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Rachel V Thomas

This 45-Minute Weight-Loss Procedure May Work Better Than Semaglutide Pills, Study Claims

Weight-loss medications such as oral <span>semaglutide</span> have become increasingly popular for treating obesity. However, a new study suggests that a 45-minute, minimally invasive procedure called <span>Endoscopic Sleeve Gastroplasty</span> (<span>ESG</span>) may deliver greater short-term <span>weight loss</span> than oral semaglutide tablets.

Published in the <em><span rel="noindex">Endoscopy</span></em> journal, the study compared two established non-surgical obesity treatments—ESG and oral semaglutide 14 mg.

<h2>ESG Led to Greater Weight Loss at 6 Months</h2>

Researchers from AIG Hospitals, Hyderabad, found that patients who underwent ESG lost significantly more weight than those taking oral semaglutide after six months.

Patients treated with ESG achieved an average 12.72% total body weight loss, compared with 8.67% among those taking semaglutide. The difference remained significant even after adjusting for age, sex, BMI and diabetes.

"The most important message from this study is that obesity treatment has to be individualized. ESG appears to offer a stronger early push in weight loss, especially for patients who need a meaningful reduction in a short period," said Dr. Nitin Jagtap, Consultant Gastroenterologist at AIG Hospitals.

He added that ESG is not a shortcut but a structured intervention that helps patients reset eating habits and build sustainable lifestyle changes.

The retrospective study included 150 adults with obesity treated between January 2024 and April 2025. Of these, 50 underwent ESG, while 100 received oral semaglutide 14 mg once daily.

All participants also followed a calorie-deficient diet and moderate exercise plan, highlighting that both treatments work best alongside lifestyle modifications.

ESG also outperformed semaglutide in the number of patients achieving clinically meaningful weight loss.

<ul><li>70% of ESG patients lost at least 10% of their body weight, compared with 43% in the semaglutide group.</li><li>36% of ESG patients achieved 15% or more weight loss, versus just 7% of those taking semaglutide.</li></ul>

No major adverse events were reported in either group.  

Notably, by 12 months, the gap between the two treatments had narrowed. Average weight loss was 11.92% in the ESG group and 10.91% in the semaglutide group, with no statistically significant difference.

The findings are particularly relevant for India, where obesity often occurs alongside diabetes, fatty liver disease and cardiovascular risk at lower BMI levels than in Western populations, the researchers said.

The researchers noted that the findings should be interpreted carefully because this was a retrospective, single-centre study, not a randomized clinical trial.

They also stressed that the comparison was limited to oral semaglutide 14 mg and should not be extended to higher-dose injectable GLP-1 drugs or newer dual-incretin therapies, which may produce different results.

"Obesity care is entering a new phase where endoscopy, pharmacology, nutrition and lifestyle medicine must come together," said Dr. D. Nageshwar Reddy, Chairman of AIG Hospitals.

He emphasized that ESG and medications like semaglutide should be viewed as complementary options rather than competing therapies, with the shared goal of achieving and maintaining meaningful weight loss.

 <h2>ESG vs Oral Semaglutide: How Do They Work?</h2>

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive procedure performed through the mouth without external incisions. Using an endoscope and suturing device, doctors reduce the stomach's size by placing internal stitches, helping patients feel full sooner without surgically removing part of the stomach.

Oral semaglutide belongs to the GLP-1 receptor agonist class of drugs. It reduces appetite, increases feelings of fullness and helps lower calorie intake. Unlike ESG, it requires daily medication, long-term adherence and continued affordability.

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Weight-loss medications such as oral semaglutide have become increasingly popular for treating obesity. However, a new study suggests that a 45-minute, minimally invasive procedure called Endoscopic Sleeve Gastroplasty (ESG) may deliver greater short-term weight loss than oral semaglutide tablets.Published in the Endoscopy journal, the study compared two established non-surgical obesity treatments—ESG and oral semaglutide 14 mg.ESG Led to Greater Weight Loss at 6 MonthsResearchers from AIG Hospitals, Hyderabad, found that patients who underwent ESG lost significantly more weight than those taking oral semaglutide after six months.Patients treated with ESG achieved an average 12.72% total body weight loss, compared with 8.67% among those taking semaglutide. The difference remained significant even after adjusting for age, sex, BMI and diabetes."The most important message from this study is that obesity treatment has to be individualized. ESG appears to offer a stronger early push in weight loss, especially for patients who need a meaningful reduction in a short period," said Dr. Nitin Jagtap, Consultant Gastroenterologist at AIG Hospitals.He added that ESG is not a shortcut but a structured intervention that helps patients reset eating habits and build sustainable lifestyle changes.How Was the Study Conducted?The retrospective study included 150 adults with obesity treated between January 2024 and April 2025. Of these, 50 underwent ESG, while 100 received oral semaglutide 14 mg once daily.All participants also followed a calorie-deficient diet and moderate exercise plan, highlighting that both treatments work best alongside lifestyle modifications.What Did the Study Find?ESG also outperformed semaglutide in the number of patients achieving clinically meaningful weight loss.70% of ESG patients lost at least 10% of their body weight, compared with 43% in the semaglutide group.36% of ESG patients achieved 15% or more weight loss, versus just 7% of those taking semaglutide.No major adverse events were reported in either group.  Notably, by 12 months, the gap between the two treatments had narrowed. Average weight loss was 11.92% in the ESG group and 10.91% in the semaglutide group, with no statistically significant difference.The findings are particularly relevant for India, where obesity often occurs alongside diabetes, fatty liver disease and cardiovascular risk at lower BMI levels than in Western populations, the researchers said.Researchers Urge CautionThe researchers noted that the findings should be interpreted carefully because this was a retrospective, single-centre study, not a randomized clinical trial.They also stressed that the comparison was limited to oral semaglutide 14 mg and should not be extended to higher-dose injectable GLP-1 drugs or newer dual-incretin therapies, which may produce different results."Obesity care is entering a new phase where endoscopy, pharmacology, nutrition and lifestyle medicine must come together," said Dr. D. Nageshwar Reddy, Chairman of AIG Hospitals.He emphasized that ESG and medications like semaglutide should be viewed as complementary options rather than competing therapies, with the shared goal of achieving and maintaining meaningful weight loss. ESG vs Oral Semaglutide: How Do They Work?Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive procedure performed through the mouth without external incisions. Using an endoscope and suturing device, doctors reduce the stomach's size by placing internal stitches, helping patients feel full sooner without surgically removing part of the stomach.Oral semaglutide belongs to the GLP-1 receptor agonist class of drugs. It reduces appetite, increases feelings of fullness and helps lower calorie intake. Unlike ESG, it requires daily medication, long-term adherence and continued affordability.

this 45-minute weight-loss procedure may work better than semaglutide pills, study claims

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