Why ESG is the Bariatric Surgery alternative you’ve been looking for!


Bariatric surgery helps people who are overweight to reduce their weight. However, being a surgical procedure, many do not want to undergo such a procedure. We find that most people who undergo bariatric surgery are people who have alarming levels of body weight.

ESG or Endoscopic Sleeve Gastroplasty has been getting very popular in recent years. It is touted as the bariatric surgery alternative. Let us see why people are showing interest in Endoscopic Sleeve Gastroplasty for weight loss.

1.    ESG doesn’t involve surgery

The first and foremost factor that differentiates Endoscopic Sleeve Gastroplasty (ESG) from bariatric surgeries is that ESG is not a surgery! 

ESG is an incisionless, minimally invasive endoscopic therapy that is used to reduce the volume of the stomach. By reducing the volume of the stomach, the patient will feel full with less amount of food.

After the patient undergoes the ESG procedure, they can only eat about 2 to 3 ounces of food. This is because ESG reduces stomach volume by 60 to 70%.

Many fear bariatric surgeries because they involve using the scalpel. There are different types of bariatric surgeries and they start with either a larger incision or multiple small incisions, based on the type of surgery.

ESG or Endoscopic Sleeve Gastroplasty does not involve any incisions. And this factor alone makes it more attractive to people who are struggling to control weight.

2.    Very low rest period

Bariatric surgeries require the patient to take some amount of rest after the surgery to ensure proper healing. The time period usually varies between 1 to 3 weeks based on the type of surgery.

For ESG, No hospitalization is required. The patient is allowed to go home the same day after the procedure. The rest period is reduced to just 2 to 3 days so that they can check for any complications. If everything is all and well, the patient can get back to work on the 4th day after they have undergone the procedure.

Such short rest periods are unheard of in bariatric surgeries.

3.    The stomach is kept intact

When you compare the different bariatric surgeries, you will notice a similar theme where a part of the stomach is removed surgically.  

Most bariatric surgeries achieve the goal of reducing the stomach size either by removing a section of the stomach or by cutting the stomach into two parts.

In ESG or Endoscopic Sleeve Gastroplasty, the stomach volume is controlled by the use of medical sutures. The stomach will not undergo any invasive procedure.

4.    Less Risk

Another reason why Endoscopic Sleeve Gastroplasty is better than bariatric surgeries is that is the amount of risk involved is very low. Complications like bleeding from the sutures can be easily identified during the procedure itself. If any such complication happens, the doctor can amend it before additional sutures are fixed.

With ESG, you are looking at a risk level that is less than 1 percent, with no deaths reported. However, the same cannot be said for bariatric surgery procedures like Gastric Bypass, Gastric Sleeve, etc.

Naturally, we are attracted to medical procedures that involve less risk.

5.    No scars

One disadvantage of surgeries is that they often leave marks on your body. Since ESG is an incision-less procedure, the patient will not have any scarring on their abdomen.

ESG is an endoscopic procedure where the patient will under general anesthesia. The whole procedure would only take 40-60 minutes to complete.

6.    Costs less

Cost is a major factor when it comes to Bariatric Surgeries. The US is one of the most expensive places in the world to undergo bariatric surgery.

This is why we see more and more people going to other countries like Mexico or India as these places cost less. When you compare ESG with any bariatric surgery, ESG costs 2k to 4k less on average at the same clinic.

When ESG can give you similar results to bariatric surgery, and costs less, it is easy to see why ESG is a great pick over a bariatric surgery

7.    Nearly the same results

With Endoscopic Sleeve Gastroplasty completely avoiding incisions, many question the effectiveness of ESG against bariatric surgeries. However, they go toe-to-toe.

The effectiveness of bariatric surgery in numbers is losing approximately 60 – 70% excess weight in 2 years. ESG has an expected weight loss of approximately 50-60% excess weight at 2 years.

So there is not much difference when it comes to the overall effectiveness of these procedures when we evaluate them at 2 years.


Weight loss surgeries have been the only solution for people who were excessively obese. However, as we discussed here, it has its downsides. With the advancements, we have made in medical science, now people have other less invasive option to get the same results.

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