Endoscopic Sleeve Gastroplasty (ESG) is an increasingly popular, highly effective weight loss procedure for individuals seeking to manage obesity and improve their overall health. By reducing the stomach’s size without surgery, ESG encourages sustainable weight loss and can help improve conditions related to obesity like high blood pressure, fatty liver disease, and sleep apnea. With ESG, there is no need for an incision. Instead, an endoscope is used to suture the stomach. If you’ve tried exercise and dieting with no success, you may want to consider this minimally invasive procedure as an option for weight loss. Here, we explore frequently asked questions about endoscopic sleeve gastroplasty, from how it works and what the benefits are to what to expect in the recovery process.
What Is Endoscopic Sleeve Gastroplasty (ESG)?
Endoscopic Sleeve Gastroplasty (ESG), also called accordion procedure, is a minimally invasive bariatric procedure designed to help individuals lose weight. Unlike traditional surgeries like sleeve gastrectomy or the Roux-en-Y gastric bypass, ESG uses an endoscope—a flexible tube with a camera and suturing device—to reshape the stomach. The procedure reduces the stomach’s volume by about 70%, forming it into a smaller, sleeve-like shape. This modification limits the amount of food a person can consume, helping to support weight loss.
Who Is a Candidate for ESG?
ESG is a suitable option for individuals with a body mass index (BMI) between 30-40 who struggle to lose weight through traditional methods like diet and exercise. It’s also an option for those with obesity-related conditions like high blood pressure, fatty liver disease, or sleep apnea, as well as those who are not candidates for traditional surgical weight loss procedures or those who prefer a nonsurgical approach. A consultation with a healthcare provider is necessary to determine whether you are eligible for ESG, and eligibility will be based on your health, weight loss goals, and medical history.
How Does ESG Work?
During ESG, the medical provider inserts an endoscope through the mouth into the stomach. Using a specialized suturing device, the stomach is reshaped into a smaller, sleeve-like structure. This reduces the stomach size, so that the smaller stomach accommodates less food, leading to reduced caloric intake.
The process also slows digestion, making the food take longer to pass through the stomach, and contributing to a sense of fullness. Patients typically lose about 15–20% of their total body weight within a year of an ESG procedure, depending on adherence to appropriate diet and exercise habits.
What Are the Benefits of ESG Compared to Other Weight Loss Procedures?
ESG offers several advantages over traditional weight loss surgeries, including:
- Minimally Invasive: ESG involves no external incisions, reducing the risk of infection or scarring.
- Faster Recovery Time: Most patients resume normal activities within a few days, compared to weeks for surgical options.
- No General Anesthesia: ESG is typically performed under sedation rather than general anesthesia, which is safer for some individuals.
- Lower Risk of Complications: The risk of complications, such as blood clotting, is significantly lower compared to surgery.
- Reversible: Unlike procedures that remove part of the stomach, ESG can be undone if necessary.
- Cost-Effective: As ESG often costs less than a traditional bariatric surgery.
These benefits make ESG an appealing option for individuals seeking effective, less invasive weight loss solutions.
What Is the Recovery Process After ESG?
Recovery from ESG is typically quick and relatively manageable. After recovering from sedation and being cleared of any complications, most patients return home the same day. Patients may experience mild abdominal discomfort or nausea for the first few days, and immediate rest may be necessary. Over-the-counter medications are recommended and are usually sufficient for relief. Patients may gradually return to activities, with most people able to return to work and light activities within 2–3 days. During the first week, patients must stick to a liquid diet to allow the stomach to heal, and then pureed foods are gradually introduced before returning to a regular diet. Lifestyle habits such as adhering to dietary restrictions and maintaining physical activity are key elements of the recovery process. Regular check-ins with your healthcare provider and a weight loss program may also be needed for follow up care.
What Are the Dietary Guidelines After ESG?
Dietary modifications are crucial for achieving long-term success with ESG. Here’s a typical progression:
Phase 1: Liquid Diet
Patients consume clear liquids, broths, and protein shakes for about one week.
Phase 2: Pureed Foods
The diet transitions to pureed foods like yogurt, mashed vegetables, and protein-rich smoothies.
Phase 3: Soft Foods
Around the third or fourth week, soft, chewable foods are introduced.
Phase 4: Solid Foods
By the second month, patients resume a balanced diet focusing on lean proteins, vegetables, and whole grains.
Patients must avoid high-calorie, sugary, and fatty foods to maintain weight loss and prevent complications.
When to Talk to Your Doctor
If you’ve struggled to lose weight through traditional methods or you are experiencing health complications related to obesity, it is time to discuss your options with your doctor. A healthcare provider can evaluate your health and eligibility, explain your options in detail, and help determine if ESG is the best fit for your needs.
Endoscopic Sleeve Gastroplasty is a groundbreaking option for individuals seeking a safe, effective and minimally invasive way to lose weight and regain control of their health. By combining this medical procedure with a commitment to lifestyle changes, ESG can help you gain control of your weight and improve your overall health and quality of life. At Albany Gastroenterology Consultants and 4ward Wellness, our providers–gastroenterologists, pathologists, anesthesiologists, nurse practitioners and physician assistants–work closely together to help you achieve well-being. Contact us today to find out more about your options for weight loss based on your individual circumstances.