Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2025; 17(10): 111290
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.111290
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.111290
Endoscopic sleeve gastroplasty vs lifestyle modification for weight loss: A real-world cost-effectiveness study
Lauren Donnangelo, Daniel Maselli, Christopher E McGowan, Department of Gastroenterology, True You Weight Loss, Cary, NC 27513, United States
Sanjay R V Gadi, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, United States
Frank Oneill, Department of Health Economics, Apollo Endosurgery, Austin, TX 78746, United States
Chase Wooley, Shannon Casey, Department of Clinical Research, True You Weight Loss, Cary, NC 27513, United States
Author contributions: Donnangelo L, Wooley C, and Casey S participated in study design, data collection and analysis; Donnangelo L and Gadi SRV prepared and edited the manuscript; Maselli D, Oneill F, and McGowan CE critically revised the manuscript; McGowan CE conceptualized and designed the study. All authors approved the final version to publish.
Institutional review board statement: The study was reviewed and approved for publication by WCG Institutional Review Board.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment as part of undergoing the endoscopic sleeve gastroplasty at the institutions participating in this study.
Conflict-of-interest statement: Dr. McGowan reports personal fees from Boston Scientific, Intuitive Surgical, and Apollo Endosurgery, outside the submitted work.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Participants gave informed consent for data sharing, and presented data are anonymized and risk of identification is low.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Christopher E McGowan, MD, AGAF, FASGE, Department of Gas
Received: June 27, 2025
Revised: July 22, 2025
Accepted: August 29, 2025
Published online: October 27, 2025
Processing time: 119 Days and 11.6 Hours
Revised: July 22, 2025
Accepted: August 29, 2025
Published online: October 27, 2025
Processing time: 119 Days and 11.6 Hours
Core Tip
Core Tip: Endoscopic sleeve gastroplasty (ESG) is an endoscopic bariatric tool that offers patients a non-surgical option for weight loss. However, the cost effectiveness of ESG as compared to conventional lifestyle modification (LM) in real world patients needs further investigation. In this study, we aimed to estimate the cost-effectiveness of ESG vs LM. Our results showed that the base-case incremental cost-effectiveness ratio for ESG vs LM was 5904 dollars per quality-adjusted life year, suggesting that ESG is cost effective across all classes of obesity.