Endoscopic Sleeve Gastroplasty (ESG)

Yes. Following the recommended diet plan and continued cardiovascular and resistance exercises are key to avoid weight regain after a gastric sleeve .

The stomach stitches placed for an ESG are permanent, although the effects can be diminished over time due to loosening or breaking of stitches from overeating or vomiting.

Even in the event of loosening, the procedure will not be reversed because the scar tissue will maintain the weight loss. In general, an ESG is considered permanent and has a high rate of sustained weight loss.

One of the major advantages of the ESG is that the procedure is fast and minimally invasive.

Performed endoscopically, the ESG takes just 60-90 minutes under anaesthesia, with a 1-2 night hospital stay. The recovery period is usually well tolerated and can even be managed with over-the-counter pain medications.

For the 2 weeks, you will need to follow a strict liquid-only diet, even limiting juice to pulp-free variants.

From 2 to 4 weeks you will progress to pureed and soft foods. From 5 weeks onwards you can progress back to solid foods, but you should take it slow and listen to your body.

It is essential to stop eating once you feel full, as overeating risks breaking a stitch. You will likely need lifelong vitamin supplementation, and you should prioritise protein first in your meals.

You should avoid alcohol for the first three months.

This depends on what is more important to you—significant, sustained weight loss, or a minimally invasive procedure with rapid recovery.

In general, gastric sleeve surgery (LSG) is recommended for those with severe obesity, who require significant weight loss, while an endoscopic sleeve might be preferable for those with mild to moderate obesity.

Both procedures are considered safe, but LSG carries a slightly higher risk of complications.

Maximum weight loss is usually achieved one year after the procedure, and is most commonly 48%* of total body weight.

This means that someone who weighs 150 kilograms can expect to have lost around 72 kilograms one year after the procedure.

Of course, results vary and the best and most sustained results are seen in patients who show a commitment to healthy lifestyle changes.

*Weight loss varies from person to person.

Yes, depending on specific cases, those who’ve had abdominal surgery previously, or who have diabetes or heart disease currently, may still be eligible for ESG.

For those who’ve had abdominal surgery, the surgeon may request you have a gastroscopy to assess whether there are any complications or scarring that might make the procedure more challenging.

Conditions like diabetes or heart disease don’t automatically rule out ESG, but the medical team will want to ensure that these conditions are well-managed before proceeding.

If you’d like to know whether you might be a candidate, you can consult with our team

No, unfortunately ESG is not covered by Medicare, although some other weight loss surgeries (like gastric bypass and gastric sleeve) may be partially covered if deemed medically necessary.

This is because ESG is newer, and hasn’t been included in the Medicare Benefits Schedule, although this may change in the future as more long-term data becomes available.

ESG is not technically considered surgery, and is performed endoscopically, meaning it involves no incisions, and is very well tolerated with a rapid recovery time.

ESG is generally considered minimally invasive and potentially revisable (you could redo or convert it to another bariatric procedure later), but it is not usually reversible.

You may be considered a good candidate if:

• You have a BMI between 30 and 40.
• You have struggled with weight loss and haven’t had success with traditional methods.
• You are in good overall health. ESG is a minimally invasive procedure, but unmanaged heart disease or severe gastrointestinal issues could interfere with recovery.
• You are motivated and committed to lifestyle changes, like improving diet and increasing physical activity, to maintain the weight loss long-term.
• You prefer a less invasive option, but still need a more significant intervention than just diet or exercise.