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A novel endoscopic device, ForePass (Keyron), demonstrated superior metabolic effects compared with semaglutide in preclinical testing. 12 young Landrace pigs underwent ForePass implantation, semaglutide treatment or sham endoscopy with a 1-month follow-up period. ForePass limited weight gain to +4.3%, compared with +36% in semaglutide-treated pigs and +47% in controls, without affecting linear growth. Food intake decreased by 26% with ForePass versus 18.5% with semaglutide. The device induced a near-flat glycaemic response and markedly improved insulin sensitivity (SI=2.75±0.37 pM⁻¹·min⁻¹), while semaglutide and sham produced only modest effects. These findings support clinical testing of ForePass as a minimally invasive, reversible approach for metabolic modulation.