ESG is a minimally invasive and incisionless endoscopic weight loss procedure that reduces the size of the stomach to help you lose weight. It is usually performed as an outpatient procedure with sedation and is well tolerated by most patients. This procedure has a significantly shorter recovery time compared to traditional weight loss surgeries and avoids external incisions/scarring to your skin.
While you are sedated, your highly trained interventional gastroenterologist will insert an endoscope, a small camera attached to a thin and flexible tube, through your mouth and into your stomach. A suturing device is connected to the tube, enabling stitches to be placed inside the stomach. After the stitches are placed and tightened, the stomach cinches and is reshaped to about 25% of its original size. This procedure results in retaining food in the stomach longer, which increases your sense of fullness and ultimately helps you eat less. This is especially helpful if you struggle with temptations to overeat.
To be a candidate, you must be of at least 21 years of age (as authorized by the FDA) with a body mass index (BMI) of at least 30 (calculate your BMI here) and have not been able to lose adequate weight with diet and exercise alone. ESG is also a great option for those who want to avoid surgery or for those who are not candidates for surgery. You will have a consultation with the doctor to review your medical history to determine if you are a candidate for ESG prior to scheduling the procedure. We encourage you to ask questions you may have regarding the procedure during this office visit. In conjunction with hands-on lifestyle coaching by experts from our practice, undergoing ESG is the start to a long-term journey for weight loss.
Estimated weight loss from ESG is about 15-20% of the starting total body weight or 60-70% of excess body weight at 1-2 years following the procedure. With a low fat diet and adequate exercise, you may even lose more weight than the projected range. Other health benefits, in addition to weight loss, include improvement in gastroesophageal reflux, high blood pressure, type 2 diabetes, high cholesterol, fatty liver, and obstructive sleep apnea.
Most patients will experience mild symptoms immedately after and for a few days following the procedure, such as abdominal discomfort and nausea. These symptoms usually disappear after your body becomes accustomed to your newly reduced stomach size and you will likely be able to return to work in 2-3 days. We will prescribe medications for use before and after your procedure to help these symptoms. Compared to surgery, the possibility of serious complications is drastically reduced. Serious symptoms requiring medical attention will be thoroughly discussed at your consultation visit and prior to your procedure.
We also offer a 24/7 concierge aftercare service for our patients. The aftercare program offers multiple benefits such as individualized meal planning and shopping lists, unlimited text messaging support (including on weekends and evenings), therapy and optional counseling with loved ones. We will help you through your recovery while giving you tools to help you stay on track and peace of mind that you are being cared for.
Yes, now that your stomach has significantly decreased in size as a result of this procedure, you will find yourself feeling fuller with smaller quantities of food. You will be given a booklet with dietary recommendations regarding what kind and quantity of food you should eat in the days to weeks after the procedure while your stomach adjusts to its new size. In addition to dietary modifications, we will also assist you in exercise planning with trained experts who will work with you individually to track your progress. These lifestyle changes are meant to be lifelong to help you maintain your weight loss.
As with any procedure, there are risks for potential complications. However, compared to laparoscopic surgery, the risks of this procedure are significantly less since there are no external incisions. According to the landmark MERIT Trial published in 2022, ESG is considered a safe and low risk intervention to help patients achieve and maintain weight loss.
1 CreAACE/TOS/ASMBS/OMA/ASA 2019: Guidelines: Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric procedures- 2019 UPTODATE. Table 6a.
2 Woźniewska P, Diemieszczyk I, Hady HR. Complications associated with laparoscopic sleeve gastrectomy – a review. Prz Gastroenterol. 2021;16(1):5-9. doi: 10.5114/pg.2021.104733. Epub 2021 Mar 26. PMID: 33986881; PMCID: PMC8112272.
3 Weight Loss Surgery Options – Brigham and Women’s Hospital. www.brighamandwomens.org. Accessed October 13, 2023.
ESG is a complex endoscopic procedure that should be performed by highly skilled gastroenterologists. We at 4ward Wellness are advanced endoscopists who have completed additional training in complex and high risk endoscopic procedures. We possess the skills and tools to not only perform these procedures but also manage the unlikely risk of potential complications associated with any endoscopic procedure. We are proud to offer an individualized approach in achieving your weight loss goals. We are here to listen and work with you as you choose the next step in your weight loss journey and achieve a healthier lifestyle.
The ESG procedure costs $11,999*. This cost not only covers the procedure but also your journey to wellness consisting of post procedure follow-up appointments and lifestyle coaching/support available to you for up to one year. These procedures are not currently covered by all insurance companies. We understand financial limitations can be a barrier to undergoing elective treatments to improve your health. We have finance options available including CareCredit to help you move 4ward in your wellness journey.
*These costs do not include any lab work and/or additional fees as outlined in your consultation.
We at 4ward Wellness welcome patients from anywhere, and we know it is crucial to have the right accommodation when visiting us. Located 20 minutes from Albany International Airport, 4ward Wellness is looking forward, in the future, to partnering with nearby hotels. For now, we encourage you to choose from the many accommodations in the greater Albany area. Our friendly staff can help you find accommodation that is suitable for your needs. Let us know how we can help.
Remember, this is not just a one-time visit, but is a long-term journey. You will return the next day to receive IV fluids at our infusion center. We will check in during this visit to assess your recovery. You will also have scheduled follow ups in the office soon after your procedure and then once every couple months for up to a year.
During the 1 year following your procedure, you will have weekly follow-ups with our bariatric counselor and nutritionist. This will also include weekend and after hour access to our specialists with any questions or concerns to help you through your recovery and give you peace of mind that you are being cared for.
