A 90-minute procedure that reduces the size the stomach without the need for surgery has been deemed “safe and effective” for the NHS to use to treat obese people in England.
It is hoped the move will save the health service money, with obesity estimated to cost £6.5 billion per year.
Endoscopic sleeve gastroplasty (ESG), also known as an “accordion procedure”, works by inserting a flexible tube with a camera and medical instruments into the stomach through a patient’s mouth.
Sections of the stomach wall are then folded and stitched together to create a tube-like sleeve, making patients feel fuller sooner.
The procedure takes 90 minutes, with patients usually able to go home on the same day, and is reversible.
In draft guidance, the National Institute for Health and Care Excellence (Nice) said ESG should be offered to patients with a BMI of 30 or more who have not lost weight with lifestyle changes and are not suitable for surgery.
One of the benefits is that this procedure can be carried out as a day case, and not involve an overnight stay, reducing the time people spend in hospital compared with other surgical options. Recovery is also quicker— Professor Jonathan Benger, Nice
Those from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds should be offered the treatment if their BMI is 27.5 or above.
Weight-loss surgery, such as gastric bands or bypasses, is currently an option for those with a BMI of 40 or more, or in patients with a BMI of over 35 with other conditions such as type 2 diabetes.
Professor Jonathan Benger, chief medical officer at Nice, said: “We know people who live with obesity or who are overweight are more likely to be at risk of other conditions such as type 2 diabetes, hypertension or cardiovascular disease.
“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.
“Our committee has found endoscopic sleeve gastroplasty for people living with obesity to be a safe and effective procedure which can reduce the size of the stomach and, therefore, make them feel fuller on a smaller amount of food.
“One of the benefits is that this procedure can be carried out as a day case, and not involve an overnight stay, reducing the time people spend in hospital compared with other surgical options. Recovery is also quicker.”
According to Nice, obesity costs the NHS an estimated £6.5 billion per year and is the second-biggest preventable cause of cancer.
The Health Survey for England 2021 found 25.9 per cent of adults in England are obese, with a further 37.9 per cent overweight.
Prof Benger added: “Surgical treatment options are in high demand and not everyone wants, or is fit enough, to undergo an operation like bariatric surgery.
“A non-invasive procedure like endoscopic sleeve gastroplasty could be a welcome new option for some people.”
A consultation on Nice’s guidance is now open and will run until October 26.The recommendation is the latest from Nice to help tackle obesity.
Earlier this year it gave weight loss jab semaglutide, sold under the brand name Wegovy, the green light for patients with a BMI of over 30, or higher than 27 in the presence of other co-morbidities.
It launched in the UK in August and is now available to patients via specialist services.
About 50,000 people are expected to benefit despite a global shortage of semaglutide.
Last month, Nice recommended tirzepatide – also known as Mounjaro – as a possible treatment for type 2 diabetes. The drug belongs to the same family as weight-loss jabs.
It is currently being appraised by Nice as a tool for weight-loss separately.
