Sleeve Gastroplasty beats oral weight loss pills over a short term, AIG study

A study by Hyderabad's AIG Hospitals found that Endoscopic Sleeve Gastroplasty delivered greater short-term weight loss than oral semaglutide among Indian adults. Researchers, however, cautioned that the findings are based on a real-world observational study and should be interpreted carefully

Hyderabad: A real-world study by Hyderabad’s Asian Institute of Gastroenterology (AIG) Hospitals, published in the Endoscopy journal, reveals that Endoscopic Sleeve Gastroplasty (ESG), a non-surgical stomach-suturing procedure, performs better than oral weight-loss tablets in the short term.

The study, which was not a randomized controlled trial (RCT), tracked 150 Indian adults between January 2024 and April 2025 and compared 50 ESG patients with 100 individuals taking a daily 14 mg dose of oral semaglutide, a press release said.

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At six months, ESG achieved significantly higher total body weight loss (12.72 percent) compared to the tablet group (8.67 percent), the AIG doctors involved in the research said.

About 70 percent of ESG patients achieved the 10 percent weight-loss threshold required to improve diabetes and fatty liver, compared to 43 percent on the oral drug.

By 12 months, however, the gap had statistically narrowed (11.92 percent vs. 10.91 percent) as real-world challenges such as medication costs and adherence caused some tablet patients to discontinue therapy.

Researchers, however, have urged caution while reading and interpreting the results. “As a retrospective, single-centre, real-world cohort study rather than a randomized controlled trial, the data has inherent limitations. Crucially, the comparison applies only to oral semaglutide (14 mg). These findings cannot be extrapolated to higher-dose injectable GLP-1 drugs or newer dual-incretin therapies, which may yield different clinical outcomes,” they said.

Dr Nitin Jagtap, Gastroenterologist, AIG Hospitals, said, “The message from this study is that obesity treatment has to be individualised. ESG appears to offer a stronger early push in weight loss. 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.”

AIG Chairman Dr D Nageshwar Reddy said, “The larger goal is to help patients achieve clinically meaningful weight loss and then sustain it through long-term behavioural and metabolic care.”