# Post-sleeve gastrectomy weight loss: Role of botulinum toxin and semaglutide injections

**Authors:** Zhengqi Li, Shaohan Zhang, Yuntao Nie, Pengpeng Wang, Baoyin Liu, Biao Zhou, Nianrong Zhang, Siqi wang, Sai Chou, Lei Zhang, Zhe wang, Hua Meng

PMC · DOI: 10.1055/a-2793-9945 · Endoscopy International Open · 2026-02-23

## TL;DR

This study compares botulinum toxin and semaglutide injections for weight loss after sleeve gastrectomy surgery.

## Contribution

The study introduces a comparison of two endoscopic injection methods for post-sleeve gastrectomy weight regain.

## Key findings

- Semaglutide injection resulted in significantly greater weight loss at 2 months compared to the LSG+SME group.
- Botulinum toxin injection was found to be a safe and effective treatment for weight regain after LSG.
- No significant differences were observed between other group comparisons.

## Abstract

Comparison of the therapeutic effects of endoscopic botulinum toxin (BTX) injection and semaglutide (SME) injection in treatment of patients with obesity and weight regain after laparoscopic sleeve gastrectomy (LSG).

The injection method for botulinum toxin is to dilute 300 U of type A botulinum toxin with 20 mL of physiological saline. Injections were made in a grid pattern throughout the antrum and body (20 injection points total), with 1 mL of drug injected at every point. The application method for semaglutide injection is to start at 0.25 mg once a week and increase by 0.25 mg every 3 weeks until the patient can tolerate the maximum dose (1.0 mg qw), for a total of 6 months.

The weight loss effect of the SME group was significantly better than that of the LSG+SME group because the SME group achieved significantly greater weight loss at 2 months than the LSG+SME group. No significant difference was seen between any other pair of groups.

Endoscopic botulinum toxin injection can be a safe and effective treatment for weight regain after LSG.

## Linked entities

- **Chemicals:** semaglutide (PubChem CID 56843331)
- **Diseases:** obesity (MONDO:0011122)

## Full-text entities

- **Genes:** GCG (glucagon) [NCBI Gene 2641] {aka GLP-1, GLP1, GLP2, GRPP}
- **Diseases:** dizziness (MESH:D004244), Weight Loss (MESH:D015431), gastrointestinal side effects (MESH:D064420), gastrointestinal adverse reactions (MESH:D005767), peptic ulcers (MESH:D010437), peritonitis (MESH:D010538), cardiovascular diseases (MESH:D002318), hypoglycemia (MESH:D007003), thyroid cancer (MESH:D013964), malnutrition (MESH:D044342), ascites (MESH:D001201), fistulas (MESH:D005402), Bloating (MESH:C535647), allergies (MESH:D004342), perforation (MESH:D057112), heart failure (MESH:D006333), abdominal distension (MESH:D000007), botulinum toxin allergy (MESH:D001906), nausea/vomiting (MESH:D020250), chronic kidney disease (MESH:D051436), aortic aneurysm (MESH:D001014), pancreatitis (MESH:D010195), muscle weakness (MESH:D018908), cancer (MESH:D009369), gallstones (MESH:D042882), breathing difficulties (MESH:D004417), corrosive inflammation (MESH:D007249), gastrointestinal symptoms (MESH:D012817), abscess (MESH:D000038), headaches (MESH:D006261), vomiting (MESH:D014839), spinal deformity (MESH:D013122), acute kidney injury (MESH:D058186), overweight (MESH:D050177), fatigue (MESH:D005221), Gastroparesis Cardinal Symptom (MESH:D018589), weight regain (MESH:D055191), nausea (MESH:D009325), esophageal varices (MESH:D004932), abnormal bleeding (MESH:D006470), obese (MESH:D009765), weight gain (MESH:D015430)
- **Chemicals:** LSG (-), saline (MESH:D012965), acetylcholine (MESH:D000109)
- **Species:** Homo sapiens (human, species) [taxon 9606], Clostridium botulinum (species) [taxon 1491]

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12951029/full.md

## References

33 references — full list in the complete paper: https://tomesphere.com/paper/PMC12951029/full.md

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Source: https://tomesphere.com/paper/PMC12951029