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All About Endoscopic Sleeve Gastroplasty (ESG)

Jan 11, 2023
All About Endoscopic Sleeve Gastroplasty (ESG)
Weight loss surgery has helped many people reach their weight goals for better health. But surgery is no longer your only option. Click here to learn about nonsurgical endoscopic sleeve gastroplasty (ESG) for weight loss.

When your weight affects your health, and diet and exercise aren’t effective at helping you drop the unwanted pounds, you may consider weight loss surgery. However, you may have concerns about undergoing major surgery. 

But with advances in surgical techniques, you can get the benefits of weight loss surgery without having surgery. 

At Transform Bariatrics in Greenbelt and Rockville, Maryland, our skilled bariatrician, Dr. Hitesh Amin, offers many options to help those struggling to reach a healthy weight. For our patients who feel weary about surgery, we offer endoscopic sleeve gastroplasty (ESG).

Because ESG is a newer procedure, you may have yet to learn about it. In this month’s blog, we want to tell you all about endoscopic sleeve gastroplasty. 

About endoscopic sleeve gastroplasty

Most weight loss surgeries involve removing some of your stomach, making it smaller, so you feel full faster, eat less, and lose weight. Endoscopic sleeve gastroplasty (ESG) also makes your stomach smaller. But instead of removing a portion of your stomach, we use sutures to create a smaller pouch.

During ESG, we insert an endoscope in your mouth and advance it to your stomach. An endoscope is the same tool gastroenterologists use to examine your upper digestive system. 

We then use an endoscopic stitching system to suture your stomach, creating a sleeve-like pouch about the same size and shape as a banana. It’s similar to the gastric sleeve but without incisions and complete removal of any part of your stomach.

Because we only use stitches to change the size of your stomach, ESG is reversible. 

Candidates for endoscopic sleeve gastroplasty

We conduct a comprehensive evaluation to determine what weight loss method makes the best choice for you. Candidates for ESG:

  • Have a body mass index (BMI) of 30 or higher
  • Are unable to lose weight with diet and exercise
  • Are looking for an alternative to weight loss surgery
  • Can commit to following a healthy lifestyle

For weight loss surgeries like the gastric sleeve or gastric bypass, we only consider you a candidate if you have a BMI of 35 or higher or a BMI of 30 or higher with weight-related health problems like heart disease or Type 2 diabetes. 

This means ESG is an option for more people struggling with their weight.

Recovering from endoscopic sleeve gastroplasty

Recovery from ESG is less intense than weight loss surgery, but you do need to adhere to our post-procedure diet protocol. This protocol supports the recovery process and helps you get used to your smaller stomach and healthy diet.

You can resume your regular balanced diet, but with smaller portions, about a month after your ESG. Though results vary, you can lose 12-20% of your body weight in the first year. 

ESG is a nonsurgical alternative to bariatric surgery that can help you lose weight and improve your health. 


Are you struggling to reach your weight goals with diet and exercise? Give us a call or request an appointment online to schedule a consultation with our bariatrician today to discuss your options.