Endoscopic Sleeve Gastroplasty for Weight Loss

By November 8, 2019 No Comments

It’s estimated that close to 45 million Americans go on a diet each year, and beyond that, dieters spend a whopping $33 billion dollars each year on weight loss aids and products. Still, World Health Organization (WHO) 2016 statistics reveal that 1.9 billion adults were overweight in the United States, with 650 million of those being clinically obese. Clearly, Americans are struggling with weight loss, and many aren’t aware of minimally invasive procedures that can help reduce weight—and keep it off. One of these procedures is known as endoscopic sleeve gastroplasty, or ESG. Read on to learn more about what ESG is, why it’s performed, and if this may be the right choice for you to kick the extra weight to the curb, finally. 

What Is ESG?

Endoscopic sleeve gastroplasty is a minimally invasive procedure that is non-surgical. Its aim is to reduce the overall size of the stomach. In turn, this reduces how much you can eat at a sitting because the stomach simply cannot hold more food than it has room for. Compared to other surgical procedures, the risks are minimal. Because there is no surgery involved, recovery time is much quicker, and patients can return to a normal lifestyle much more quickly. ESG does require an intent to eat more healthily and avoid a sedentary lifestyle afterward, but if following these simple instructions, it carries a high success rate, with many patients still keeping the weight off even five years after the procedure. These success rates are backed by recent scientific studies, making ESG an ever more favorable option for those who are overweight and obese.

Why It’s Done

Those who are slightly overweight and only need to shed a couple of pounds are not at significant risk for weight-related health problems. However, those who have a high body mass index (BMI) are at risk for long-term complications that can severely affect health. Some of these conditions are potentially dangerous and include heart disease and stroke, high blood pressure, sleep apnea, type 2 diabetes, and gastroesophageal reflux disease (GERD). 

Your physician will likely not recommend endoscopic sleeve gastroplasty as a first option. These types of procedures are reserved for those who have tried other more conventional means of exercise, such as diet and exercise, and have exhausted these options. The ESG procedure is a perfect choice for those who must lose weight to avoid medical complications in the future. 

Who It’s For

ESG is a minimally invasive weight loss procedure for those who do not want, or cannot have, other types of bariatric surgery, such as lap band procedures, gastric sleeve procedures, or other methods. Sleeve gastroplasty is also designed for those who have a body mass index of over 30 or more. If you are not sure how to calculate your BMI, there are many online calculators to help, or your physician can help you with the calculations. 

There is a screening process involved with an endoscopic sleeve procedure, and your physician will go over your medical history, previous attempts at weight loss, and collect other information to make sure you are a good candidate for the procedure. Your doctor will want to ensure your commitment to weight loss as well. ESG is a long-term solution for those who suffer from obesity. Post-procedure, you will be expected to develop healthier eating and exercise habits. However, your doctor is there for you every step of the way to help you with diet and exercise questions. 

There are also some medical barriers to the procedure. Those who have had a hiatal hernia larger than 3 centimeters, those who have had stomach surgery, or those who have experienced stomach bleeding are not good candidates for ESG.

What You Can Expect

Your physician will certainly be present to answer any questions that you may have. Generally speaking, endoscopic sleeve gastroplasty is performed in the endoscopic unit of your local hospital, as it does use an endoscope to perform the procedure. An endoscope is a tube with a camera and a suturing device attached to it. During the procedure, general anesthesia is necessary, so you will be unconscious. The endoscope is inserted in the throat and enters the stomach this way.

During the procedure, the physician will make 12 sutures in the stomach. These, in turn, will change the way your stomach is structured, forming it into a tubular shape. From this point on, your stomach will hold less food as well as absorb less calories, making it much harder to regain weight. 

The entire procedure takes about 90 minutes in total. After the procedure, you will be taken to an endoscopic recovery room to allow you time to recover. Many patients go home after the sedation has worn off, although you will need someone to drive you home. Depending on each individual case, some physicians may want to observe a patient post-procedure, so you may have an overnight stay in the hospital. Your physician will likely discuss this with you before the procedure. 

How You Prepare

Just as with what to expect, each physician will give each patient individual instructions. Generally speaking, there is a battery of lab tests you’ll need to have performed prior to the procedure, and you may have to have different medical exams. In the days leading up to having an ESG, your doctor will give you eating and drinking restrictions in order to ensure that the procedure goes smoothly. Your doctor may also want to implement physical activity regimens prior to ESG. 

It’s a good idea to plan well for the days you’ll be at home, post-procedure. You will need someone to drive you home from the hospital, and you may want to have someone present in your home for several days afterward. Generally speaking, patients can resume normal, everyday activities typically 48 hours after having sleeve gastroplasty.

After Endoscopic Sleeve Gastroplasty

Immediately after the procedure, you won’t be allowed to eat or drink anything for about eight hours. After this period of time, you’ll be on a renal (liquid) diet for about two weeks. Your physician will go over which foods you can and cannot eat, but staple foods will be broth, gelatin, and other liquid foods. 

For the next two weeks after that, you’ll be on a diet of semi-solid foods, which are easiest and best for your stomach to digest. Once four weeks total have passed, you will be allowed to resume a regular diet, which your doctor can discuss with you. Your physician can help you prepare foods that include fruits and vegetables, whole grains, lean proteins, healthy carbs, and leafy greens. Adherence to this diet will bolster your success after ESG.

How Much Weight Will I Lose with ESG?

No two patients are exactly alike, but in general, patients saw significant weight loss—about 50 percent of their excess body weight at six months post-procedure and up to 80 percent of excess body weight one year afterward. This is because the procedure reduces the size of the stomach by 70 to 80 percent.

Commitment to the program after the procedure helps to ensure that patients will hit these weight loss markers and targets. Your physician is there to help walk you through how to meal plan, which foods to eat, and how and when to exercise properly. Studies have followed up with patients at both the one-year mark and the five-year mark, and those who were committed were successful in their weight loss goals. 

More About ESG

There are many more details not answered in this piece that would definitely be of interest to patients considering the procedure, or wondering if it’s right for them. NEW You Weight Loss recently did a Facebook Live Q&A session, which provides a lot of useful information. You can also read about the top five questions about endoscopic sleeve gastroplasty, and read success stories from former and current patients. 

If you need more information about ESG or are wondering if it’s the right choice for you, request a consultation at NEW You Weight Loss today. We’re here to help you through the weight loss process, every step of the way.


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