But not everyone is a candidate for this procedure. In this article, we will explore the qualifications and characteristics of those best suited for ESG. Join us on a journey of discovery as we uncover the secrets of this innovative procedure and discover if it could be the solution you’ve been searching for.
Here Are Good Candidates For Endoscopic Sleeve Gastroplasty
Individuals With A Body Mass Index (BMI) Of 30-40:
These individuals are considered to be suffering from obesity and are at a higher risk for weight-related health complications such as diabetes, heart disease, and sleep apnea. Endoscopic sleeve gastroplasty is a minimally invasive option for weight loss that can help reduce the risk of these complications.
Individuals With A BMI Of 40-50 Who Do Not Want To Undergo Bariatric Surgery:
These individuals are considered to be suffering from severe obesity and are at a very high risk for weight-related health complications. Endoscopic sleeve gastroplasty offers these patients a minimally invasive option that can help them lose weight and improve their overall health without having to undergo a more invasive, higher-risk surgery.
Individuals Who Have Failed Previous Weight Loss Attempts With Diet And Exercise:
These individuals may have difficulty losing weight or maintaining weight due to metabolic or hormonal factors. By suturing the stomach and reducing its size, endoscopic sleeve gastroplasty can help these patients lose a substantial amount of weight and keep it off long-term.
Individuals Who Have A History Of Weight Cycling Or Yo-Yo Dieting:
These individuals need help maintaining weight loss. While they are making the effort and going through diets and exercise programs, these patients tend to gain the weight back. This is not an unusual scenario. It is due to the body’s hormonal and metabolic reaction to weight loss. Endoscopic sleeve gastroplasty can help these individuals break the cycle and achieve long-term weight loss.
Individuals With A History Of Acid Reflux Or Gastroesophageal Reflux Disease (GERD):
Individuals who suffer from obesity and acid reflux at the same time may experience worsening of their reflux if they undergo laparoscopic sleeve gastrectomy. Endoscopic sleeve gastroplasty can help these patients achieve weight loss without aggravating their acid reflux or GERD.
Individuals With A BMI Of 27-30 And A Weight-Related Comorbid Condition:
While ESG is approved by the FDA for patients with a BMI range of 30-50, individuals who struggle with being overweight and who have a weight-related medical condition, such as high blood pressure, diabetes, obstructive sleep apnea, or arthritis, may be considered for ESG on a case by case basis.
How Is ESG Performed?
Now that we identified who Endoscopic Sleeve Gastroplasty is for, let’s go over what to expect during the process. An experienced endoscopist will insert the endoscope, a flexible tube with a camera at its tip, through the patient’s mouth and into the stomach. The Overstitch endoscopic suturing device is attached to the tip of the scope. Once in the stomach, the endoscopist will use the suturing device to place full-thickness sutures in the walls of the stomach. This results in shortening and decreasing the size of the stomach. The endoscope is then removed, leaving the patient with a reduced stomach.
The procedure is minimally invasive and has been shown to be very effective in achieving weight loss. Patients can expect to lose about 18% to 20% of their total body weight within a year. The weight loss has been shown to be maintained long-term
It is essential to have a detailed discussion with your gastroenterologist before undergoing ESG to understand the risks and benefits of the procedure. This will also help you decide if you are a good candidate for ESG and if the process is right for you.
What To Expect After ESG And Tips For A Successful Recovery
The recovery process after Endoscopic Sleeve Gastroplasty (ESG) is an essential part of the procedure. It is important to understand what to expect during this time and how to best care for yourself to ensure a successful weight loss journey.
After the procedure, patients can expect to experience some mild discomfort in the stomach. This is normal and usually subsides within a couple of days. Nausea may also occur in the first day or two. The doctor will prescribe pain and nausea medications to help manage such symptoms.
Following a strict clear liquid diet for the first two days after the procedure is essential. This will allow your stomach time to heal. Three days post-ESG, the diet is advanced to a full liquid diet for two weeks, then to a soft diet for another two weeks. At four weeks post-ESG, the patient can start eating a regular-consistency diet. Gradually, various solid foods can be gradually added back into the diet. A detailed diet plan will be provided by a dedicated bariatric dietitian. One-on-one visits with the dietitian will be scheduled 2 weeks and 4 weeks post-procedure, then once a month for 12 months. Working with the dietitian is an essential part of the after-care and it is crucial for achieving the best long-term results.
In addition to diet changes, it is important to make other lifestyle changes after ESG. This includes increasing physical activity, quitting smoking (preferably before the procedure), and limiting alcohol consumption. These lifestyle changes will help with weight loss and improve overall health.
To ensure a smooth recovery and a successful journey, it’s essential to maintain follow-up appointments with the doctor and follow their instructions. They will monitor the weight loss progress, answer questions, and make any necessary adjustments to the diet or lifestyle plan.
Conclusion
If you believe you are a candidate for endoscopic sleeve gastroplasty, and you’re interested in learning more about it, it’s important to discuss the procedure with our specialists. They will be able to assess your individual needs and determine if this is the right solution for you.
Don’t wait. Take the first step towards your weight loss journey and schedule a consultation with The Silhouette Clinic to find out if you are a candidate for Endoscopic Sleeve Gastroplasty and to start your journey today.
FAQs:
Am I a candidate for Endoscopic Sleeve Gastroplasty (ESG)?
You may be a candidate if you’re an adult with obesity who hasn’t achieved or maintained weight loss with diet and exercise, and you’re ready to commit to long-term lifestyle changes. ESG reduces stomach volume endoscopically (no external incisions) and is done as an outpatient procedure.
What BMI do I need to qualify for ESG?
ESG is typically offered to people with a BMI of 30–40. It can also be considered for some with a BMI of 40–50 who prefer a non-surgical option. The FDA has approved ESG for patients with a BMI of 30-50. In select cases, individuals with a BMI of 27–30 and a weight-related condition (e.g., high blood pressure, type 2 diabetes, sleep apnea, fatty liver, or arthritis) may be considered on a case-by-case basis.
I’ve tried diet and exercise, and regained the weight. Does ESG help with “yo-yo” dieting?
Yes. ESG helps you feel full with smaller portions and slows gastric emptying, making it easier to maintain consistent habits and break the weight-cycling pattern, when paired with nutrition and activity support.
Is ESG a better option than surgical sleeve gastrectomy if I have acid reflux (GERD)?
For many people with obesity and GERD, ESG is a good alternative because it does not remove stomach tissue and generally does not worsen reflux. Your evaluation will include a reflux assessment to choose the safest option for you.
Who should not have ESG?
You may not be a candidate if you have prior gastric or bariatric surgery, an active eating disorder, untreated ulcers, active GI bleeding, a large hiatal hernia that requires repair, certain bleeding or clotting disorders, are pregnant or breastfeeding, or cannot safely undergo anesthesia/endoscopy. Your clinician will review medical and psychological readiness.
What medical issues need to be optimized before ESG?
Conditions like diabetes, hypertension, sleep apnea, anemia, and significant heart or lung disease should be well controlled. You may need CPAP compliance (if you have OSA), medication adjustments, and smoking cessation before the procedure.
What tests are done to see if I’m eligible?
Most patients have a medical exam and lab work. In certain situations, an endoscopy may be needed to rule out contraindications. Most patients will complete nutrition and psychology screening to confirm readiness for lifestyle changes.
How much weight can I expect to lose after ESG?
Results vary, but many patients lose about 18%–20% of total body weight within 12 months when they follow the nutrition and activity plan. Long-term success depends on sustained healthy habits.
What is recovery like, and when can I return to work?
ESG is outpatient and usually takes under an hour. Expect mild stomach discomfort or nausea for a day or two, typically managed with medications. Most people resume normal routines within a few days.
What diet will I follow after ESG?
You’ll start with clear liquids for 2–3 days, progress to full liquids for 2 weeks, then soft foods for 2 weeks, and transition to regular-consistency, high-protein meals around week 4. Your dietitian will give you a detailed plan and follow you closely.
Do I need vitamins after ESG?
Yes, especially during rapid weight loss. We commonly recommend a daily multivitamin plus calcium, vitamin D, and vitamin B12. Unlike gastric bypass, ESG doesn’t cause malabsorption. However, taking vitamin supplements during the initial rapid weight loss period supports healthy weight loss.
Can I have ESG if I’m taking GLP-1 medications (e.g., semaglutide, tirzepatide)?
Often yes. Some patients stop the medication before the procedure; others use ESG and medication sequentially or in combination as part of a medical plan. We’ll coordinate a personalized approach.
Will ESG affect future pregnancy plans?
We generally recommend avoiding pregnancy during the active weight-loss phase (about 6–12 months after ESG). After that period, pregnancy is not a problem. ESG doesn’t cause adhesions (scars inside the abdomen) and doesn’t lower the chances of getting pregnant. Weight loss after ESG can improve fertility.
Can I have ESG if I already had bariatric surgery (sleeve, bypass)?
ESG is contraindicated after prior gastric/bariatric surgery. If you’ve had a sleeve or bypass and regained weight, you may qualify for other endoscopic revision procedures.
Is ESG covered by insurance?
Coverage is evolving and varies by plan. Many insurers still classify ESG as an esthetic procedure; some may offer case-by-case coverage. We can review your benefits, submit documentation, and discuss financing options.
How do I know for sure if I qualify for ESG?
Schedule a consultation for a comprehensive assessment of your BMI, medical history, anatomy, and readiness for lifestyle change. Our doctors will outline your options and help you choose the safest, most effective path.
Where can I get evaluated for ESG if I’m in the Washington, DC area?
The Silhouette Clinic serves patients across Maryland, Washington, DC, and Northern Virginia with a full ESG program, nutrition support, and long-term follow-up. Contact us to see if you’re a candidate and to plan next steps.