Endoscopic Sleeve Gastroplasty (ESG) reduces your stomach size by 70% — no incisions, same-day discharge, and lasting results. Performed by board-certified bariatric surgeons.
15–20% avg. total body weight loss at 12 months · Based on peer-reviewed meta-analysis of 1,772 patients (Hedjoudje et al., 2020)
Answer a few quick questions to see if ESG could be right for you. Takes about 2 minutes.
Step 1 of 4
A minimally invasive procedure that reduces your stomach size by 70% — no incisions, no surgery, same-day discharge.
The average stomach holds about 1 liter of food. Excess capacity can lead to overeating and difficulty feeling full.
This animation shows exactly how ESG is performed — from scope insertion to the final suturing pattern.
13.6%
Total body weight loss in RCT
Abu Dayyeh et al., The Lancet, 2022
<2%
Serious adverse event rate
Singh et al., Surgical Endoscopy, 2020
5+ yr
Durable long-term results
Lopez-Nava et al., Obesity Surgery, 2021
See how ESG compares to other weight loss procedures and treatments.
| Feature | ESG Recommended | Gastric Sleeve | Gastric Bypass | GLP-1 Medications |
|---|---|---|---|---|
| Procedure Type | Endoscopic (no incisions) | Laparoscopic surgery | Laparoscopic surgery | Weekly injection |
| Anesthesia | General | General | General | None |
| Procedure Time | 60-90 min | 1-2 hours | 2-3 hours | N/A |
| Hospital Stay | Same-day discharge | 1-2 nights | 2-3 nights | N/A |
| Recovery Time | 3-5 days | 2-4 weeks | 3-6 weeks | None |
| Expected Weight Loss | 15-20% body weight | 25-30% body weight | 30-35% body weight | 10-15% body weight |
| Reversible | Yes | No (permanent) | Technically (complex) | Stops when medication stops |
| Typical BMI Range | 30-40 | 35-60+ | 40-60+ | 27-40 |
| Complication Rate | <1% | 2-5% | 3-7% | GI side effects common |
| Approximate Cost | $10,000-$15,000 | $15,000-$25,000 | $20,000-$35,000 | $800-$1,500/mo ongoing |
Sources: Hedjoudje et al., CGH, 2020; Abu Dayyeh et al., The Lancet, 2022; Fayad et al., GIE, 2019; Wilding et al. (STEP 1), NEJM, 2021. Individual results may vary.
Hear directly from people who chose ESG and transformed their lives.
Emily shares her weight loss journey with ESG and how it transformed her life.
Backed by clinical evidence
Average 18.2% total body weight loss
Based on ASGE meta-analysis of 5,000+ patients See the research
ESG outcomes are supported by peer-reviewed clinical trials and meta-analyses published in leading medical journals.
15–20%
Average total body weight loss at 12 months
5,000+
Patients studied across published clinical trials
<2%
Serious adverse event rate
0%
Mortality rate in all published ESG studies
5+ yr
Durable weight loss results demonstrated
60 min
Average procedure time, same-day discharge
Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial
Abu Dayyeh BK, Bazerbachi F, Vargas EJ, et al.
The Lancet, 2022 · 209 patients
ESG achieved 13.6% total body weight loss vs 0.8% in the control group at 52 weeks, with significant improvements in cardiometabolic parameters.
13.6%
TBWL in landmark RCT
Efficacy and Safety of Endoscopic Sleeve Gastroplasty: a Systematic Review and Meta-Analysis
Hedjoudje A, Abu Dayyeh BK, Cheskin LJ, et al.
Clinical Gastroenterology and Hepatology, 2020 · 1,772 patients
Pooled data from 1,772 patients showed mean total body weight loss of 15–20% at 12 months with a serious adverse event rate of approximately 2%.
15–20%
TBWL at 12 months (meta-analysis)
Endoscopic Sleeve Gastroplasty for Obesity: Five-Year Outcomes
Lopez-Nava G, Sharaiha RZ, Vargas EJ, et al.
Obesity Surgery, 2021
Patients maintained approximately 15% total body weight loss at 5-year follow-up, demonstrating durable long-term results from ESG.
5 yr
Durable weight loss maintained
Endoscopic Sleeve Gastroplasty Significantly Reduces Body Mass Index and Metabolic Complications in Obese Patients
Sharaiha RZ, Kumta NA, Saumoy M, et al.
Clinical Gastroenterology and Hepatology, 2017
One of the first large U.S. multicenter series demonstrating 15% TBWL at 6 months and significant metabolic improvements including reduced blood pressure and improved lipid profiles.
15%
TBWL at 6 months (U.S. multicenter)
Safety and efficacy of endoscopic sleeve gastroplasty worldwide: a systematic review and meta-analysis
Singh S, Hourneaux de Moura DT, Khan A, et al.
Surgical Endoscopy, 2020
Global systematic review confirmed 15–17% TBWL at 12 months with a serious adverse event rate of approximately 2%, reinforcing the safety profile across diverse clinical settings.
~2%
Serious adverse event rate
Large International Multicenter ESG Registry: Safety and Efficacy Outcomes
Alqahtani AR, et al.
Gastrointestinal Endoscopy, 2019 · 1,000+ patients
International registry of over 1,000 patients confirmed ESG safety with an adverse event rate of 1–2% and no mortality.
0%
Mortality in published literature
Note: Individual results may vary. The clinical data above represents averages from peer-reviewed published studies. Your actual weight loss will depend on adherence to the post-procedure dietary and lifestyle program. Discuss your specific health situation with your physician during your consultation.
Get answers to the most common questions about ESG, candidacy, recovery, and more.
Board-certified bariatric surgeons with specialized training in bariatric endoscopy.
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MD, FASGE
Lead Bariatric Surgeon
"I believe every patient deserves a weight loss option that fits their life. ESG bridges the gap between diet programs and surgery, offering lasting results with minimal downtime."
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MD, MPH
Bariatric Surgeon
"My focus is on whole-patient care. ESG is not just a procedure — it is the start of a comprehensive program that addresses nutrition, behavior, and long-term health."
Take the first step toward lasting weight loss. Schedule a consultation with our team.
