Mixed
Endoscopic Bariatric Procedures (EBP), including intragastric balloon (IGB), aspiration therapy (AT), and primary obesity surgery endoluminal (POSE), are generally less effective than newer OMMs (semaglutide, tirzepatide) and have limited long-term data.
Endoscopic procedures (IGB, AT, POSE, ESG) offer moderate weight loss (3.8-12.8% TBWL) in the short term but are generally less effective than newer medications (semaglutide, tirzepatide) and lack long-term efficacy data. They may be considered for patients who are not candidates for surgery or high-dose medications, but they are not the most effective option for significant, sustained weight loss.
EBP, except ESG, was less effective than newer OMMs. Long- term data were lacking for most OMM and all EBP.
Why this rating
Based on 21 RCTs (n=2934), with limited long-term follow-up data available.
Source
Efficacy and Safety of Pharmacological, Endoscopic, and Surgical Treatments for Obesity: A <scp>GRADE</scp> ‐Based Network Meta‐Analysis
Maurizio De Luca et al. · Obesity · 2026
DOI 10.1002/oby.70083
More from this paper
- Metabolic bariatric surgery (MBS) procedures, specifically Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), single anastomosis duodenal-ileal bypass (SADI), and biliopancreatic diversion (BPD), provide superior long-term total body weight loss (TBWL) compared to obesity management medications (OMM) and endoscopic bariatric procedures (EBP).Good
- Newer obesity management medications (OMMs), specifically semaglutide (2.4 mg) and tirzepatide (10-15 mg), demonstrate high efficacy comparable to metabolic bariatric surgery (MBS) in the short term (26-52 weeks), with tirzepatide achieving >15% TBWL.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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