Dr. Watson is a paid consultant of Boston Scientific.
How ESG works
A specially trained doctor gently passes a small, flexible camera (or endoscope) through your mouth to place sutures that reduce the capacity of your stomach.
Non-surgical weight loss procedure
Unlike traditional bariatric surgery, ESG is a minimally invasive procedure that does not use incisions and leaves no scars. Studies have shown that most people typically went home the same day as the procedure and returned to routine daily activities in 2–3 days.2,3
Proven, lasting weight loss
ESG is a one-time weight loss procedure. Yet, this isn’t a quick fix. Real change takes time and commitment. A study of people who had the ESG procedure combined with diet and lifestyle changes showed:
Average total body weight loss after one year1
Of those people, 68% lost 25% or more excess body weight after two years1
For you, ESG with diet and lifestyle changes may mean lasting results and steady progress on your weight loss journey.
Potential side effects of ESG
The most common side effects of an ESG procedure are nausea, abdominal pain, vomiting, and abdominal discomfort—especially during the first week. Other symptoms like constipation, heartburn, or bloating may occur but usually go away within 30–60 days. Your doctor can help you understand what’s typical and when to check in if something feels off.
Maintaining your weight loss
ESG can set you up for steady, lasting weight loss when combined with diet and lifestyle changes. To reach your specific weight loss goals, you’ll want to consult with your ESG medical team, dietitian, and nutritionist.
How much does ESG cost?
ESG procedure costs vary depending on provider location, insurance, and other factors. The procedure is FSA and HSA eligible, allowing you to utilize pre-tax dollars for related healthcare expenses, so be sure to discuss costs and coverage with your ESG provider.
Does insurance cover ESG?
As of May 2026, more than 100 million individuals may have access to ESG through their health insurance.* Multiple insurance providers—such as Cigna Healthcare, Elevance Health, and Peak Health—include ESG as a covered benefit when medical necessity criteria have been met (subject to specific plan details). ESG may be covered by insurance, including Medicare or Medicaid, on a case-by-case basis depending on your plan and medical necessity.
Your first ESG conversation
What can you expect when meeting with an ESG provider for the first time? It starts with a discussion about your weight loss journey and goals to help determine if ESG is right for you and if you’re eligible for the procedure. No commitment—just a conversation.
Is ESG a good fit for you?
The ESG weight loss procedure is designed to work with you and your body. Talk with an ESG provider to discuss whether it's the best option for you.
Important OverStitch Endoscopic Suturing System Safety Information
ESG is performed using a suturing device called OverStitch. Learn about the risks of the OverStitch Endoscopic Suturing System & OverStitch NXT Endoscopic Suturing System (OverStitch) for bariatric surgery.
Talk with your doctor to fully understand all the risks and benefits associated with using this device. Ask your doctor whether this device is right for you.
Indications for Use:
OverStitch is for adult patients with obesity with BMI between 30-50 kg/m2. OverStitch can reduce the size of the stomach by stitching the inside. It can also fix the stomach outlet from previous bypass surgery.
When OverStitch is used to help with weight loss, you need to follow a healthy diet and exercise program. You may not lose weight if you do not adopt healthy habits.
Contraindications:
Your doctor will ask you about your medical history and perform a physical exam to decide if OverStitch is right for you. At the time of your procedure, the doctor may detect internal issues that prevent you from receiving OverStitch. For example, stomach ulcers or inflammation in the stomach may impact device placement.
You should not receive OverStitch if you: have a large hiatal hernia; have a history of bleeding in your stomach or food pipe; have a history of eating disorders; are pregnant; have bleeding disorders or are on blood thinners.
Warnings:
Talk to your doctor if you develop major, continued upper abdominal or back pain with difficulty breathing at any time after getting OverStitch.
OverStitch contains nickel. Nickel may cause an allergic reaction in people with nickel sensitivity.
Potential Risks:
Breathing any foreign object or substance such as food, saliva, or stomach contents into your lungs; Intestine blockage; Switching to a different type of surgery; Nausea, vomiting, dehydration; Bleeding; Infection; Swelling, redness, and pain in tissues caused by injury or damage; Damage to or a hole through the tissue around the stomach, food pipe or surrounding organs; Unintended transfer of fluid or gas from one area of the body to another; Pain; Feeling pins and needles; Buildup of fluid around the stomach; Air leaking from the lungs; Difficulty breathing; Narrowing or tightening in the stomach; Wound opening; Death
MRI Safety Information:
OverStitch can be MRI scanned under certain conditions. Scanning under other conditions may result in injury or device malfunction. Inform your doctor or MRI technician of the device before undergoing an MRI scan. This allows them to take any needed precautions.
If you have additional questions, talk with your doctor. For full safety information, visit IFU-BSCI.com.
Individual weight loss may vary.
*Coverage is subject to change or discontinuation at any time at the discretion of the insurer.
For the OverStitch Endoscopic Suturing System you need to follow a healthy diet and exercise program to lose weight. You may not lose weight if you do not adopt healthy habits. Your doctor’s clinical team, including dietitians, nutritionists and/or exercise trainers, should help you on your weight loss journey.
1. Abu Dayyeh BK, Bazerbachi F, Vargas EJ, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. The Lancet. July 2022;400(10350): 441–451.
2. Kumar N, Abu Dayyeh BK, Lopez-Nava Breviere G, et al. Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique. Surg Endosc. Apr 2018;32(4):2159-2164.
3. Abu Dayyeh BK, Acosta A, Camilleri M, Mundi MS, Rajan E, Topazian MD, Gostout CJ. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clinical Gastroenterology and Hepatology. 2017;15(1):37-43.e1.
CAUTION: U.S. Federal law restricts this device to sale by or on the order of a physician.
All photographs taken by Boston Scientific.