Research
Mixed
Endoscopic Sleeve Gastroplasty (ESG) is a highly cost-effective, less invasive alternative to surgery for Class I obesity, with an ICER well below willingness-to-pay thresholds.
For Class I obesity, ESG offers a durable, cost-effective alternative to surgery with a favorable safety profile. It is particularly valuable for patients who want more than lifestyle changes but are not candidates for or willing to undergo surgery.
GoodSupportsHIGH confidence
ESG, a less invasive endoscopic procedure, yields around 15% weight loss and has demonstrated favorable cost-effectiveness, particularly in class I obesity.
Why this rating
Based on multiple economic modeling studies (US, UK) showing favorable ICERs.
Source
Cost-Effectiveness of Obesity Treatments: Glucagon-Like Peptide-1 Receptor Agonists, Endoscopic Sleeve Gastroplasty, and Metabolic/Bariatric Surgery
Yeon‐Ju Huh · Journal of Metabolic and Bariatric Surgery · 2025
DOI 10.17476/jmbs.2025.14.2.97
narrative_reviewCited 4×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Metabolic/bariatric surgery (MBS) is the most cost-effective intervention for class II and III obesity, often demonstrating dominance (cost-saving) over non-surgical management.Good
- GLP-1 receptor agonists (GLP-1 RAs) are not cost-effective at current prices, requiring significant price reductions to meet standard willingness-to-pay thresholds.Good
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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