Beyond Weight Loss: The Comprehensive Benefits of ESG

Published on: September 29, 2023

Table of Contents

Beyond Weight Loss: The Comprehensive Benefits of ESG


Endoscopic Sleeve Gastroplasty (ESG) has gained prominence in recent years as a ground-breaking procedure in the realm of weight management. ESG is a minimally invasive bariatric procedure that utilises an endoscope to reduce the size of the stomach, effectively promoting weight loss by limiting food intake and curbing hunger[1]. 

While its primary application is undoubtedly in the arena of weight reduction, the benefits of ESG extend far beyond mere numbers on a scale. The ripple effects of this procedure on the body’s physiology are manifold, offering patients a plethora of health advantages. From bolstering cardiovascular health and playing a pivotal role in diabetes management, to enhancing gastrointestinal health and ushering in improvements in mental well-being, ESG serves as a beacon of holistic health[2]. 

Its distinction from other weight loss surgeries, such as gastric bypass and gastric banding, lies in the procedure’s nuances and the wide-ranging positive health outcomes it facilitates[3]. This article delves into these comprehensive benefits, casting a spotlight on the myriad ways ESG contributes to enhanced overall health and wellness. By understanding the broader implications of ESG, one can appreciate it as a weight-loss solution and a pivotal step towards holistic health transformation[4,5].

A Glimpse at the Procedure

Understanding Endoscopic Sleeve Gastroplasty

Endoscopic Sleeve Gastroplasty (ESG) is a revolutionary non-surgical weight loss procedure that has been transforming the landscape of bariatric treatments[6]. Unlike traditional bariatric surgeries, ESG doesn’t require large incisions or permanent changes to the digestive tract. Instead, it uses an endoscope—a flexible tube with a camera and suturing device attached—that’s inserted through the mouth and into the stomach. By strategically placing sutures, the size of the stomach is reduced, leading to an immediate reduction in its food holding capacity[7].

Differentiating ESG from Other Weight Loss Surgeries

Compared to other popular weight loss surgeries like gastric bypass and gastric banding, ESG offers distinct advantages. One of its major benefits is that it’s less invasive, translating to shorter hospital stays and a quicker recovery period for patients[8]. Moreover, since ESG doesn’t involve removing any part of the stomach or rerouting the intestines, potential long-term complications and nutritional deficiencies often associated with other bariatric surgeries are notably diminished[9]. 

Furthermore, ESG stands out because of its reversibility; if needed, the sutures can be removed, restoring the stomach to its original size. This provides a level of flexibility and adaptability that few other weight loss procedures can boast of[10].

The Widely Known Benefit: Weight Loss

How ESG Contributes to Weight Loss

Endoscopic Sleeve Gastroplasty (ESG) operates on a straightforward principle: reducing the stomach’s volume diminishes the amount of food it can hold, which in turn restricts calorie intake. The strategically placed sutures create a smaller, tubular-shaped stomach, mimicking the results one might expect after a surgical sleeve gastrectomy but without making any incisions in the abdominal wall[11]. 

As a result, patients experience early satiety—feeling full after consuming much smaller quantities of food. This reduced food intake and a sustained commitment to a balanced diet and regular exercise facilitate consistent weight loss[12].

Comparing ESG Weight Loss Results with Other Procedures

While ESG is a relatively newer entrant in the world of bariatric interventions, its efficacy in achieving weight loss is impressive. Studies have shown that individuals undergoing ESG can expect to lose between 15% to 20% of their total body weight within the first year post-procedure[13]. When benchmarked against other weight loss surgeries, the outcomes are comparable to those of laparoscopic gastric banding. 

However, ESG might not result in as drastic weight loss as gastric bypass or duodenal switch. However, it comes with fewer potential complications, making it a favourable choice for many seeking a less invasive solution[14]. The long-term weight maintenance after ESG also appears promising, but like all weight loss interventions, success heavily depends on the individual’s commitment to lifestyle modifications and post-operative follow-up care[15].

Beyond Weight Loss: The Comprehensive Benefits

A Holistic Approach to Health

Beyond the undeniable benefit of weight reduction, Endoscopic Sleeve Gastroplasty (ESG) showcases a series of health enhancements that enrich the patient’s overall well-being. Addressing obesity isn’t merely about shedding pounds—it’s about improving one’s health in its entirety. With the procedure’s ability to foster a myriad of positive health outcomes, ESG bridges the gap between weight loss and holistic health transformation[16].

For instance, cardiovascular health sees a significant upturn post-ESG. With weight loss comes a reduction in risk factors associated with heart diseases, such as hypertension and elevated cholesterol levels[17]. Additionally, ESG has shown promise in aiding the management and even the reduction of Type 2 diabetes. By improving insulin sensitivity and promoting weight loss, this endoscopic procedure can ameliorate or at times even reverse diabetic conditions in certain individuals[18].

Enhanced Quality of Life and Mental Well-being

Physical health benefits aside, ESG paves the way for an enriched quality of life. With weight loss comes improved mobility, increased energy levels, and an overall enhancement in daily functional activities[19]. 

But the advantages continue beyond there. The psychological impact of weight loss and improved health can’t be understated. Many patients report positive shifts in body image perception, leading to increased self-esteem and confidence. Furthermore, as physical health improves, many also experience a notable reduction in symptoms of depression and anxiety that were previously tied to their weight or related comorbidities[20].

Safety and Efficacy of ESG

A Track Record of Safety

Endoscopic Sleeve Gastroplasty (ESG) has, over the years, established itself as effective and remarkably safe, especially when compared to traditional bariatric surgeries. As a less invasive procedure, it minimises common surgical risks such as wound infections, hernias, and prolonged hospital stays[21]. 

Though infrequent, adverse events associated with ESG are generally mild and include symptoms like abdominal pain or nausea, which typically resolve within a few days[22]. Serious complications like gastric perforation or leakage are exceedingly rare, thanks to advancements in endoscopic techniques and the expertise of trained endoscopists.

Validated Efficacy in Weight Management

The efficacy of ESG is validated by numerous clinical studies highlighting its potential in driving substantial weight loss, especially when complemented by a structured post-procedure dietary and lifestyle regimen[23]. Patients undergoing ESG, on average, experience a significant reduction in excess body weight within the first year, with many maintaining this weight loss or even achieving further reductions in subsequent years[24]. 

What makes ESG notably effective is its dual mechanism of action: It physically reduces the stomach’s size and influences gut hormones responsible for appetite regulation. This hormonal modulation and reduced gastric volume provide a two-pronged approach to effective weight management. Moreover, the versatility of ESG, given its less invasive nature, means that it can also serve as a bridge to other bariatric surgeries for patients requiring sequential treatments or those not initially eligible for more invasive procedures[25].


Endoscopic Sleeve Gastroplasty (ESG) has proven to be more than just a weight loss solution. Its holistic benefits encompass a wide range of health improvements, from cardiovascular and metabolic enhancements to significant elevations in mental well-being and quality of life[26]. 

The procedure’s minimal invasiveness and impressive safety profile position it as a compelling alternative to more invasive bariatric surgeries, with the added advantage of fewer complications and faster recovery times[27]. It’s essential to appreciate ESG for its weight loss capabilities and broader health implications. 

As studies continue to validate its efficacy and safety[28], it’s evident that ESG will play an increasingly pivotal role in the fight against obesity and its associated health complications. Embracing a comprehensive approach to health and wellness, ESG exemplifies the future of bariatric interventions[29,30].


  1. Lopez-Nava G., et al. “Endoscopic Sleeve Gastroplasty: How I do it?” *Obesity Surgery*, 2015. https://pubmed.ncbi.nlm.nih.gov/26003549/
  2. Sharaiha, R. Z., et al. “Endoscopic Sleeve Gastroplasty Significantly Reduces Body Mass Index and Metabolic Complications in Obese Patients.” *Clinical Gastroenterology and Hepatology*, 2017.
  3. Abu Dayyeh, B. K., et al. “Endoscopic Sleeve Gastroplasty: a Potential Endoscopic Alternative to Surgical Sleeve Gastrectomy for Treatment of Obesity.” *Gastrointestinal Endoscopy*, 2013.
  4. Kumar, N. “Endoscopic Bariatric Therapies: The Current Landscape.” *Current Treatment Options in Gastroenterology*, 2017.
  5. Sullivan, S., et al. “Evolving Roles of Endoscopic Bariatric Therapies in Obesity Management.” *Current Opinion in Gastroenterology*, 2018.
  6. Singh, S., et al. “Endoscopic Sleeve Gastroplasty – A New Tool to Manage Obesity.” *Clinical Endoscopy*, 2017.
  7. Gagner, M. & Hutchinson, C. “Endoscopic Sleeve Gastroplasty: Technical Aspects and Feasibility.” *Surgical Endoscopy*, 2016.
  8. Kumar, N., & Sullivan, S. “Comparative Effectiveness of Endoscopic Sleeve Gastroplasty versus Laparoscopic Sleeve Gastrectomy.” *Endoscopy International Open*, 2019.
  9. Thompson, C.C., et al. “Percutaneous Gastrostomy Device for the Treatment of Class II and Class III Obesity: Results of a Randomized Controlled Trial.” *The American Journal of Gastroenterology*, 2017. https://pubmed.ncbi.nlm.nih.gov/27922026/
  10. Neto, M.G., et al. “Endoscopic Sleeve Gastroplasty: An Updated Review of Physiology, Techniques, and Outcomes.” *Obesity Surgery*, 2018.
  11. Khan, Z., et al. “Endoscopic Sleeve Gastroplasty: Role in Obesity Management.” *Current Gastroenterology Reports*, 2019.
  12. Brethauer, S.A., et al. “Endoscopic Sleeve Gastroplasty for Clinical Obesity: A Systematic Review.” *Surgery for Obesity and Related Diseases*, 2019.
  13. Fayad, L., et al. “Endoscopic Sleeve Gastroplasty versus Laparoscopic Sleeve Gastrectomy: a Comparative Study with 12-Month Follow-up.” *Surgical Endoscopy*, 2020.
  14. Rosenthal, R.J., et al. “International Sleeve Gastrectomy Expert Panel Consensus Statement: Best practice guidelines based on experience of >12,000 cases.” *Surgery for Obesity and Related Diseases*, 2012. https://pubmed.ncbi.nlm.nih.gov/22248433/
  15. Abu Dayyeh, B.K., et al. “Long-Term Outcomes of Endoscopic Sleeve Gastroplasty: a Multicenter Study.” *Gastrointestinal Endoscopy*, 2020.
  16. Romero, F.J., et al. “Endoscopic Sleeve Gastroplasty for Obesity Treatment: Two Years of Experience.” *Arquivos Brasileiros de Cirurgia Digestiva*, 2017.
  17. Iannelli, A., et al. “Endoscopic Sleeve Gastroplasty Significantly Decreases Blood Pressure and Antihypertensive Medication in Patients with Obesity and Hypertension.” *Surgery for Obesity and Related Diseases*, 2020.
  18. Bazerbachi, F., et al. “Effect of Endoscopic Sleeve Gastroplasty on Glycemic Control in Patients with Obesity and Type 2 Diabetes.” *Gastrointestinal Endoscopy*, 2019.
  19. Lopez-Nava, G., et al. “Quality of Life, Weight Loss, and Improvement in Co-morbidities Following Endoscopic Sleeve Gastroplasty: A Systematic Review.” *Obesity Surgery*, 2020.
  20. Sullivan, S., et al. “Psychosocial Effects of Endoscopic Sleeve Gastroplasty: A Systematic Review.” *Clinical Gastroenterology and Hepatology*, 2021.
  21. Jirapinyo, P., et al. “A Meta-analysis of 12,775 Patients Undergoing Endoscopic Bariatric Therapies.” *Gastrointestinal Endoscopy*, 2020.
  22. Storm, A.C., & Thompson, C.C. “Complications of Bariatric Procedures: Presentation and Emergency Management—a Review.” *Current Gastroenterology Reports*, 2016.
  23. Fayad, L., et al. “Endoscopic Sleeve Gastroplasty versus Intragastric Balloon Insertion: Efficacy, Durability, and Safety.” *Endoscopy*, 2018.
  24. Novikov, A.A., et al. “Endoscopic Sleeve Gastroplasty, Laparoscopic Sleeve Gastrectomy, and Laparoscopic Band for Weight Loss: How Do They Compare?” *Journal of Gastrointestinal Surgery*, 2018.
  25. Abu Dayyeh, B.K., & Kumar, N. “Endoscopic Bariatric Therapies: a Comprehensive Review.” *Current Treatment Options in Gastroenterology*, 2017.
  26. Sartoretto, A., et al. “Endoscopic Sleeve Gastroplasty (ESG) is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption: a Large, International Multicenter Study.” *Obesity Surgery*, 2018. https://pubmed.ncbi.nlm.nih.gov/29450845/
  27. Alqahtani, A., et al. “Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients.” *Gastrointestinal Endoscopy*, 2019.
  28. Chen, Y., et al. “Effectiveness and Safety of Endoscopic Sleeve Gastroplasty for Obesity Patients: a Systematic Review and Meta-analysis.” *Obesity Surgery*, 2021.
  29. Kumar, N. “The Future of Endoscopic Bariatric Therapies.” *Current Gastroenterology Reports*, 2021.
  30. Camilleri, M., & Acosta, A. “Endoscopic Sleeve Gastroplasty Alters Gastric Physiology and Induces Loss of Body Weight in Obese Individuals.” *Clinical Gastroenterology and Hepatology*, 2017. https://pubmed.ncbi.nlm.nih.gov/26748219/

Related News