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Comparative studies evaluating ESG plus AOMs versus ESG alone in adults with overweight or obesity were included. Random-effects models were used for pooled analyses<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies comprising 578 participants met inclusion criteria. At approximately seven months, combination therapy showed a modest, non-significant advantage in total weight loss (mean difference +1.9% TWL; 95% CI \u2212\u00a01.22 to 4.99), with substantial heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2248 80\u201390%). For metabolic outcomes, the pooled mean difference in HbA1c change was minimal (\u2212\u00a00.04%; 95% CI \u2212\u00a00.37 to 0.28;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.79), and individual studies reported inconsistent effects\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ESG combined with AOMs may enhance early weight loss in selected settings; however, current evidence does not support consistent long-term superiority over ESG alone for weight or glycemic outcomes. Although the available data remain limited and heterogeneous, concomitant therapy may be considered in selected patients rather than as a universally superior strategy. Multicenter randomized trials with standardized pharmacotherapy protocols, longer follow-up, and improved patient stratification are needed to clarify durability, cost-effectiveness, and the subgroups most likely to benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12936-w","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:35:03Z","timestamp":1784907303000},"page":"6508-6527","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the concomitant use of anti-obesity medications with endoscopic sleeve gastroplasty versus endoscopic sleeve gastroplasty alone: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9586-8109","authenticated-orcid":false,"given":"Luiz Gustavo","family":"de Quadros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoel Galv\u00e3o","family":"Neto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caio Colturato","family":"Coimbra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Teixieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Admar Concon","family":"Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto Luiz Kaiser","family":"Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martins Fideles","family":"dos Santos Neto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina Colombelli","family":"Pacca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Grecco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"5","key":"12936_CR1","doi-asserted-by":"publisher","first-page":"Itc65","DOI":"10.7326\/AITC202405210","volume":"177","author":"AH Gilden","year":"2024","unstructured":"Gilden AH, Catenacci VA, Taormina JM (2024) Obesity. 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