16 May DDW21: Semaglutide Augments Weight Loss With Minimal Surgical Procedure

MedicalResearch.com Interview with:

Dr. Hoff

Anna Carolina Hoff, MD
Lead researcher on the study
Founder and Clinical Director
Angioskope Brazil
São José dos Campos 

MedicalResearch.com: What is the background for this study?

Response: Obesity is a chronic disease that has become a global pandemic, and its prevalence continues to increase. Overweight (Body Mass Index (BMI) ≥ 27 kg/m2) and obesity (BMI ≥ 30kg/m2) lead to numerous clinical comorbidities, including metabolic, cardiovascular, oncologic, and mental health disorders. It is challenging to achieve significant and sustained weight loss with diet and lifestyle modification alone. Additionally, a reversal of obesity-related co-morbidities and improvement in quality of life entails a percent total body weight loss (%TBWL) of between 5-10%, which is rarely achieved with medications alone. The Endoscopic Sleeve Gastroplasty (ESG) results in a %TBWL between 14.6%-19.7% at 18-24 months,  and improvements in systolic blood pressure (SBP), HbA1c, and dyslipidemia at 12 months.

MedicalResearch.com: Would you briefly describe the ESG procedure?

Response: ESG is an incisionless, minimally invasive technique that involves remodeling of the greater curvature of the stomach. procedures are performed in an outpatient endoscopy suite or at a hospital with the patient under general anesthesia and carbon dioxide insufflation. Full-thickness sutures are applied with an endoscopic suturing system along the stomach’s greater curvature to create a narrow sleeve-like structure and reduce the volume by approximately 70%. Patients don’t need to stay at the hospital overnight.

MedicalResearch.com: Can semaglutide be prescribed in patients without diabetes?

Response: A recent study published in 2021 answers this question. Findings of the STEP 1 study show marked weight loss in people with obesity but without type 2 diabetes during more than a year of treatment with a high dose of semaglutide. There were no reports of hypoglycemia among non-diabetic patients. 

MedicalResearch.com: What are the main findings? 

Response: Our study demonstrates that semaglutide, when used in combination with ESG, will augment weight loss, promote reduction in visceral fat, and reduce HbA1c at 12 months. Combination therapy of ESG with semaglutide has great potential, given that weight loss outcomes approach Bariatric surgery outcomes, and none of our patients discontinued treatment due to side effects. 

MedicalResearch.com: What should readers take away from your report? 

Response: Bariatric surgery remains the gold standard for significant, sustained weight loss and improvement of metabolic outcomes. However, less than 2% of eligible patients pursue this option due to negative perceptions of invasiveness, perceived risk of associated adverse events, lack of resources, or availability of care. As the prevalence of obesity and its comorbidities increase, cost-effective alternative methods of management that achieve similar weight loss outcomes and improvement in metabolic parameters are essential. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Since we have already shown that a GLP-1 analogue induces weight loss specially combined with EBT, we are now developing a combination of other analogue hormones to improve outcomes.

MedicalResearch.com: Is there anything else you would like to add?

Response: My personal belief is that obesity treatments are moving towards minimally invasive therapies associated with weight loss medications. Once the targeted weight is achieved, we can adjust drugs and dosage for weight maintenance.  Being a bit bold I’d say we could sort an individual subcutaneous implant that deploys the exact amount needed for obesity control. It’s a chronic disease. But we’re walking towards remission. That’s what I seek in my everyday job and research.

I have no disclosures.

Citation:

DDW 21 abstract
“Semaglutide in association to endoscopic sleeve gastroplasty: Taking endoscopic bariatric procedures outcomes to the next level,” abstract Su548,

Sponsored text: Furthermore, the benefits of combining ESG with semaglutide may extend beyond weight loss and glycemic control. Considering the positive outcomes observed in our study cohort, exploring the accessibility of such therapies, including online semaglutide in Los Angeles (or any other location), could potentially broaden the scope of treatment options for individuals struggling with obesity and diabetes.

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Last Updated on February 28, 2024 by Marie Benz MD FAAD