ESG FAQ

What is Endoscopic Sleeve Gastroplasty (ESG)?

ESG is an endoscopic, incisionless weight loss procedure performed by a doctor, who sutures the stomach
with a specialized device to make your stomach smaller.

How is the ESG procedure performed?
While you are asleep, a specially trained doctor passes a suturing device and camera through your mouth.
After they reach the inside of your stomach, the doctor sews it into a smaller shape.

How does it help people lose weight?
The procedure makes the stomach 70–80% smaller. You eat less food so your system absorbs fewer calories.
Food stays in the stomach longer, and you feel full longer.

How is ESG different than a laparoscopic gastric sleeve, gastric bypass, or other bariatric surgery?
ESG is similar to a traditional gastric sleeve surgery because it reduces the stomach size to restrict the amount of
food a patient can eat. However, unlike traditional bariatric surgery, ESG is performed without any incisions and no
part of the stomach is removed.

What are the most common side effects?
The most common side effects are gastrointestinal symptoms such as nausea, abdominal pain, vomiting,
constipation, burping, or diarrhea. These symptoms typically resolve within 30–60 days.1

All procedures have risk.

Patients should talk with their doctor and understand all risks before having any procedure.

Who is a good candidate for this procedure?
ESG is for adults with obesity (defined as having a Body Mass Index (BMI) between 30 and 50 kg/m2) who have not been able to lose weight or maintain weight loss through diet and exercise alone.

Who cannot have ESG?
Patients who are unable to have an upper endoscopy, are pregnant, are using certain types of blood-thinning
medications or have malignant tissue, large hiatal hernia, potentially bleeding gastric lesions, or eating disorders
are not eligible for the procedure. Talk to your doctor about whether you are a candidate for ESG.

When do most people return to routine daily activities after ESG?
In a study, patients typically returned to routine daily activities in 2–3 days.

How much weight can I lose with ESG?
According to a large, randomised clinical study, patients lost an average of 13.6% of their body weight 12 months after undergoing ESG. Results will vary by person. Patients 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.

Are the sutures permanent or dissolvable?
The sutures are made of a durable, permanent material that does not dissolve. However, the sutures can break. In
the event the sutures break, you may not feel as full after eating as you did immediately after the procedure. If this
happens, another procedure can be done to replace the broken sutures and restore the sleeve.

Is the procedure permanent?
Over time, scarring and bridging tissue forms to maintain the smaller stomach size and sleeve-like shape. As with
weight loss surgeries, the sleeve can stretch over time. In the event the sleeve stretches, you may not feel as full
after eating as you did after the procedure. If this happens, a retightening procedure can be performed to place
new sutures and restore the sleeve.

Is the sleeve reversible?
In the event that you cannot tolerate the sleeve, your doctor may consider reversal. Reversal soon after the
procedure can typically be done by cutting and removing the sutures in your stomach. If more time has passed
and scarring has formed, the sleeve could be reversed by a procedure to cut the bridging tissue and remove the
sutures, if recommended by your doctor. Like with any procedure, reversal of ESG is associated with risks and
should be discussed with your doctor before proceeding.

How much does it cost?
Health care providers work with patients one-on-one to determine payer coverage and financing options.

Will I have to take nutritional supplements or vitamins?
No, you are typically not required to take nutritional supplements or vitamins following ESG. Follow your doctor’s
instructions on any specialised diet plans during recovery. However, patients 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.