Background

This study aims to provide insights into weight loss patterns and comorbidity improvements over a minimum 5-year follow-up period following ESG in a single academic centre in India.

Methods

In this prospective cohort study, ESG procedures were performed by the same surgeon on patients with a body mass index (BMI) greater than 30 kg/m2 (or >27 with comorbidities) for obesity treatment. The patients were systematically followed annually after the procedure, and data on primary and secondary outcomes were collected and analyzed.

Results

A total of 941 patients, predominantly female (69.3%), with an average age of 40.70 +- 12.66 years and a mean BMI of 34.30 +- 5.05 kg/m2, underwent ESG. Follow-up rates at 1, 2, 3, 4and five years were 90.1%, 77.2%, 70.7%, 67.8%, and 65.9%, respectively. The mean percentage total body weight loss was 12.19% (95% confidence interval [CI]: 11.12-13.18), with 90% of participants maintaining a percentage of total weight loss of >=5% and 70% maintaining an excess weight loss (EWL) of >=25% at five years. Furthermore, comorbidities, such as type 2 diabetes mellitus (T2DM), hypertension, dyslipidaemia, and obstructive sleep apnea, showed significant improvements with remission rates of 51.2%, 65.8%, 73.6%, and 89.9%, respectively. There were no emergency interventions, mortality, or significant morbidity cases.

Conclusions

This study demonstrates the favourable long-term outcomes of ESG for five years in a single academic centre in India. Regular multidisciplinary monitoring supports sustained weight loss, comorbidity resolution, and improved quality of life with low perioperative complications.