By Dr Melvin Look
Endoscopic Sleeve Gastroplasty (ESG): A New Weight-Loss Procedure Without Surgery
Obesity is a significant public health concern worldwide. Modern diets and sedentary lifestyles have led to obesity rates tripling over the past five decades. This condition is linked with metabolic disorders such as diabetes, high blood pressure, abnormal lipid levels, and heart disease.
Understanding Body Fat
Body fat, or adipose tissue, serves an important role in storing energy for times when food intake is low. However, when calorie intake consistently exceeds what the body expends, fat storage increases beyond healthy limits. Over time, this imbalance can contribute to obesity and its related health effects.
Weight Management Challenges
Weight reduction typically involves reducing caloric intake and increasing physical activity. However, maintaining long-term weight loss through lifestyle modification alone can be difficult for many individuals. Factors such as metabolism, appetite regulation, social habits, and emotional well-being influence weight control.
Pharmacological options, such as glucagon-like peptide-1 (GLP-1) receptor agonists, have recently gained attention for their role in managing obesity. While these medications can assist with weight reduction, they may cause side effects and are often intended for use under medical supervision.
For individuals with severe obesity, bariatric surgery has been the standard treatment. Procedures such as Gastric Bypass and Sleeve Gastrectomy are performed through minimally invasive techniques and have shown to produce substantial and sustained weight loss, along with improvement in metabolic conditions. These procedures, however, carry the usual surgical risks and require a period of recovery. They are generally recommended for individuals with a Body Mass Index (BMI) above 32–37 kg/m².
Individuals with a lower BMI (27–32 kg/m²) may not qualify for surgery but may still face health challenges related to excess weight. In such cases, less invasive options may be considered as part of a comprehensive management plan.
Endoscopic Sleeve Gastroplasty (ESG)
Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive endoscopic procedure that reduces the size of the stomach without the need for incisions. It is performed using a flexible endoscope inserted through the mouth under general anaesthesia. Using a suturing device, the inner wall of the stomach is folded and stitched, reducing its volume by approximately 70–80%.
By decreasing stomach capacity and delaying gastric emptying, ESG promotes earlier satiety and helps individuals consume smaller portions comfortably. The procedure usually takes about an hour. Some individuals may experience mild abdominal discomfort, nausea, or bloating, which typically resolve within a few days. Most are able to resume regular activities after a short recovery period.
After the procedure, a gradual diet progression is recommended — starting with liquids and advancing to soft and then solid foods over several weeks. This helps the stomach adjust to its new structure.
Compared with surgical options such as Laparoscopic Sleeve Gastrectomy (LSG), ESG generally involves less downtime and no external scars. The effects can last several years and, if necessary, the sutures can be adjusted or reversed endoscopically.
Safety and Effectiveness
ESG is approved by the U.S. Food and Drug Administration (FDA) and has been performed internationally with an established safety record. Clinical studies have shown that participants may achieve approximately 15–20% total body weight loss within one to two years after the procedure — corresponding to roughly 50% of excess weight loss.
As with any medical intervention, ESG is most effective when combined with a comprehensive weight management plan that includes dietary modification, physical activity, and behavioural support.
Disclaimer:
This article is intended for general educational purposes only and should not be construed as medical advice. Individuals considering weight management treatments should consult a qualified healthcare professional for personalised assessment and recommendations. PRIME
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