David Geffen School of Medicine at UCLA Los Angeles, California
Farnoosh Vahedi, MD1, Vahagn Aldzhyan, MS1, Vismaya Bachu, BS, MD2, Meghna Yalamanchi, MD3, Kelsy N. Larios, BS1, Jose Garcia-Corella, MD4, Hellen Jumo, BS1, Melanie Ramirez, 1, Vidhi Singh, 1, Lavender Micalo, BSc1, Venkataraman R. Muthusamy, MD, MAS1, Danny Issa, MD5 1David Geffen School of Medicine at UCLA, Los Angeles, CA; 2University of California Los Angeles Medical Center, Los Angeles, CA; 3Olive View-UCLA Medical Center, Sylmar, CA; 4UCLA-Kern Medical, Bakersfield, CA; 5David Geffen School of Medicine at UCLA, West Hills, CA Introduction: It remains unclear whether patients with long-standing obesity respond similarly to weight loss interventions as those with more recent, rapid weight gain. We hypothesized that longer obesity duration may affect responsiveness to treatment. This study aimed to evaluate the impact of the chronicity of obesity on outcomes following two interventions: endoscopic sleeve gastroplasty (ESG) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Methods: Adults treated with ESG or GLP-1RAs (semaglutide or tirzepatide) from 2016 to 2024 were included. Long-term obesity (chronically obese) was defined as a stable BMI >30 kg/m² prior to Jan 2020. Recent obesity was defined as ≥7% weight gain since January 2020, and BMI ≥30 kg/m² within 3 years of treatment. Patients were categorized into four groups: chronic GLP-1 RA, recent GLP-1 RA, chronic ESG, and recent ESG. The primary outcome was total body weight loss (%TBWL) at 3, 6, and 12 months. Comparisons were conducted using t-tests and multivariate regression. Results: A total of 115 patients were included: chronic GLP-1 RA (n=43), recent GLP-1 RA (n=38), chronic ESG (n=22), and recent ESG (n=12). Mean age was 50 ± 12 years; 84% were female. Baseline characteristics were similar across groups. At 3 months, recent ESG group achieved significantly greater %TBWL than chronic ESG group (13% ± 5% vs. 8% ± 3%, p< 0.05), a difference that persisted at 6 months (17% ± 6% vs. 10% ± 4%, p< 0.05) but not at 12 months (19% ± 9% vs. 17% ± 9%, p=0.621). Among GLP-1RA users, %TBWL did not differ significantly between recent and chronic groups at 3 months (5% ± 3% vs. 6% ± 4%, p=0.184), 6 months (9% ± 6% in both, p=0.995), or 12 months (12% ± 7% vs. 16% ± 10%, p=0.230). ESG produced significantly greater weight loss than GLP-1RA at 3 (10% ± 5% vs. 6% ± 4%, p< 0.05) and 6 months (14% ± 7% vs. 10% ± 6%, p< 0.05). By 12 months, the difference was no longer statistically significant (18% ± 9% vs. 14% ± 8%, p=0.121). Discussion: Patients with recent-onset obesity achieved significantly greater weight loss at 3 and 6 months following ESG compared to those with long-standing obesity. However, by 12 months, outcomes were comparable. In contrast, GLP-1RA effectiveness did not differ based on obesity duration. These findings suggest that prolonged exposure to obesity may impair the body's early response to endoscopic interventions. Larger studies are warranted to explore the pathophysiological mechanisms and to tailor treatment strategies based on obesity chronicity.
Figure: Table 1. Demographic and clinical characteristics, and weight loss outcomes of chronically and recently obese adults treated with ESG or GLP1-RA
Figure: Figure 1. Total body weight loss over time by treatment and obesity chronicity
Disclosures: Farnoosh Vahedi indicated no relevant financial relationships. Vahagn Aldzhyan indicated no relevant financial relationships. Vismaya Bachu indicated no relevant financial relationships. Meghna Yalamanchi indicated no relevant financial relationships. Kelsy Larios indicated no relevant financial relationships. Jose Garcia-Corella indicated no relevant financial relationships. Hellen Jumo indicated no relevant financial relationships. Melanie Ramirez indicated no relevant financial relationships. Vidhi Singh indicated no relevant financial relationships. Lavender Micalo indicated no relevant financial relationships. Venkataraman Muthusamy: Boston Scientific – Consultant. Danny Issa: Boston Scientific – Consultant.
Farnoosh Vahedi, MD1, Vahagn Aldzhyan, MS1, Vismaya Bachu, BS, MD2, Meghna Yalamanchi, MD3, Kelsy N. Larios, BS1, Jose Garcia-Corella, MD4, Hellen Jumo, BS1, Melanie Ramirez, 1, Vidhi Singh, 1, Lavender Micalo, BSc1, Venkataraman R. Muthusamy, MD, MAS1, Danny Issa, MD5. P2707 - Impact of Obesity Duration on Weight Loss Outcomes Following Endoscopic Sleeve Gastroplasty and GLP-1 Receptor Agonists, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
