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What Is Endoscopic Sleeve Gastroplasty?
Obesity is more than just a number on a scale, it’s a complex health issue that affects nearly one in three Canadians. Beyond the individual health toll, it creates a significant economic burden , with the cost of inaction now reaching $27.6 billion per year (Obesity Canada). But the real impact isn’t just financial; it’s personal. Many people living with obesity are also managing associated comorbidities like diabetes, high blood pressure, high cholesterol, sleep apnea, and joint pain, all of which can limit daily life and increase long-term health risks.
For those who have tried diet and exercise without success, weight loss surgery can be a powerful tool. But not everyone is ready for, or even eligible for, a gastric sleeve or gastric bypass. This is where endoscopic sleeve gastroplasty (ESG) comes in (a minimally invasive approach that’s helping people achieve real, sustainable weight loss).
Below is an overview of what ESG involves, who might benefit, and how it compares to other weight loss interventions.
Endoscopic sleeve gastroplasty (ESG) is a non-surgical weight loss procedure that reduces the stomach’s capacity without removing any part of it. Instead, a thin, flexible tube, also known as an endoscope,is inserted through the mouth. Using a specialized suturing device at the end of this scope, a medical professional folds the stomach tissue to decrease its volume by roughly 70%. As a result, individuals often feel satisfied with less food, facilitating steady weight loss over time.
ESG typically targets adults with a body mass index (BMI) between 30 and 40 who haven’t seen success through lifestyle adjustments alone. It’s also an option for those who either don’t qualify for more invasive bariatric operations,or simply prefer a less extensive intervention.
Although it’s intended for long-term outcomes, ESG is technically reversible. If the situation ever calls for it, the sutures can be removed, returning the stomach to its original size. Even so, ESG is generally pursued with the idea of ongoing weight management, much like other recognized bariatric procedures.
The process happens under general anesthesia and typically takes place in an outpatient setting.
A flexible endoscope with a suturing device is introduced through the mouth and guided into the stomach
A series of internal stitches fold the stomach inward, cutting its capacity by about 70%.
No external incisions are necessary, and the procedure usually lasts 60 to 90 minutes.
After a brief recovery period, most patients head home the same day.
Following ESG, a specific diet protocol helps with healing and adapting to the reduced stomach size:
First Week: Stick to a mostly liquid diet of protein shakes, and water.
Weeks 2–4: Move to soft or pureed foods.
Week 5 Onward: Gradually reintroduce solid meals, focusing on high-protein, low-carbohydrate choices.
For more details on post-surgical care, visit our surgery guidelines page.
Pros
Minimally Invasive: No large incisions and fewer visible marks.
Short Downtime: Many people resume normal activities within days.
Lower Risk of Complications: Fewer potential issues than with gastric sleeve or bypass surgery.
Reversible: Sutures can be taken out if absolutely necessary.
Steady Weight Loss: On average, individuals can lose 15–20% of their total body weight.
Cons
Less Rapid Weight Loss: Results may be more gradual compared to gastric sleeve or bypass.
Lifestyle Adjustments Remain Crucial: A balanced diet and consistent exercise are still essential, as is the case with any surgical weight-loss method
Potential Side Effects: Some individuals experience temporary nausea, abdominal pain, or mild discomfort.
Risk of Weight Regain: As with any weight loss strategy, there’s potential for weight gain if patients do not also develop lasting dietary changes and healthy lifestyle habits.
Financing is often a central concern when exploring ESG. Fortunately, several medical financing providers offer flexible payment plans:
Medicard – Swift approvals and a range of tailored payment schedules.
Credit Medical – Competitive rates and the option to finance the full cost of the procedure.
Beautifi – Specializes in medical loans featuring manageable monthly payments and no initial fees.
For more information on costs, visit our fees page.
ESG can be an appealing choice for obese patients seeking a minimally invasive solution that still promotes significant weight loss. If you’ve struggled with conventional weight management strategies and want to explore an alternative to traditional bariatric surgery to lose weight, ESG may be worth a closer look.
Interested in finding out more? Reach out to Clinique Michel Gagner for a consultation and learn whether endoscopic sleeve gastroplasty fits your health goals and lifestyle.
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/endoscopic-sleeve-gastroplasty
https://www.mayoclinic.org/tests-procedures/endoscopic-sleeve-gastroplasty/about/pac-20393958
https://my.clevelandclinic.org/health/treatments/24771-endoscopic-sleeve-gastroplasty
https://www.healthline.com/health/weight-loss/endoscopic-sleeve-gastroplasty
https://pmc.ncbi.nlm.nih.gov/articles/PMC7775813
https://www.nth.nhs.uk/resources/esg-surgery
