A groundbreaking 90-minute procedure that reduces stomach size without resorting to surgery has been officially declared “safe and effective” for implementation within the NHS to address obesity issues in England.
This innovative development is expected to bring significant financial relief to the healthcare system, as the annual cost attributed to obesity in the United Kingdom stands at a staggering £6.5 billion.
The procedure, known as Endoscopic Sleeve Gastroplasty (ESG) or colloquially referred to as the “accordion procedure,” involves the insertion of a flexible tube equipped with a camera and medical instruments through the patient’s mouth into the stomach. Within the stomach, segments of the stomach wall are folded and stitched together to form a tube-like sleeve, which induces an earlier sense of fullness in patients.
Notably, this procedure is completed in just 90 minutes, with patients typically returning home on the same day of the operation. Importantly, it is also reversible.
According to draft guidance provided by the National Institute for Health and Care Excellence (Nice), ESG should be offered to individuals with a Body Mass Index (BMI) of 30 or higher who have not achieved significant weight loss through lifestyle changes and are not suitable candidates for surgery.
Furthermore, individuals from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean family backgrounds should be considered for this treatment if their BMI is 27.5 or above.
Weight-loss surgeries, such as gastric bands or bypasses, are currently options for individuals with a BMI of 40 or higher, or those with a BMI exceeding 35 accompanied by other conditions, such as type 2 diabetes.
Professor Jonathan Benger, Chief Medical Officer at Nice, emphasized the potential benefits of ESG, stating, “A procedure which helps to reduce a person’s weight is one way to lower the risk of developing these conditions, and to improve overall health and wellbeing.” He added that the procedure’s advantages include its suitability for outpatient care, eliminating the need for overnight hospital stays and expediting recovery.
According to Nice, obesity presents a considerable financial burden on the NHS and ranks as the second-largest preventable cause of cancer.
The Health Survey for England 2021 revealed that 25.9 percent of adults in England are obese, with an additional 37.9 percent classified as overweight.
Professor Benger emphasized the significance of offering non-invasive alternatives, stating, “A non-invasive procedure like endoscopic sleeve gastroplasty could be a welcome new option for some people.”
A public consultation on Nice’s guidance is currently open and will continue until October 26, allowing stakeholders and experts to provide input on the recommendation.
This announcement follows previous recommendations by Nice to combat obesity, including the approval earlier this year of the weight loss injection semaglutide, marketed as Wegovy, for patients with a BMI over 30 or higher than 27 when accompanied by other co-morbidities. Wegovy was made available to patients in the UK in August.
Despite a global shortage of semaglutide, approximately 50,000 individuals are expected to benefit from this treatment.
In a related development, Nice also recommended tirzepatide, known as Mounjaro, as a potential treatment for type 2 diabetes, a drug belonging to the same family as weight-loss injections. Notably, tirzepatide is currently undergoing separate evaluation by Nice for its efficacy in weight loss.