{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:02:28Z","timestamp":1754154148071,"version":"3.41.2"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Endoscopic sleeve gastroplasty (ESG) is an effective treatment for obesity but typically is not covered by insurance. It is not known whether patients with financial investment in their endoscopic procedure are more likely to achieve and\/or maintain weight loss as compared with those who have no financial buy-in. We aimed to compare treatment adherence and outcomes between patients paying out-of-pocket (OOP) and those who underwent ESG as part of any clinical trial where costs were covered by a study protocol (no payment; NP).<\/jats:p><jats:p>Data were collected via retrospective chart review. One hundred sixty-four patients who had an ESG with at least 6 months of follow-up were included. Repeated measures with generalized linear model were used to evaluate weight loss at different time points after ESG and labs values at baseline and 1-year follow-up to assess for comorbidity improvement between cohorts. Compliance was evaluated by comparing exercise adherence rates.<\/jats:p><jats:p>The pattern of weight loss and change in laboratory values was not different over time between the OOP group (n = 139) and NP group (n = 25). Patients lost an average of 14% (12.2\u201315.9) and 12.9% (9.3\u201316.5) of total body weight over all time points, respectively, in both groups (6, 12 and 24 months). Treatment adherence also did not differ between the groups.<\/jats:p><jats:p>Having \u201cskin in the game\u201d by paying for ESG OOP does not correlate with better outcomes or treatment adherence, which further supports broad insurance coverage for this procedure.<\/jats:p>","DOI":"10.1055\/a-2631-7439","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T20:11:28Z","timestamp":1749586288000},"source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Financial buy-in does not affect outcomes of endoscopic sleeve gastroplasty: Retrospective cohort"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4391-4393","authenticated-orcid":false,"given":"Lea","family":"Sayegh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Akiki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim","family":"Al Annan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yara","family":"Salameh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khushboo","family":"Gala","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal","family":"Abi Mosleh","sequence":"additional","affiliation":[{"name":"Surgery, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manpreet","family":"Mundi","sequence":"additional","affiliation":[{"name":"Endocrinology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Surgery, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barham K.","family":"Abu Dayyeh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0619-5235","authenticated-orcid":false,"given":"Andrew C.","family":"Storm","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.gie.2013.04.197","article-title":"Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity","volume":"78","author":"BK Abu Dayyeh","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/S0140-6736(22)01280-6","article-title":"Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial","volume":"400","author":"BK Abu Dayyeh","year":"2022","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"3504","DOI":"10.1007\/s11695-022-06254-y","article-title":"Comparative effectiveness and safety between endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy: a meta-analysis of 6775 individuals with obesity","volume":"32","author":"A Beran","year":"2022","journal-title":"Obes Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2667","DOI":"10.2337\/db11-1118","article-title":"Poverty and Obesity in the U.S","volume":"60","author":"JA Levine","year":"2011","journal-title":"Diabetes"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1002\/oby.21837","article-title":"Skin in the game: Does paying for obesity treatment out of pocket lead to better outcomes compared to insurance coverage?","volume":"25","author":"JD Ard","year":"2017","journal-title":"Obesity (Silver Spring)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3527","DOI":"10.1007\/s11695-023-06778-x","article-title":"Medium-term weight loss and remission of comorbidities following endoscopic sleeve gastroplasty: A systematic review and meta-analysis","volume":"33","author":"M Fehervari","year":"2023","journal-title":"Obesity Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1002\/oby.22307","article-title":"Coverage for obesity prevention and treatment services: analysis of Medicaid and state employee health insurance programs","volume":"26","author":"N Jannah","year":"2018","journal-title":"Obesity (Silver Spring)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1056\/NEJMp2300516","article-title":"Medicare Part D coverage of antiobesity medications - Challenges and uncertainty ahead","volume":"388","author":"K Baig","year":"2023","journal-title":"N Engl J Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e246221","DOI":"10.1001\/jamanetworkopen.2024.6221","article-title":"Semaglutide vs endoscopic sleeve gastroplasty for weight loss","volume":"7","author":"M Haseeb","year":"2024","journal-title":"JAMA Network Open"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1038\/oby.2008.636","article-title":"The stigma of obesity: a review and update","volume":"17","author":"RM Puhl","year":"2009","journal-title":"Obesity (Silver Spring)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"E709","DOI":"10.1002\/oby.20387","article-title":"To pay or not to pay: public perception regarding insurance coverage of obesity treatment","volume":"21","author":"SJ Woolford","year":"2013","journal-title":"Obesity (Silver Spring)"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1038\/oby.2006.208","article-title":"Confronting and coping with weight stigma: an investigation of overweight and obese adults","volume":"14","author":"RM Puhl","year":"2006","journal-title":"Obesity (Silver Spring)"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.mayocp.2020.05.049","article-title":"Associations between experience of early childhood trauma and impact on obesity status, health, as well as perceptions of obesity-related health care","volume":"96","author":"MS Mundi","year":"2021","journal-title":"Mayo Clin Proc"}],"container-title":["Endoscopy International 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