It’s estimated that more than 40% of US adults struggle with their weight, with many turning to medical weight loss options for help; obesity has been linked to various serious conditions, such as heart disease and type 2 diabetes, making it one of the country’s most common health issues. Furthermore, studies have shown that obese individuals can incur annual medical expenses of up to US$1,429 higher than those of normal weight.
There are a variety of medically supported weight loss options available. you’ve likely heard of the more common diet and exercise tips, or gastric bypass surgery, but you may not have heard of endoscopic sleeve gastroplasty (ESG). A relatively new procedure in the weight loss community, ESG is a non-surgical, minimally invasive option for patients with a BMI of 30 or more, who may not have experienced weight loss success with diet and exercise.
How does endoscopic sleeve gastroplasty work?
ESG works by inserting a flexible tube fitted with a small camera and suturing device into a patient’s stomach, via their throat. This procedure is performed while the patient is sedated, and involves a medical professional placing sutures into the patient’s stomach to reduce its size. While this procedure may not be suitable for everyone, including patients with large hernias or conditions which may cause gastrointestinal bleeding, it may provide lasting results when used in conjunction with a healthy lifestyle.
ESG might be a good option for obese patients who wish to avoid traditional gastric sleeve surgery; gastric sleeve surgery is performed using general anesthetic, and involves using surgical incisions and internal staples to reduce the size of a patient’s stomach. There are many alleged risks associated with gastric sleeve surgery, including internal hernias, ulcers, and gallstone formation, which could be a factor in patients choosing to pursue ESG instead.
Let’s explore some reasons as to why a patient might choose an ESG procedure:
1. Minimally Invasive
ESG is a much less invasive option than traditional weight loss surgeries such as gastric bypass surgery, which may require general anesthetic and a hospital stay of up to 5 days.
Gastric bypass surgery requires keyhole incisions being made in the patient’s abdomen, and could potentially require a more invasive open surgery in some cases. By comparison, ESGs require no incisions, as the suturing device is inserted via the throat while the patient is sedated.
2. Fast Recovery Time
After recovering from the sedation used during the ESG procedure, many patients are able to go home on the same day, although a hospital stay of a day or so may be required for patients who experience complications. Some may experience pain and nausea in the days following the procedure; however, these can usually be managed with medications, and a liquid diet should be observed for around two weeks.
Thanks to the reduced hospitalization time compared to other weight loss procedures, and absence of surgical incisions, patients typically experience a faster recovery time than for traditional surgeries.
3. Low Risk of Complications
ESG has a far lower rate of post-procedure complications than some other weight loss surgeries, with recent studies reporting that ESG complication rates are between 2.0 and 2.7%. By comparison, laparoscopic sleeve gastrectomy (a surgical weight loss procedure) has a complication rate between 9.2 and 16.9%.
Another recent study of eight ESG patients in Poland found only one patient experiencing a minor hemorrhage complication, which did not require any surgical intervention.
4. Can Help to Provide Lasting Weight Loss
In addition to being a non-surgical procedure with a lower complication rate than some traditional weight loss surgeries, ESG may result in 15-20% total body mass weight loss within 12 to 24 months.
While ESG and other weight loss interventions can help to provide temporary weight loss benefits, it’s important that patients commit to making healthier lifestyle choices to ensure that they achieve long-term success in their weight loss goals. An active lifestyle and healthy diet are crucial, and patients are encouraged to consult a nutritionist or other health professionals to maximize their results.
5. May Reduce Risk of other Chronic Conditions
In addition to the weight loss benefits of ESG, the procedure may provide additional value in that losing excess body weight can help to lower the risk of a variety of weight-related health problems.
Sleep apnea, type 2 diabetes, high blood pressure, and heart disease are all chronic health conditions that can be exacerbated by excess body weight. The CDC has reported that about one in ten Americans have diabetes, with between 90 and 95% of these having type 2. A recent study conducted by the Journal of the American Heart Association (JAHA) found that weight loss of only 5 to 7% reduced the risk of developing type 2 diabetes by 58% in adults at high risk the disease, and Dr. Kuldeep Singh of the Maryland Bariatric Center at Mercy has stated that a modest drop of 10% body weight can improve blood sugar levels and decrease overall risk of early death, as well as other serious complications.
Risks of Endoscopic Sleeve Gastroplasty
Like any medical procedure, there are some risks associated with ESG.
Patients may experience cramping and nausea for a few days after the procedure. These are typically mild symptoms, and can usually be managed with medication; eating or drinking too much can cause cramping, so being mindful about eating habits can assist in managing symptoms. Patients may be required to take antacid medication during the week following the procedure, to help combat any reflux symptoms such as heartburn and belching. Patients should also be aware that as a result of the gradual return to normal eating habits after an ESG procedure, they may be at risk of nutrient deficiencies, and require dietary supplements until they’re able to eat a balanced diet again.
Weight loss procedures can be a relatively accessible option for people who have a high BMI, and have not experienced significant weight loss success through healthy eating and regular exercise. ESG may provide a safer, less invasive option for some patients.
As with any medical procedure, make sure to speak to your doctor about whether ESG is appropriate for you, and how the procedure may be able to support your weight loss goals.
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