Question 1

Who is a good candidate for ESG?

Accepted Answer

ESG is typically recommended for adults with a BMI between 30 and 40 who have not achieved lasting weight loss through diet and exercise alone. Candidates should not have had prior stomach surgery. During your consultation, our team will evaluate your complete health profile to determine if ESG is right for you.

Question 2

Can I get ESG if I have diabetes?

Accepted Answer

Yes — in fact, many patients with type 2 diabetes see significant improvement after ESG. Weight loss often leads to better blood sugar control, and some patients are able to reduce or eliminate diabetes medications. Your physician will work with your endocrinologist to coordinate care.

Question 3

Is there a minimum or maximum BMI for ESG?

Accepted Answer

ESG is most commonly performed on patients with a BMI of 30-40. Patients with a BMI over 40 may still be candidates depending on their overall health and goals. Our screening tool can give you an initial assessment, followed by a thorough physician evaluation.

Question 4

I've tried GLP-1 medications. Can I still get ESG?

Accepted Answer

Absolutely. Many of our patients have tried GLP-1 medications like semaglutide or tirzepatide. ESG can be an excellent next step if medications alone did not achieve your goals, or as a complementary approach. Some patients use GLP-1s alongside ESG for enhanced results.

Question 5

How does ESG work?

Accepted Answer

ESG uses an endoscope (a flexible tube with a camera) inserted through the mouth to place sutures in the stomach, reducing its volume by approximately 70%. No incisions are made. The smaller stomach helps you feel full sooner and eat less, leading to significant weight loss.

Question 6

How long does the procedure take?

Accepted Answer

The ESG procedure typically takes 60 to 90 minutes. It is performed under general anesthesia as an outpatient procedure, meaning you go home the same day.

Question 7

Is ESG reversible?

Accepted Answer

While ESG is technically reversible — the sutures can be removed endoscopically — it is designed to be a long-term solution. The vast majority of patients maintain their results and do not seek reversal.

Question 8

How is ESG different from gastric sleeve surgery?

Accepted Answer

Gastric sleeve surgery permanently removes about 80% of the stomach through surgical incisions. ESG achieves a similar size reduction using internal sutures — no cuts, no removal of tissue. This means faster recovery (days vs. weeks), a serious adverse event rate under 2% (Singh et al., Surgical Endoscopy, 2020), and same-day discharge. The surgical sleeve produces greater average weight loss (25–30% vs. 15–20%) but carries higher complication rates and is irreversible.

Question 9

What is recovery like after ESG?

Accepted Answer

Most patients experience mild nausea and discomfort for 2-3 days after the procedure. You will follow a liquid diet for about 2 weeks, then gradually transition to soft foods and eventually regular meals. Most patients return to normal activities within 3-5 days.

Question 10

When can I return to work?

Accepted Answer

Most patients return to desk work within 2-3 days. If your job involves physical labor, you may need 5-7 days. Your care team will provide personalized guidance based on your recovery.

Question 11

What diet do I follow after ESG?

Accepted Answer

After ESG, you'll follow a structured dietary progression: clear liquids for 3 days, full liquids for 2 weeks, soft/pureed foods for 2 weeks, then gradual return to solid foods. We provide a comprehensive diet guidebook and work with you throughout the transition.

Question 12

How much does ESG cost?

Accepted Answer

ESG typically costs between $10,000 and $15,000, which includes the procedure, anesthesia, facility fees, and follow-up care. While this is an investment, it is generally less expensive than surgical weight loss procedures and comes with fewer risks.

Question 13

Does insurance cover ESG?

Accepted Answer

Most insurance plans do not currently cover ESG, as it is still considered an emerging procedure. However, coverage is expanding. We can provide documentation to submit to your insurance, and we offer flexible financing options to make ESG accessible.

Question 14

Do you offer financing?

Accepted Answer

Yes, we partner with healthcare financing companies to offer monthly payment plans. Many patients qualify for 0% interest for 12-24 months. Our team can walk you through financing options during your consultation.

Question 15

How much weight can I expect to lose?

Accepted Answer

On average, ESG patients lose 15–20% of their total body weight within 12–18 months (Hedjoudje et al., Clinical Gastroenterology and Hepatology, 2020 — meta-analysis of 1,772 patients). The landmark MERIT randomized controlled trial published in The Lancet (2022) demonstrated 13.6% TBWL at 52 weeks. For a 250-pound patient, that translates to roughly 35–50 pounds. Results vary based on adherence to dietary and lifestyle recommendations.

Question 16

Are the results permanent?

Accepted Answer

ESG provides a durable anatomical change to the stomach. Combined with lifestyle modifications, most patients maintain significant weight loss long-term. Published data from Lopez-Nava et al. (Obesity Surgery, 2021) shows patients maintaining approximately 15% TBWL at 5-year follow-up. Our comprehensive aftercare program is designed to help you maintain your results.

Question 17

What support do I receive after the procedure?

Accepted Answer

Our program includes regular follow-up visits, nutritional counseling, behavioral coaching, and access to a patient support community. We monitor your progress and adjust your plan as needed to ensure long-term success.

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