Endoscopic Sleeve Gastroplasty (ESG), commonly known as "ESG Stomach Tightening," is a non-surgical procedure for individuals struggling with obesity. The procedure is performed entirely internally using an endoscope, making it minimally invasive. Below, you will find a general overview and all the information you need to know when considering this procedure.
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How Does ESG Stomach Tightening Work?
First, it's important to go through and get to know the procedure. It starts with the doctor inserting a flexible tube called an endoscope through the mouth and into the stomach. The tube has a camera that displays a live view of the stomach on a screen. Gas is then gently released to expand the stomach, providing better visibility and easier working conditions.
Using a special tool (suturing device) on the endoscope, the doctor makes from 8 to 10 stitches inside the stomach, pulling opposite walls together to create internal folds. These folds reshape the stomach into a narrow sleeve, reducing its size by about 60–75%. The stitches are permanent, and the stomach tissue heals around them, holding the new shape in place.
Over time, the stomach may stretch or some sutures may break, which could reduce the procedure's effectiveness and necessitate a revision. The positive side of the procedure is that, because no part of the stomach is removed, it can sometimes be reversed by cutting and removing the sutures.
Who is ESG For?
Is it for you? The ideal candidate for ESG stomach tightening has a Body Mass Index (BMI) of 30 or more. However, this assessment is based on your unique medical history and overall health profile. ESG is a versatile procedure available to both children and adults diagnosed with obesity. It is usually one of the best options for individuals who are significantly overweight but not necessarily morbidly obese.
The procedure is particularly well-suited for those who have attempted weight loss through let's say conventional lifestyle changes, such as diet and exercise, but with no significant results.
We often mention that all these procedures are just tools, and there still needs to be a lot of hard work put into everyday tasks, from the smallest to the bigger commitments, such as regular workouts. The patient must demonstrate a willingness to actively participate in a medically supervised program.
The Good And the Bad of ESG
ESG stomach tightening offers a series of significant benefits for weight loss and associated health improvements; however, it remains a medical procedure, carrying potential risks that you should be aware of.
Benefits
ESG presents a range of advantages for individuals seeking effective weight management:
- ESG helps most patients lose 15–20% of their total body weight in the first year, with some achieving up to 25% weight loss.
- Many obesity-related health issues improve or resolve, including type 2 diabetes, high blood pressure, high cholesterol, heart disease, sleep apnea, and joint pain. It also improves insulin sensitivity and reduces the hormones that stimulate hunger.
- ESG is minimally invasive, done through the mouth, with no incisions or scars.
- Recovery is quick—most people return to work within a week.
- Complications are rare (1–2%), and there's no risk of implanted devices or major nutrient deficiencies.
- Better energy, mobility, sleep, self-confidence, and, in some cases, improved fertility.
Risks
There is also the other side of the story, which involves some of the risks a patient is taking, and that needs to be considered:
- Pain, nausea, and heartburn are common, but they are usually mild and short-term.
- Some of the more serious complications are bleeding, perforation, or organ injury. However, they are rare and treatable.
- Over time, the stomach may stretch or sutures may loosen, which can potentially lead to weight regain.
- Approximately 11% of patients may require revision surgery after 10 years.
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The Recovery Journey and Expected Outcomes
The recovery period following ESG is notably quicker and less demanding than that for surgical alternatives. You may be able to return to work within the first week, often as early as 1 to 3 days after the procedure. If everything goes as planned, you will be able to resume your normal daily activities within a few days. It is important to listen to the body during the recovery and gradually increase physical exercise. While the more acute symptoms resolve quickly, the stomach requires approximately one month to fully heal from the internal modifications.
Long-Term Nutritional Monitoring
Long-term nutritional monitoring is an important part of post-ESG care. Regular blood tests are essential for screening potential nutritional deficiencies. You will do these tests at 6 and 12 months in the first year following the procedure, and once per year after that. While ESG carries a lower risk of malabsorption and associated nutrient deficiencies compared to some other bariatric surgeries that reroute the digestive system, consistent monitoring is important for your overall health and well-being.
Plan For a Lasting Success
ESG stomach tightening provides a powerful, less invasive option for achieving significant weight loss and improving overall health. With no incisions, faster recovery, and fewer risks than traditional surgery, it's an appealing choice for many people seeking lasting change.
But ESG is just the beginning—it works best when combined with long-term lifestyle changes. Challenges such as sticking to new eating habits, hitting weight loss plateaus, or stomach stretching over time are all possible. That's why ongoing support from healthcare professionals, including dietitians and fitness experts, is key.
FAQ
How much weight can I lose with ESG stomach tightening?
Most patients lose 15–20% of their total body weight in the first year after ESG, with some reaching up to 25%, especially when paired with lifestyle changes.
Who is a good candidate for ESG?
ESG is ideal for people with a BMI of 30 or higher who have struggled to lose weight through diet and exercise alone. It’s suitable for adults and some adolescents.
What are the risks of ESG stomach tightening?
Common side effects include mild pain, nausea, or heartburn. Rare but serious complications include bleeding or stomach injury. There’s also a chance of stomach stretching over time.
How long is the recovery after ESG?
Most patients return to work within a week, and many resume normal activities in just 1 to 3 days. Full internal healing of the stomach takes about one month.
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