S812 Long-Term Weight Loss After Endoscopic Sleeve Gastroplasty: The Role of Clinical Follow-Up and Lifestyle Engagement

Introduction: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive bariatric procedure that induces meaningful weight loss in individuals with obesity. Long-term success, however, may depend on sustained behavioral and clinical support. Despite growing utilization, limited data exist on how follow-up intensity and lifestyle interventions impact long-term weight outcomes. This study aimed to evaluate the effects of close clinical follow-up and exercise participation on total body weight loss (TBWL) up to 3 years after ESG. Methods: We conducted a retrospective cohort study of adults who underwent ESG at a tertiary academic center. Patients with less than 2 years of follow-up were excluded. The cohort was divided into 2 groups based on the number of post-procedure clinical visits: ≥5 visits versus <5 visits. Demographic, clinical, and behavioral data, including participation in a structured exercise regimen, were extracted from the electronic health record. The primary aim was to assess the association between TBWL and clinical follow-up frequency. The secondary aim was to evaluate whether exercise engagement contributed to greater TBWL. Between-group comparisons were performed using t-tests and chi-square tests. Results: Seventy-seven patients met inclusion criteria (mean age 49.6 ± 11.3 years; 81.8% women; 89.6% White) with a follow up period of 29.0 ± 6.0 months. No significant differences in baseline demographics, comorbidities or follow-up periods were observed between groups. Patients with ≥5 follow-up visits (n = 35) achieved significantly greater TBWL (−13.7 ± 11.2%) compared to those with <5 visits (n = 21; −6.7 ± 8.2%; P = 0.0. Exercise participation was reported in 69.7% of the cohort. Those who reported engaging in exercise had slightly greater TBWL (−11.0 ± 11.4%) than non-exercisers (−9.3 ± 10.8%), although this difference was not statistically significant (P = 0.55). Conclusion: In this real-world cohort of ESG patients followed for 2 or more years, close clinical follow-up was associated with significantly greater weight loss. Exercise participation was also linked to improved TBWL, though not statistically significant. These findings emphasize the importance of structured, long-term multidisciplinary care in optimizing ESG outcomes and suggest that close follow-up should be a cornerstone of post-ESG management strategies.