weight at one year, compared to 0.8% total body weight loss and 3.2% excess weight loss in the control arm at the same time point. Weight loss Prior to the MERIT study, numerous meta-analyses of studies on ESG report a total body weight loss of approximately 16% at one year. Excess weight loss was observed to be approximately 60% at one year. Weight loss reported from high volume community practices that have both expertise in ESG and robust longitudinal aftercare programs with dietitians have shown even greater outcomes, with total body weight loss approaching 30% and excess weight loss of 66% at one year. Predictors of greater weight loss Patient selection is an important consideration for any weight loss therapy. The present published literature shows either no influence or conflicting results for patient age, sex, starting weight/BMI on weight loss from ESG. Long-term after care programs have demonstrated benefit for sustained weight loss after ESG, with one study showing that patients who continued after care visits following ESG had 20.5% total body weight loss compared to 16.9% total body weight loss in those who dropped out of long-term follow up programs. Weight-related comorbidities There are over 200 obesity-related comorbidities, and it has been reported that achieving a total body weight loss of 10% has a significant impact of such conditions. Thus, the weight loss outcomes with ESG are unsurprisingly accompanied by an improvement in several obesity-related comorbidities. Weight loss facilitated by ESG has been observed to bring about benefits in or even cure of diabetes/insulin sensitivity, dyslipidemia, blood pressure, and fatty liver disease, as well as quality of life. The MERIT study showed 80% of patients who underwent ESG had improvement in one or more comorbidities at one year. Durability Mid-term durability from ESG appears promising. A total body weight loss of 17% and excess weight loss of between approximately 60-67% was observed to be sustained at 18–24 months. This was later confirmed in the multicenter, randomized controlled MERIT study, which observed that 68% of subjects who underwent an ESG maintained 25% or more of their excess weight loss at two years. As a novel therapy, ESG presently lacks studies assessing long-term durability, though more data on this component of ESG are anticipated as more ESGs are performed over time. One recent study observed at 5 years from ESG that at least 10% total body weight loss was maintained in