Endoscopic Sleeve Gastroplasty: Is It the Right Weight Loss Option for You?

You’ve tried smaller portions, cut back on snacks, and made changes to your daily routine. Maybe the weight came off initially, but keeping it off has been another challenge.

For people living with obesity, diet and exercise don’t always produce lasting results. Sometimes, medical treatment can provide additional support.

Endoscopic sleeve gastroplasty (ESG) is one option for people who want to explore weight loss treatment without traditional abdominal surgery.

At Nihalani Group in New Jersey, patients can learn about ESG, understand its limitations, and discuss whether it fits their health needs.

What Is Endoscopic Sleeve Gastroplasty?

Endoscopic sleeve gastroplasty is a minimally invasive weight loss procedure that reduces stomach capacity using internal stitches.

Unlike traditional gastric sleeve surgery, ESG doesn’t involve removing stomach tissue or making abdominal incisions.

Instead, a specialist inserts a flexible endoscope through the mouth and into the stomach. A suturing device brings sections of the stomach wall together to create a narrower, sleeve-like shape.

The smaller stomach helps patients feel satisfied after eating less food.

ESG is performed under general anesthesia. Although it doesn’t require external incisions, it is still an invasive medical procedure.

How Does the ESG Weight Loss Procedure Work?

The process begins before the actual procedure.

1. Initial consultation

Your specialist reviews your BMI, medical history, previous weight loss attempts, and overall health. This assessment helps determine whether ESG is appropriate.

2. Preparation

You receive instructions about fasting, medications, and any necessary medical evaluations.

3. Endoscopic procedure

While you’re under anesthesia, the specialist passes an endoscope through your mouth. Internal sutures reshape the stomach without removing tissue.

4. Recovery

Many patients return home the same day. A temporary liquid diet is usually required, followed by a gradual transition to other foods.

5. Follow-up care

Nutritional guidance, lifestyle changes, and medical appointments help support your long-term results.

Learn more about endoscopic sleeve gastroplasty in NJ.

Who Is a Good Candidate for Endoscopic Sleeve Gastroplasty?

ESG may be an option for adults who haven’t achieved adequate weight loss through lifestyle changes or other appropriate treatments.

The American Society for Metabolic and Bariatric Surgery recommends ESG primarily for selected patients with a BMI between 30 and 40, although individual circumstances may justify consideration outside this range.

You may want to discuss ESG if you’re looking for a weight loss procedure without abdominal incisions, are willing to make long-term dietary changes, and understand that weight loss results vary.

However, not everyone qualifies. Previous stomach procedures, gastrointestinal conditions, and certain medical concerns can affect eligibility.

A medical consultation is necessary before deciding.

What Are the Benefits of ESG?

One reason patients consider endoscopic sleeve gastroplasty is that it offers a less invasive approach than conventional bariatric surgery.

Potential benefits include:

• No external abdominal incisions or surgical scars.

• No removal of stomach tissue.

• A generally shorter recovery period than traditional surgery.

• Support for portion control and reduced food intake.

• Meaningful weight loss when combined with lifestyle changes.

ESG also preserves the normal connection between the stomach and intestines.

However, it typically produces less weight loss than established bariatric operations, including sleeve gastrectomy and gastric bypass.

How Much Weight Can You Lose With ESG?

Weight loss depends on several factors, including starting weight, eating habits, physical activity, and follow-up care.

In the MERIT randomized clinical trial, patients who received ESG alongside lifestyle treatment lost an average of 13.6% of their total body weight at 52 weeks.

For example, someone weighing 250 pounds would lose approximately 34 pounds at that average rate.

This is a research average, not a guaranteed individual outcome. Some patients lose more, while others lose less.

What Is Recovery Like After Endoscopic Sleeve Gastroplasty?

Recovery is generally quicker than with traditional bariatric surgery, but the stomach still needs time to heal.

During the first few days, patients may experience nausea, abdominal discomfort, bloating, or cramping.

Your medical team will provide a structured eating plan, usually starting with liquids before gradually introducing other foods.

It’s important to follow instructions about hydration, medications, and physical activity.

Serious complications are uncommon but can include bleeding, infection, stomach injury, leakage, and anesthesia-related problems. Severe abdominal pain, fever, or persistent vomiting requires prompt medical assessment.

ESG vs. Gastric Sleeve Surgery: What’s the Difference?

Patients interested in surgical weight loss can also explore robotic gastric sleeve surgery.

Why Consider Nihalani Group for ESG in New Jersey?

Nihalani Group provides bariatric and endoscopic weight loss treatment options for patients in Edison, Clark, and surrounding New Jersey communities.

Led by Dr. Anish Nihalani, MD, FACS, the practice helps patients compare their options before making treatment decisions.

Rather than focusing only on a procedure, the consultation considers your medical history, weight loss goals, nutritional needs, and long-term care.

Patients can also discuss alternatives such as the endoscopic gastric balloon or surgical weight loss procedures.

Frequently Asked Questions

1. Is endoscopic sleeve gastroplasty painful?

ESG is performed under anesthesia. Some patients experience nausea or abdominal discomfort afterward, which often improves during recovery.

2. How long does the ESG procedure take?

The procedure commonly takes approximately 60–120 minutes, depending on the individual case.

3. Is ESG permanent?

ESG is intended to create lasting changes to stomach shape. Although revision may sometimes be possible, complete reversal isn’t guaranteed.

4. Can you regain weight after ESG?

Yes. Weight regain is possible, especially without continued healthy eating habits, physical activity, and medical follow-up.

5. Does insurance cover ESG in New Jersey?

Coverage varies by insurance provider and policy. Some patients may need to consider self-pay options. Confirm coverage and costs before treatment.