***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background We report our initial experience and 6-month outcomes in a single center using the per-oral Incisionless Operating Platform ™ ( IOP ) ( USGI Medical ) to place transmural plications in the gastric fundus and distal body using specialized suture anchors ( the Primary Obesity Surgery Endolumenal [ POSE ] procedure ) . Methods A prospect i ve observational study was undertaken with institutional Ethics Board approval in a private hospital in Barcelona , Spain . Indicated patients were WHO obesity class I – II , or III , where patients refused a surgical approach . Results Between February 28 , 2011 and March 23 , 2012 , the POSE procedure was successfully performed in 45 patients : 75.6 % female ; mean age 43.4 ± 9.2 SD ( range 21.0–64.0 ) . At baseline : mean absolute weight ( AW , kg ) , 100.8 ± 12.9 ( 75.5–132.5 ) ; body mass index ( BMI , kg/m2 ) , 36.7 ± 3.8 ( 28.1–46.6 ) . A mean 8.2 suture-anchor plications were placed in the fundus , 3.0 along the distal body wall . Mean operative time , 69.2 ± 26.6 min ( 32.0–126.0 ) ; patients were discharged in < 24 h. Six-month mean AW was 87.0 ± 10.3 ( 68.0–111.5 ) ; BMI decreased 5.8 to 31.3 ± 3.3 ( 25.1–38.6 ) ( p < 0.001 ) ; EWL was 49.4 % ; TBWL , 15.5 % . No mortality or operative morbidity . Minor postoperative side effects resolved with treatment by discharge . Patients reported less hunger and earlier satiety post procedure . Liquid intake began 12 h post procedure with full solids by 6 weeks . Conclusions At 6-month follow-up of a prospect i ve case series , the POSE procedure appeared to provide safe and effective weight loss without the scarring , pain , and recovery issues of open and laparoscopic bariatric surgery . Long-term follow-up and further study are required Background and study aims : Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity . The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure . Patients and methods : Prospect i ve single-center follow-up study of 25 patients ( 5 men , 20 women ) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction .  A multidisciplinary team provided post-procedure care . Patient outcomes were recorded at 1 year after the procedure . Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up . Results :  Mean body mass index ( BMI ) was 38.5 ± 4.6 kg/m2 ( range 30 – 47 ) and mean age 44.5 ± 8.2 years ( range 29 – 60 ) . At 1 year , 22 patients continued with the follow-up ( 2 dropped out at 6 months and 1 at 3 months ) . There were no major intra-procedural , early , or delayed adverse events . Mean BMI loss was 7.3 ± 4.2 kg/m2 , and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year . In the linear regression analysis , adjusted by initial BMI , variables associated with % TBWL involved the frequency of nutritional ( β = 0.563 , P = 0.014 ) and psychological contacts ( β = 0.727 , P = 0.025 ) . The number of nutritional and psychological contacts were predictive of good weight loss results . Conclusions : Endoscopic sleeve gastroplasty is a feasible , reproducible , and effective procedure to treat obesity . Nutritional and psychological interaction are predictive of success OBJECTIVE To examine the effect of a large , long st and ing and intentional weight reduction on the incidence of diabetes , hypertension and lipid disturbances in severely obese individuals as compared to weight-stable obese controls . RESEARCH METHODS AND PROCEDURES The ongoing prospect i ve SOS ( Swedish Obese Subjects ) intervention consists of a surgically treated group and a matched control group obtaining conventional obesity treatment . This report is based on 845 surgically treated patients and 845 controls ( BMI 41.0+/-4.6 kg/m2 ( mean+/-st and ard deviation [ S ] ) ) followed for 2 years . RESULTS Surgically treated patients lost 28+/-15 kg and controls 0.5+/-8.9 kg ( p<0.0001 ) . Two-year incidence of hypertension , diabetes , hyperinsulinemia , and lipid disturbances was compared in the two treatment groups . Adjusted odds ratios ( 95 % CI ) for the surgically treated group versus controls were 0.38 ( 0.22 , 0.65 ) for hypertension , 0.02 ( 0.00 , 0.16 ) for diabetes , 0.10 ( 0.03 , 0.28 ) for hyperinsulinemia , 0 . 10 ( 0.04 , 0.25 ) for hypertriglyceridemia , 0.28 ( 0.16 , 0.49 ) for low HDL-cholesterol and 1.24 ( 0.84 , 1.8 ) for hypercholesterolemia . Compared to controls , the 2-year recovery rates from hypertension , diabetes , hypo-HDL , and hypertriglyceridemia were significantly higher in the surgically treated group . DISCUSSION Intentional weight loss in the obese causes a marked reduction in the 2-year incidence of hypertension , diabetes and some lipid disturbances . The results suggest that severe obesity can and should be treated Objectives : The AspireAssist System ( AspireAssist ) is an endoscopic weight loss device that is comprised of an endoscopically placed percutaneous gastrostomy tube and an external device to facilitate drainage of about 30 % of the calories consumed in a meal , in conjunction with lifestyle ( diet and exercise ) counseling . Methods : In this 52-week clinical trial , 207 participants with a body-mass index ( BMI ) of 35.0–55.0 kg/m2 were r and omly assigned in a 2:1 ratio to treatment with AspireAssist plus Lifestyle Counseling ( n=137 ; mean BMI was 42.2±5.1 kg/m2 ) or Lifestyle Counseling alone ( n=70 ; mean BMI was 40.9±3.9 kg/m2 ) . The co- primary end points were mean percent excess weight loss and the proportion of participants who achieved at least a 25 % excess weight loss . Results : At 52 weeks , participants in the AspireAssist group , on a modified intent-to-treat basis , had lost a mean ( ±s.d . ) of 31.5±26.7 % of their excess body weight ( 12.1±9.6 % total body weight ) , whereas those in the Lifestyle Counseling group had lost a mean of 9.8±15.5 % of their excess body weight ( 3.5±6.0 % total body weight ) ( P<0.001 ) . A total of 58.6 % of participants in the AspireAssist group and 15.3 % of participants in the Lifestyle Counseling group lost at least 25 % of their excess body weight ( P<0.001 ) . The most frequently reported adverse events were abdominal pain and discomfort in the perioperative period and peristomal granulation tissue and peristomal irritation in the postoperative period . Serious adverse events were reported in 3.6 % of participants in the AspireAssist group . Conclusions : The AspireAssist System was associated with greater weight loss than Lifestyle Counseling alone IMPORTANCE Short-term studies show that bariatric surgery causes remission of diabetes . The long-term outcomes for remission and diabetes-related complications are not known . OBJECTIVES To determine the long-term diabetes remission rates and the cumulative incidence of microvascular and macrovascular diabetes complications after bariatric surgery . DESIGN , SETTING , AND PARTICIPANTS The Swedish Obese Subjects ( SOS ) is a prospect i ve matched cohort study conducted at 25 surgical departments and 480 primary health care centers in Sweden . Of patients recruited between September 1 , 1987 , and January 31 , 2001 , 260 of 2037 control patients and 343 of 2010 surgery patients had type 2 diabetes at baseline . For the current analysis , diabetes status was determined at SOS health examinations until May 22 , 2013 . Information on diabetes complications was obtained from national health registers until December 31 , 2012 . Participation rates at the 2- , 10- , and 15-year examinations were 81 % , 58 % , and 41 % in the control group and 90 % , 76 % , and 47 % in the surgery group . For diabetes assessment , the median follow-up time was 10 years ( interquartile range [ IQR ] , 2 - 15 ) and 10 years ( IQR , 10 - 15 ) in the control and surgery groups , respectively . For diabetes complications , the median follow-up time was 17.6 years ( IQR , 14.2 - 19.8 ) and 18.1 years ( IQR , 15.2 - 21.1 ) in the control and surgery groups , respectively . INTERVENTIONS Adjustable or nonadjustable b and ing ( n = 61 ) , vertical b and ed gastroplasty ( n = 227 ) , or gastric bypass ( n = 55 ) procedures were performed in the surgery group , and usual obesity and diabetes care was provided to the control group . MAIN OUTCOMES AND MEASURES Diabetes remission , relapse , and diabetes complications . Remission was defined as blood glucose < 110 mg/dL and no diabetes medication . RESULTS The diabetes remission rate 2 years after surgery was 16.4 % ( 95 % CI , 11.7%-22.2 % ; 34/207 ) for control patients and 72.3 % ( 95 % CI , 66.9%-77.2 % ; 219/303 ) for bariatric surgery  patients ( odds ratio [ OR ] , 13.3 ; 95 % CI , 8.5 - 20.7 ; P < .001 ) . At 15 years , the diabetes remission rates decreased to 6.5 % ( 4/62 ) for control patients and to 30.4 % ( 35/115 ) for bariatric surgery patients ( OR , 6.3 ; 95 % CI , 2.1 - 18.9 ; P < .001 ) . With long-term follow-up , the cumulative incidence of microvascular complications was 41.8 per 1000 person-years ( 95 % CI , 35.3 - 49.5 ) for control patients and 20.6 per 1000 person-years ( 95 % CI , 17.0 - 24.9 ) in the surgery group ( hazard ratio [ HR ] , 0.44 ; 95 % CI , 0.34 - 0.56 ; P < .001 ) . Macrovascular complications were observed in 44.2 per 1000 person-years ( 95 % CI , 37.5 - 52.1 ) in control patients and 31.7 per 1000 person-years ( 95 % CI , 27.0 - 37.2 ) for the surgical group ( HR , 0.68 ; 95 % CI , 0.54 - 0.85 ; P = .001 ) . CONCLUSIONS AND RELEVANCE In this very long-term follow-up observational study of obese patients with type 2 diabetes , bariatric surgery was associated with more frequent diabetes remission and fewer complications than usual care . These findings require confirmation in r and omized trials . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01479452 BACKGROUND AND STUDY AIMS Obesity is a major public health problem with few effective treatment options . A novel device for treating obesity , the AspireAssist aspiration therapy system , was evaluated . PATIENTS AND METHODS After 4 weeks taking a very-low-calorie diet , 25 obese men and women ( BMI 39.8 ± 0.9 kg/m(2 ) ) had the AspireAssist gastrostomy tube placed during a gastroscopy . A low-profile valve was installed 14 days later and aspiration of gastric contents was performed approximately 20 minutes after meals three times per day . Cognitive behavioral therapy was also started . RESULTS At month 6 , mean weight lost was 16.5 ± 7.8 kg in the 22 subjects who completed 26 weeks of therapy ( P = 0.0 
    Output:
    
Best Practice Advice 2 : EBTs can be used in patients with severe obesity as a bridge to traditional bariatric surgery .