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weight loss

Endoscopic Sleeve Gastroplasty

In medicine, endoscopic sleeve gastroplasty (ESG) is a minimally-invasive, non-surgical (incisionless), endoscopic weight loss procedure that is part of the field of endoscopic bariatric therapies. To perform ESG, a physician sutures a patient's stomach into a narrower, smaller tube-like configuration.

By The Treatment Registry

Quick Facts

Price range
Varies by clinic
Recovery
Varies
Sessions
Varies
Category
weight loss
Anaesthesia
Varies
Min. stay abroad
Varies
Price Range (International)
Varies by clinic
Average Recovery
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Typical Sessions
Varies
Category
weight loss

Overview

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, non-surgical and incisionless endoscopic weight-loss procedure, and one of the endoscopic bariatric therapies. Rather than removing part of the stomach through incisions, a physician passes an endoscope through the mouth and places sutures that draw the stomach into a narrower, smaller, tube-like configuration. The result is a more restricted stomach that leads patients to feel fuller sooner and eat fewer calories, which facilitates weight loss. Endoscopic bariatric therapies are judged mainly on total body weight loss and excess weight loss. In 2015 a joint expert panel from the American Society for Gastrointestinal Endoscopy and the American Society for Metabolic and Bariatric Surgery recommended that any new endoscopic weight-loss therapy should achieve excess weight loss above 25% with a serious adverse-event rate below 5%, and multiple studies indicate that ESG meets these thresholds. The MERIT study, the first and only randomised controlled trial of ESG for obesity, enrolled 209 adults with class I and II obesity (body mass index 30 to 40) across nine centres in the United States. Participants in the ESG arm lost 13.6% of body weight and 49.2% of excess body weight at one year, compared with 0.8% total body weight loss in the control arm, which received lifestyle modification only.

Key Considerations

    Common Risks

      Detailed risk profile →

      Credentials a clinic should hold

      Specialty-board certifications and facility-level accreditations relevant to this procedure. Verify on the issuer's public register before booking — most issuers publish a searchable directory.

      • IFSO Centre of Excellence

        Issuer International Federation for the Surgery of Obesity

        Facility + surgical-team accreditation for bariatric surgery; requires minimum case volumes, multidisciplinary follow-up, and outcomes reporting.

        Verify on the issuer's register →

      Current clinical trials

      Ongoing research studies registered on ClinicalTrials.gov whose intervention involves endoscopic sleeve gastroplasty. This is a neutral pointer to public research — not an endorsement, not a recruitment drive, and not medical advice. Trial status changes often; confirm eligibility and current status with the study team via each record.

      Showing 6 recent ongoing studies. Source: ClinicalTrials.gov — all matching trials (U.S. National Library of Medicine, public domain). Retrieved 2026-08-02.

      Recovery Timeline

      Average recovery for Endoscopic Sleeve Gastroplasty is 0 days. Individual recovery varies — always follow your surgeon’s specific guidance.

      1. 01Day 0–1

        Immediate

        First 24–48 hours post-procedure. Monitoring, anaesthesia recovery, initial pain management. Most clinics expect you to remain on-site or nearby.

      2. 02Day 2–2

        Early recovery

        Wound care, swelling or bruising peaks, restricted activity. Typical window for follow-up visits and drain removal if applicable. Travel is usually not advised.

      3. 03Day 3–3

        Intermediate recovery

        Gradual return to non-strenuous daily activity. Many international patients fly home during this window. Surgeon may require medical clearance for long-haul travel.

      4. 04Day 4–0

        Full recovery

        Return to full activity, exercise, and work. Final results may still be settling. Final follow-up with local doctor recommended.

      Questions to Ask Your Clinic

        Browse all destinations offering Endoscopic Sleeve Gastroplasty →Detailed cost breakdown →

        Frequently Asked Questions

        What is endoscopic sleeve gastroplasty?

        It is a minimally invasive, non-surgical and incisionless endoscopic weight-loss procedure that is part of the field of endoscopic bariatric therapies. A physician sutures the stomach into a narrower, smaller, tube-like configuration.

        Does ESG involve incisions or removing part of the stomach?

        No. ESG is non-surgical and incisionless. The stomach is reshaped from the inside using sutures placed through an endoscope, rather than through external incisions.

        How does ESG cause weight loss?

        By suturing the stomach into a narrower, more restricted shape, the procedure forces patients to feel fuller sooner and eat fewer calories, which facilitates weight loss.

        Who is ESG studied in?

        The MERIT randomised controlled trial enrolled 209 adults with class I and II obesity, defined as a body mass index between 30 and 40, across nine centres in the United States.

        How much weight loss does it produce?

        In the MERIT study, participants in the ESG arm lost 13.6% of body weight and 49.2% of excess body weight at one year, compared with 0.8% total body weight loss in the control arm, which received lifestyle modification only.

        What safety and effectiveness threshold applies to endoscopic weight-loss therapies?

        In 2015 a joint expert panel from the American Society for Gastrointestinal Endoscopy and the American Society for Metabolic and Bariatric Surgery recommended that any new endoscopic weight-loss therapy achieve excess weight loss above 25% with a serious adverse-event rate below 5%. Multiple studies indicate that ESG satisfies these criteria.

        Conditions treated

        Clinical conditions for which endoscopic sleeve gastroplasty is a treatment-ladder option.

        Severe obesity with comorbidity

        Related Procedures

        Other weight loss procedures in our registry

        Gastric Sleeve (Sleeve Gastrectomy)Roux-en-Y Gastric BypassMini Gastric BypassGastric BalloonRevisional Bariatric SurgeryDuodenal SwitchSADI-S

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