Can Endoscopic Sleeve Gastroplasty Be Reversed?

By: Dr. Christopher McGowan

Understanding Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic sleeve gastroplasty (ESG) is emerging as the safest and most effective alternative to traditional bariatric surgery. It offers a non-surgical weight loss solution without the need for incisions, scarring, prolonged recovery times, or the risk of complications. Patients can anticipate losing around 20% of their body weight following an ESG procedure, making it a viable option for those looking to lose weight without invasive surgery.

Dr. Christopher
DR. CHRISTOPHER MCGOWN

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

How ESG Works

Unlike traditional bariatric surgery, ESG involves no cutting of the stomach. Instead, the stomach is sutured from the inside, creating a sleeve-like pouch that reduces its capacity by 70-80%. This significant reduction limits food intake and increases feelings of fullness, promoting substantial weight loss.

Is ESG Permanent?

Contrary to some misconceptions, ESG is not reversible. Unlike traditional gastric sleeve surgery, which removes about 80% of the stomach, ESG does not involve tissue removal. However, the procedure uses permanent sutures made from Prolene, a type of synthetic polypropylene, which remains intact indefinitely to maintain the stomach’s reduced size.

Long-Term Effectiveness

Studies show that the weight loss achieved with ESG is maintained for up to five years or more, demonstrating its efficacy as a long-term solution for chronic obesity. The procedure’s permanence is reinforced as stomach tissues heal around the sutures, making them indistinguishable from healthy tissue after about six months.

Why Reversing ESG is Not Advisable

Reversing ESG is not recommended for two primary reasons:

  1. Tissue Healing: The stomach tissues heal around the sutures, making them indistinguishable from the surrounding tissue.
  2. Potential Damage: Removing the sutures could cause the stomach to unfold improperly, leading to defects or holes.

Modification Options

While ESG isn’t reversible, it can be modified. If additional intervention is needed, the procedure can be surgically converted to a gastric bypass or repeated to further tighten the stomach.

Procedure Overview

During ESG, a gastroenterologist uses an endoscope equipped with a camera and suturing device to place 6-10 sutures along the stomach’s greater curve, reshaping it into a sleeve. The procedure is performed under sedation in an outpatient setting, typically taking less than an hour. Patients usually return to normal activities within a few days.

Suitability for ESG

ESG may be suitable if you:

  • Are 21 or older
  • Have a BMI of 30 or higher
  • Have not achieved weight loss goals through diet and exercise alone
  • Seek an alternative to invasive bariatric surgery
  • Do not qualify for traditional bariatric surgery for medical reasons
  • Are committed to long-term lifestyle changes

Exclusions

ESG is not recommended for individuals with certain gastrointestinal conditions, bleeding disorders, or major health issues. A physician can help determine the most appropriate weight loss options for each individual.

Expertise at True You Weight Loss

True You Weight Loss has performed more ESG procedures than any other center in the U.S., helping thousands achieve and maintain their weight loss goals. Our personalized approach includes expert medical and nutritional support throughout the entire process, from initial consultation to lifelong follow-up.

For more information or to schedule a consultation, visit True You Weight Loss.

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