Losing weight is never easy, especially when relying on cutting calories or adding exercise into your weekly routine. While healthy eating and exercise are important for overall health as well as trimming down, it can be difficult to actually achieve the kind of weight loss outcome you’ve really been hoping for. This is because these traditional weight loss methods are both time consuming and challenging to sustain. As advances in bariatric surgery have provided new possibilities, surgical options like laparoscopic sleeve gastrectomy (LSG) have increased in popularity. But at True You, we want to provide non-surgical alternatives like endoscopic sleeve gastroplasty (ESG) that can get you the same results without the need for incisions.
Like many types of weight loss surgery, both a sleeve gastrectomy and an endoscopic sleeve gastroplasty work by the same principle: reduce the size of the stomach in order to decrease the amount of food it can hold. With less food able to be ingested in a single setting, the goal is to achieve an ongoing caloric deficit that will, in time, force the body to burn excess fat for energy.
One of the primary differences between the two types, however, comes down to how the surgery is actually performed. A sleeve gastrectomy, which is currently the most common form of bariatric surgery, is performed laparoscopically; this means that the doctor inserts a special camera and tools through incisions in the abdomen in order to perform the surgery on the stomach. Compared to open surgery, where a large incision allows direct access to the abdomen, laparoscopy is considered minimally invasive and therefore preferable in terms of recovery time and surgery-related complications.
By contrast (and as the name implies), the endoscopic sleeve gastroplasty procedure we offer at True You uses gastrointestinal endoscopy (GIE) technology, which involves a long, flexible tube that can be inserted through the mouth. An endoscope also has a camera and tools attached to the end, but the fact that no incisions have to be made through the abdomen make it even more safe and with fewer potential complications. Indeed, due to how noninvasive it is, an endoscopic sleeve gastroplasty isn’t even actually considered “surgery.” Because no incisions need to be made, the recovery process is very quick and with much less discomfort. Patients return home within 1-2 hours after their procedure, and are back to work in 2-3 days.
The other big difference between the two procedures is related to the manner in which the stomach size is reduced. In a sleeve gastrectomy, the surgeon uses the laparoscope to actually cut and remove a sizable portion of stomach tissue along the greater curvature of the stomach. This stomach tissue, which represents about 80%-85% of total stomach volume, is totally removed from the body, and the remaining stomach tissue is formed into a banana-shaped gastric sleeve.
In an endoscopic sleeve gastroplasty bariatric procedure, we aim for a similar reduction in the volume of the stomach (70%-80%), but this reduction is achieved without removing stomach tissue. Instead, we use a specialized suturing tool mounted to the endoscope to plicate (another word for fold or corrugate) the excess stomach tissue from inside the stomach itself. In essence, a large portion of the stomach is partitioned off by sewing it shut along the greater curvature. The end result is a smaller-shaped stomach but without the need for any incisions. With ESG, we are also able to shorten the stomach. So instead of a banana-shaped tube, the stomach has a scrunched-up, pouch-like shape. This leads to slower emptying of food, and a prolonged sense of fullness.
One of the reasons both of these weight loss options have been gaining popularity in recent years is because of how effective they are, especially when compared to traditional methods of weight loss. Patients undergoing sleeve gastrectomy surgery can expect a total body weight loss (TBWL) of around 25%-30%; another way of looking at it is that you can lose 60%-70% of excess weight, which is defined as weight over and above what is considered normal for a person’s height and sex. A patient having an endoscopic sleeve gastroplasty can expect to lose a similar amount: 20% of total weight or 70% of excess weight.
Many people seek a weight loss procedure for aesthetic reasons, but the truth is that overweight and obesity bring with them the possibility of different health concerns. So even though it feels great to have the body you’ve always wanted to have, losing weight can also rectify or improve a number of adverse health conditions: high blood pressure, heart disease, type 2 diabetes, and sleep apnea, just to name a few.
If you have a body mass index (BMI) over 30 and have been struggling to lose weight, it might be time to consider a new approach to weight loss. If you’re interested in learning more about weight loss procedures, request a consultation at True You Weight Loss. Our highly experienced staff can discuss the various non-surgical weight loss procedures we offer and which might be best for you.
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.