Get to know your weight loss options

ESG is an endoscopic procedure designed to reduce the stomach size by 70–80%.¹ The doctor inserts a flexible scope in the mouth to reach the stomach, so there’s no need to make an incision in the body. The procedure involves using a camera and suturing device passed through the mouth to make the stomach smaller from the inside.²  View the ESG procedure guide.

ESG reduces the size of the stomach, which may help you feel full with smaller portions and support weight loss when combined with lifestyle changes.²

Results vary, but in a clinical study, patients lost an average of 13.6% of their total body weight 12 months after undergoing the ESG procedure.¹ To do this, they had to follow a prescribed diet and exercise program. Your doctor can help you set realistic expectations based on your starting point and goals.²

All procedures have risks. Be sure to talk with your doctor so that you thoroughly understand all risks and benefits associated with this procedure. The most common side effects of ESG are nausea, abdominal pain, vomiting, and abdominal discomfort, especially during the first week. The most serious side effects are rare, but include death, perforation, or abdominal obstruction.²  

ESG may be an option for adults with a BMI between 30 and 50 who haven’t had lasting success with diet and exercise alone. If you’ve had prior stomach surgery, this may not be the right approach. A doctor can help determine if this could be a good fit for you based on your goals and health history.² Learn more about when ESG may be an option in the ESG eligibility guide.

ESG is not a good fit for people who’ve had prior stomach surgery, can’t undergo an endoscopy, are pregnant, or have certain health conditions like bleeding ulcers or large hiatal hernias. If you’re taking blood thinners or have an eating disorder, that could also be a factor. You’ll need to talk with your doctor to see what’s appropriate for you.² Learn about weight loss options.

The first ESG procedures were performed in 2013, and the first studies were published that same year. OverStitch™, which is the suturing device used to perform ESG, was the subject of a randomized, clinical trial published in 2022, and commercialized in the United States in that year.³

ESG isn’t traditional surgery—it’s done entirely through the mouth using an endoscope. That means no external cuts and no scars.² Learn more about the procedure in the ESG procedure guide. 

ESG and surgical sleeves both reduce stomach size, but ESG doesn’t remove any part of the stomach. It’s done endoscopically through the mouth.² See what else is different in the ESG procedure guide.

A traditional ESG isn’t possible after gastric bypass because a gastric bypass permanently changes your anatomy. But there's another endoscopic procedure called TORe (Transoral Outlet Reduction), which is specifically designed for people who have had a gastric bypass.²  

Reversal is possible in some cases, especially early on, but becomes more complex over time as scar tissue forms. If needed, your doctor can talk with you about whether reversal or revision is an option.²

While you're under anesthesia, a doctor uses an endoscope and a suturing device passed through your mouth to place internal stitches in your stomach. These sutures fold the stomach inward to reduce its volume.²

Your doctor will decide what type of anesthesia is appropriate and explain what to expect.²

The procedure often takes 60 to 90 minutes. Many patients go home the same day, but plan to spend a few hours at the facility for prep and recovery.² Get more information about the procedure and recovery process in the ESG procedure guide or ESG recovery guide.

The sutures used during ESG are designed to stay in place and are not dissolvable.²  

Yes, someone should drive you home and stay with you for a bit while you rest. Your doctor will give you clear instructions.²

Some people feel discomfort, bloating, or nausea at first. You may feel tired or have a reduced appetite while your body adjusts. These symptoms are usually short-term and are usually managed with medication.² Your doctor will work with you to determine the best strategy.

Recovery varies by person, but many patients go home the same day. A clinical study found that most patients returned to routine daily activity in 2–3 days.¹ Your doctor will give you guidance based on how you're feeling. Get a better idea of what to expect in our ESG recovery guide.

Symptoms like nausea, cramping, or bloating are common at first. If anything feels severe or unusual, it’s important to check in with your care team.²

Yes. You’ll likely start with liquids and gradually transition to soft foods, then solids. Your care team can guide you through each step.² View the ESG recovery guide.

You’ll follow a staged diet to support healing and help your stomach adjust. It’s important to stick with the plan to avoid discomfort and get the best results.² We’ve put together an outline of what you could expect in the ESG recovery guide.

ESG helps you feel full with smaller portions, which can make it easier to eat less and build lasting habits. ESG works together with lifestyle changes to help you lose weight.²

To support long-term results, it’s important to commit to healthy eating, regular physical activity, and follow-up with your care team. ESG is a tool—but your habits are what help you see lasting results.²

The doctor will review your health history, discuss your goals, and explain your potential options. It’s also a chance to ask any questions you may have. Get a discussion guide and other helpful information in our consultation guide.

Each practice handles insurance differently, so it's best to contact your insurance company and the provider’s office directly. They can review your benefits and answer any specific questions. For more information, view our cost and coverage guide.