{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:13:47Z","timestamp":1792782827223,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Wake Forest University","id":[{"id":"https:\/\/ror.org\/0207ad724","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bariatric interventions rely on lifestyle changes that benefit from long-term follow-up and patient engagement. Mid- and long-term outcomes following endoscopic sleeve gastroplasty (ESG) are heterogeneous and likely multifactorial. While the literature has explored patient demographic and anthropometric influence, as well as procedural technique, on post-ESG weight loss, there are knowledge gaps about the influence of aftercare programs. We hypothesize that clinician follow-up intensity and exercise participation correlate with weight loss after ESG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults who underwent ESG at a tertiary academic center with expertise in bariatric endoscopy. Patients with at least two years of follow-up and complete weight and behavioral data were included. Follow-up intensity was defined by the number of post-ESG physician or advanced practice clinician visits and categorized as close (\u2265\u20095 visits) or limited (&lt;\u20095 visits). The primary outcome was total body weight loss (TBWL%) at the most recent follow-up visit; the secondary outcome was the association between exercise participation and TBWL%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 56 individuals met inclusion criteria (mean age 49.6\u00a0years, 82.2% female). The mean duration of follow-up was 29.0\u00a0months. Baseline demographic and clinical characteristics were similar between groups. Patients with close clinician follow-up achieved significantly greater TBWL compared with those with limited follow-up (\u2212\u200913.7\u2009\u00b1\u200911.2% vs.\u2009\u2212\u20096.7\u2009\u00b1\u20098.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In categorical analyses, a higher proportion of the close follow-up group achieved\u2009\u2265\u200910,\u2009\u2265\u200915, and\u2009\u2265\u200920% TBWL. Exercise participation was reported by 69.7% of participants and was associated with numerically higher but nonsignificant TBWL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.55).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Heightened clinician follow-up after ESG was associated with approximately twice the magnitude of long-term weight loss. These findings emphasize that structured, ongoing engagement from clinical team members, as opposed to solely nutritional team members, is a critical determinant of durable success after ESG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13151-3","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:57:07Z","timestamp":1784746627000},"page":"8622-8629","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes after endoscopic sleeve gastroplasty: impact of clinician follow-up and lifestyle engagement"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9389-6795","authenticated-orcid":false,"given":"Wissam","family":"Ghusn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayah","family":"Matar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Al Annan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Sayegh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khushboo","family":"Gala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar M.","family":"Ghanem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Maselli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barham K. Abu","family":"Dayyeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Storm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"13151_CR1","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1016\/j.mayocp.2023.05.026","volume":"98","author":"B Busebee","year":"2023","unstructured":"Busebee B, Ghusn W, Cifuentes L, Acosta A (2023) Obesity: a review of pathophysiology and classification. Mayo Clin Proc 98:1842\u20131857","journal-title":"Mayo Clin Proc"},{"key":"13151_CR2","doi-asserted-by":"publisher","first-page":"2440","DOI":"10.1056\/NEJMsa1909301","volume":"381","author":"ZJ Ward","year":"2019","unstructured":"Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax C, Long MW, Gortmaker SL (2019) Projected U.S. state-level prevalence of adult obesity and severe obesity. N Engl J Med 381:2440\u20132450","journal-title":"N Engl J Med"},{"key":"13151_CR3","doi-asserted-by":"publisher","DOI":"10.1172\/JCI140065","volume":"131","author":"AM Chao","year":"2021","unstructured":"Chao AM, Quigley KM, Wadden TA (2021) Dietary interventions for obesity: clinical and mechanistic findings. J Clin Invest 131:e140065","journal-title":"J Clin Invest"},{"key":"13151_CR4","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1056\/NEJMoa2206038","volume":"387","author":"AM Jastreboff","year":"2022","unstructured":"Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A (2022) Tirzepatide once weekly for the treatment of obesity. N Engl J Med 387:205\u2013216","journal-title":"N Engl J Med"},{"key":"13151_CR5","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1038\/s41366-023-01456-5","volume":"48","author":"W Ghusn","year":"2024","unstructured":"Ghusn W, Fansa S, Anazco D, Tama E, Nicolalde B, Gala K, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feres F, Hurtado MD, Acosta A (2024) Weight loss and cardiovascular disease risk outcomes of semaglutide: a one-year multicentered study. Int J Obes 48:662\u2013667","journal-title":"Int J Obes"},{"key":"13151_CR6","doi-asserted-by":"publisher","DOI":"10.1002\/oby.70058","author":"H Gasoyan","year":"2025","unstructured":"Gasoyan H, Butsch WS, Casacchia NJ, Schulte R, Criswell V, Fox J, Renner H, Le P, Alpert J, Rothberg MB (2025) Reasons for discontinuation of obesity pharmacotherapy with semaglutide or tirzepatide in clinical practice. Obesity. https:\/\/doi.org\/10.1002\/oby.70058","journal-title":"Obesity"},{"key":"13151_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1149328","volume":"14","author":"Z Zhang","year":"2023","unstructured":"Zhang Z, Zhang Q, Tan Y, Chen Y, Zhou X, Liu S, Yu J (2023) GLP-1RAs caused gastrointestinal adverse reactions of drug withdrawal: a system review and network meta-analysis. Front Endocrinol 14:1149328","journal-title":"Front Endocrinol"},{"key":"13151_CR8","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1136\/bmj.p1863","volume":"382","author":"C Brown","year":"2023","unstructured":"Brown C (2023) High price and demand for semaglutide means lack of access for US patients. BMJ 382:1863","journal-title":"BMJ"},{"key":"13151_CR9","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61020350","volume":"61","author":"W Ghusn","year":"2025","unstructured":"Ghusn W, Zeineddine J, Betancourt RS, Gajjar A, Yang W, Robertson AG, Ghanem OM (2025) Advances in metabolic bariatric surgeries and endoscopic therapies: a comprehensive narrative review of diabetes remission outcomes. Medicina 61:350","journal-title":"Medicina"},{"key":"13151_CR10","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13698","volume":"25","author":"M Majstorovic","year":"2024","unstructured":"Majstorovic M, Chur-Hansen A, Andrews JM, Burke A (2024) Factors associated with progression or non-progression to bariatric surgery in adults: a systematic review. Obes Rev 25:e13698","journal-title":"Obes Rev"},{"key":"13151_CR11","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1053\/j.gastro.2017.01.035","volume":"152","author":"BK Abu Dayyeh","year":"2017","unstructured":"Abu Dayyeh BK, Edmundowicz S, Thompson CC (2017) Clinical practice update: expert review on endoscopic bariatric therapies. Gastroenterology 152:716\u2013729","journal-title":"Gastroenterology"},{"key":"13151_CR12","doi-asserted-by":"publisher","first-page":"469","DOI":"10.4253\/wjge.v15.i6.469","volume":"15","author":"DB Maselli","year":"2023","unstructured":"Maselli DB, Hoff AC, Kucera A, Weaver E, Sebring L, Gooch L, Walton K, Lee D, Cratty T, Beal S, Nanduri S, Rease K, Gainey CS, Eaton L, Coan B, McGowan CE (2023) Endoscopic sleeve gastroplasty in class III obesity: efficacy, safety, and durability outcomes in 404 consecutive patients. World J Gastrointest Endosc 15:469\u2013479","journal-title":"World J Gastrointest Endosc"},{"key":"13151_CR13","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14134681","volume":"14","author":"W Ghusn","year":"2025","unstructured":"Ghusn W, Divakar A, Salameh Y, Abi Mosleh K, Storm AC (2025) Emerging trends in endoscopic bariatric therapies: personalization through genomics and synergistic pharmacotherapy. J Clin Med 14:4681","journal-title":"J Clin Med"},{"key":"13151_CR14","doi-asserted-by":"publisher","first-page":"4318","DOI":"10.1007\/s11695-024-07510-z","volume":"34","author":"BKA Dayyeh","year":"2024","unstructured":"Dayyeh BKA, Stier C, Alqahtani A, Sharaiha R, Bandhari M, Perretta S, Jirapinyo SP, Prager G, Cohen RV (2024) IFSO bariatric endoscopy committee evidence-based review and position statement on endoscopic sleeve gastroplasty for obesity management. Obes Surg 34:4318\u20134348","journal-title":"Obes Surg"},{"key":"13151_CR15","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.igie.2023.12.004","volume":"3","author":"DB Maselli","year":"2024","unstructured":"Maselli DB, Kucera A, Chapman CG, Coan B, Waseem A, Wooley C, McGowan CE (2024) The endoscopic bariatric patient: characteristics, beliefs, and fears. iGIE 3:82\u201391","journal-title":"iGIE"},{"key":"13151_CR16","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/S0140-6736(22)02403-5","volume":"401","author":"CM Perdomo","year":"2023","unstructured":"Perdomo CM, Cohen RV, Sumithran P, Cl\u00e9ment K, Fr\u00fchbeck G (2023) Contemporary medical, device, and surgical therapies for obesity in adults. Lancet 401:1116\u20131130","journal-title":"Lancet"},{"key":"13151_CR17","doi-asserted-by":"publisher","first-page":"2711","DOI":"10.1007\/s11695-023-06715-y","volume":"33","author":"DB Maselli","year":"2023","unstructured":"Maselli DB, Waseem A, Lee D, Wooley C, Donnangelo LL, Coan B, McGowan CE (2023) Performance characteristics of endoscopic sleeve gastroplasty in patients with prior intragastric balloon: results of a propensity score matched study. Obes Surg 33:2711\u20132717","journal-title":"Obes Surg"},{"key":"13151_CR18","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1007\/s11695-024-07109-4","volume":"34","author":"MV Matteo","year":"2024","unstructured":"Matteo MV, Bove V, Ciasca G, Carlino G, Di Santo R, Vinti L, Polidori G, Pontecorvi V, Papi M, Spada C, Bo\u0161koski I (2024) Success predictors of endoscopic sleeve gastroplasty. Obes Surg 34:1496\u20131504","journal-title":"Obes Surg"},{"key":"13151_CR19","doi-asserted-by":"publisher","first-page":"E1349","DOI":"10.1055\/a-1221-9835","volume":"8","author":"E Espinet-Coll","year":"2020","unstructured":"Espinet-Coll E, Nebreda-Dur\u00e1n J, Galvao-Neto M, Bautista-Altamirano C, Diaz-Gal\u00e1n P, G\u00f3mez-Valero JA, Vila-Lolo C, Guirola-Puche MA, Fern\u00e1ndez-Hu\u00e9lamo A, Bargall\u00f3-Carulla D, Juan-Creix Comamala A (2020) Suture pattern does not influence outcomes of endoscopic sleeve gastroplasty in obese patients. Endosc Int Open 8:E1349\u2013E1358","journal-title":"Endosc Int Open"},{"key":"13151_CR20","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1097\/CM9.0000000000002097","volume":"135","author":"B Rapaka","year":"2022","unstructured":"Rapaka B, Maselli DB, Lopez-Nava G, Bautista-Casta\u00f1o I, Matar R, Jaruvongvanich V, Vargas EJ, Storm AC, Acosta A, Abu Dayyeh BK (2022) Effects on physiologic measures of appetite from intragastric balloon and endoscopic sleeve gastroplasty: results of a prospective study. Chin Med J 135:1234\u20131241","journal-title":"Chin Med J"},{"key":"13151_CR21","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1136\/gutjnl-2022-327816","volume":"72","author":"EJ Vargas","year":"2023","unstructured":"Vargas EJ, Rizk M, Gomez-Villa J, Edwards PK, Jaruvongvanich V, Storm AC, Acosta A, Lake D, Fidler J, Bharucha AE, Camilleri M, Abu Dayyeh BK (2023) Effect of endoscopic sleeve gastroplasty on gastric emptying, motility and hormones: a comparative prospective study. Gut 72:1073\u20131080","journal-title":"Gut"},{"key":"13151_CR22","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1002\/oby.21591","volume":"24","author":"MA Kalarchian","year":"2016","unstructured":"Kalarchian MA, Marcus MD, Courcoulas AP, Lutz C, Cheng Y, Sweeny G (2016) Structured dietary intervention to facilitate weight loss after bariatric surgery: a randomized, controlled pilot study. Obesity 24:1906\u20131912","journal-title":"Obesity"},{"key":"13151_CR23","doi-asserted-by":"publisher","first-page":"E222","DOI":"10.1055\/s-0041-110771","volume":"4","author":"G Lopez-Nava","year":"2016","unstructured":"Lopez-Nava G, Galvao M, Bautista-Casta\u00f1o I, Fernandez-Corbelle JP, Trell M (2016) Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success. Endosc Int Open 4:E222\u2013E227","journal-title":"Endosc Int Open"},{"key":"13151_CR24","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1056\/NEJMe020117","volume":"347","author":"AR Tall","year":"2002","unstructured":"Tall AR (2002) Exercise to reduce cardiovascular risk\u2014how much is enough? N Engl J Med 347:1522\u20131524","journal-title":"N Engl J Med"},{"key":"13151_CR25","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1037\/0022-006X.56.4.529","volume":"56","author":"MG Perri","year":"1988","unstructured":"Perri MG, McAllister DA, Gange JJ, Jordan RC, McAdoo G, Nezu AM (1988) Effects of four maintenance programs on the long-term management of obesity. J Consult Clin Psychol 56:529\u2013534","journal-title":"J Consult Clin Psychol"},{"key":"13151_CR26","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.mcna.2017.08.012","volume":"102","author":"KD Hall","year":"2018","unstructured":"Hall KD, Kahan S (2018) Maintenance of lost weight and long-term management of obesity. Med Clin North Am 102:183\u2013197","journal-title":"Med Clin North Am"},{"key":"13151_CR27","doi-asserted-by":"publisher","first-page":"E1691","DOI":"10.1055\/a-1007-1769","volume":"7","author":"G Lopez-Nava","year":"2019","unstructured":"Lopez-Nava G, Asokkumar R, Rull A, Corbelle F, Beltran L, Bautista I (2019) Bariatric endoscopy procedure type or follow-up: what predicted success at 1 year in 962 obese patients? Endosc Int Open 7:E1691\u2013E1698","journal-title":"Endosc Int Open"},{"key":"13151_CR28","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1017\/S1368980099000452","volume":"2","author":"MA van Baak","year":"1999","unstructured":"van Baak MA (1999) Physical activity and energy balance. Public Health Nutr 2:335\u2013339","journal-title":"Public Health Nutr"},{"key":"13151_CR29","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.1249\/MSS.0000000000000303","volume":"46","author":"M Schumann","year":"2014","unstructured":"Schumann M, K\u00fc\u00fcsmaa M, Newton RU, Sirparanta AI, Syv\u00e4oja H, H\u00e4kkinen A, H\u00e4kkinen K (2014) Fitness and lean mass increases during combined training independent of loading order. Med Sci Sports Exerc 46:1758\u20131768","journal-title":"Med Sci Sports Exerc"},{"key":"13151_CR30","doi-asserted-by":"publisher","first-page":"1257061","DOI":"10.3389\/fendo.2023.1257061","volume":"14","author":"FM Finucane","year":"2023","unstructured":"Finucane FM, Gibson I, Hughes R, Murphy E, Hynes L, Harris A, McGuire BE, Hynes M, Collins C, Cradock K, Seery S, Jones J, O\u2019Brien T, O\u2019Donnell MJ (2023) Factors associated with weight loss and health gains in a structured lifestyle modification programme for adults with severe obesity: a prospective cohort study. Front Endocrinol 14:1257061","journal-title":"Front Endocrinol"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13151-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13151-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13151-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T15:13:04Z","timestamp":1790953984000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-026-13151-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["13151"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-13151-3","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"4 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"ACS: Research Grants from Apollo Endosurgery, Boston Scientific, Endogenex, Endo-TAGSS, Enterasense, EnVision Endoscopy, MGI Medical, OnePass, SofTac, Consultant for Apollo Endosurgery, Boston Scientific, Cook, Fuji, Sotelix, GI Dynamics, Intuitive, Medtronic, Microtech, Olympus. DBM: Prior consultant for Apollo Endosurgery\/Boston Scientific. Prior independent contract work for Bariendo Medical Group. BKA: Received consultancy fees and research support from Boston Scientific, Apollo Endosurgery, Olympus, and Medtronic. He has also received research support from Endogastric Solutions and serves as a consultant and advisory board member for Metamodix. In addition, he is a co-inventor of Endogenex, a technology licensed by the Mayo Clinic. Dr Vitor Brunaldi is a speaker, consultant, proctor, and preceptor for Boston Scientific LATAM and a consultant for GI Windows, USA. All other authors have no conflicts of interest to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}