbidities and functional decline. While lifestyle interventions and some pharmacotherapies show benefits, bariatric surgery indications and outcomes in the elderly remain unclear. Endoscopic sleeve gastroplasty (ESG) is a less invasive alternative that mimics restrictive bariatric surgery and has demonstrated efficacy and safety in younger populations. This study addresses the gap by analyzing ESG outcomes specifically in patients aged 65 years and older.

Data Highlights

Statistical analysis showed significant differences over time for EWL% (p = 0.034) and TBWL% (p = 0.009), indicating meaningful weight loss trends post-ESG.

Key Findings

• Eighteen patients aged ≥65 years underwent ESG with no peri-procedural or post-procedural adverse events.
• Mild crampy abdominal pain was the only common side effect, managed successfully with antispasmodics.
• Median excess weight loss (EWL%) was 39% at 6 months and 41% at 24 months post-procedure.
• Median total body weight loss (TBWL%) was 15.1% at 6 months and 15.5% at 24 months, comparable to younger cohorts.
• All patients were discharged within 24–48 hours after ESG, indicating a short hospital stay.
• Statistically significant improvements in weight loss parameters were observed over follow-up visits.

Clinical Implications

ESG offers a safe and effective minimally invasive weight loss option for older adults who are either ineligible for or refuse bariatric surgery. The procedure results in meaningful and sustained weight loss with minimal adverse effects and short hospitalization. Multidisciplinary evaluation remains essential to select appropriate candidates and optimize outcomes.

Conclusion

Endoscopic sleeve gastroplasty is a promising therapeutic alternative for obesity management in older adults, demonstrating favorable safety and efficacy profiles comparable to younger populations. Further studies with larger cohorts and longer follow-up are warranted to confirm these findings.

References

1. Various Authors/Multiple Sources/2021 -- Results of Endoscopic Sleeve Gastroplasty in Older Adults