Effect of Aspiration Therapy on Obesity-Related Comorbidities: Systematic Review and Meta-Analysis
Open accessAbstract
BACKGROUND/AIMS: Aspiration therapy (AT) involves endoscopic placement of a gastrostomy tube with an external device that allows patients to drain 30% of ingested calories after meals. Its efficacy for inducing weight loss has been shown. This study aimed to assess the effect of AT on obesity-related comorbidities. METHODS: A meta-analysis of studies that assessed AT outcomes was conducted through December 2018. Primary outcomes were changes in comorbidities at 1 year following AT. Secondary outcomes were the amount of weight loss at up to 4 years and pooled serious adverse events (SAEs). RESULTS: Five studies with 590 patients were included. At 1 year, there were improvements in metabolic conditions: mean difference (MD) in systolic blood pressure: -7.8 (-10.7 - -4.9) mm Hg; MD in diastolic blood pressure: -5.1 (-7.0 - 3.2) mm Hg; MD in triglycerides: -15.8 (-24.0 - -7.6) mg/dL; MD in high-density lipoprotein: 3.6 (0.7-6.6) mg/dL; MD in hemoglobin A1c (HbA1c): -1.3 (-1.8 - -0.8) %; MD in aspartate transaminase: -2.7 (-4.1 - -1.3) U/L; MD in alanine transaminase: -7.5 (-9.8 - -5.2) U/L. At 1 (n=218), 2 (n=125), 3 (n=46), and 4 (n=27) years, the patients experienced 17.8%, 18.3%, 19.1%, and 18.6% total weight loss (TWL), corresponding to 46.3%, 46.2%, 48.0%, and 48.7% excess weight loss (EWL) (p<0.0001 for all). Subgroup analysis of 2 randomized controlled trials (n=225) showed that AT patients lost more weight than did controls by 11.6 (6.5-16.7) %TWL and 25.6 (16.0-35.3) %EWL and experienced greater improvement in HbA1c and alanine transaminase by 1.3 (0.8-1.8) % and 9.0 (3.9-14.0) U/L. The pooled SAE rate was 4.1%. CONCLUSION: Obesity-related comorbidities significantly improved at 1 year following AT. Additionally, a subgroup of patients who continued to use AT appeared to experience significant weight loss that persisted up to at least 4 years.
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Aspiration therapy reduces ALT by 5.2-8.9 U/L over 12 months.
“Aspiration therapy, though effective, resulted in slower ALT declines of 5.2–8.9 U/L over 12 months [91].”
From Impact of Bariatric Surgery and Endoscopic Therapies on Liver Health in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review (2025) · cites this paper as [91]
The Results (Primary outcome) report that ALT decreased by 7.5 U/L at one year, supporting the direction and timeframe of the claim. The reported 95% confidence interval is 5.2–9.8 U/L, not the cited range of 5.2–8.9 U/L. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAspiration therapy reduces AST by 2.7 U/L.
“Additionally, a meta-analysis of 590 patients reported significant reductions in ALT (−5.2 to −9.8 U/L) and AST (−2.7 U/L) levels (p < 0.0001) [91].”
From Impact of Bariatric Surgery and Endoscopic Therapies on Liver Health in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review (2025) · cites this paper as [91]
Aspiration therapy reduces ALT by 5.2 to 9.8 U/L.
“Additionally, a meta-analysis of 590 patients reported significant reductions in ALT (−5.2 to −9.8 U/L) and AST (−2.7 U/L) levels (p < 0.0001) [91].”
From Impact of Bariatric Surgery and Endoscopic Therapies on Liver Health in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review (2025) · cites this paper as [91]
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Cites
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Updates in endoscopic bariatric and metabolic therapies.
Qureshi, H., Saeed, N., & Jovani, M. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12031126 · Cited by 21 · see citing works
Tasabehji, D., Saleh, S., & Mokadem, M. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14124012 · Cited by 14 · see citing works
- Authors
- Jirapinyo, P., de Moura, D. T. H., Horton, L. C., & Thompson, C. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Thompson, Christopher C.
- Venue
- Clinical Endoscopy
- Published
- 2020-11-30
- Volume
- 53
- Issue
- 6
- Pages
- 686-697
- ISSN
- 2234-2400 (ISSN-L)
- 2234-2443
- PMC
- PMC7719414
- OpenAlex
- W3007631376
- Cited by
- 32
- References
- 6
- Citations by year
- 2025: 4 · 2024: 6 · 2023: 5 · 2022: 5 · 2021: 11 · 2020: 1
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Endoscopy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- aspiration therapy, obesity, obesity-related comorbidities, weight loss, blood pressure, triglycerides, HDL cholesterol, HbA1c, liver enzymes, adverse events, metabolic syndrome, type 2 diabetes, dyslipidemia, hypertension, non-alcoholic fatty liver disease, bariatric surgery alternatives, excess weight loss, serious adverse events
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