Endoscopic sleeve gastroplasty (ESG) is a safe and highly effective non-surgical, minimally invasive weight loss treatment option for any patient who has struggled to lose weight with diet and exercise alone.
DR. CHRISTOPHER MCGOWAN
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.
One of the major advantages of endoscopic sleeve gastroplasty (ESG) is the minimal recovery time required. Unlike traditional bariatric surgery, most patients return to their normal activities within three days. That means back to work, taking care of kids, exercising, seeing friends and family – all the normal day-to-day stuff. With ESG, you’ll have no incisions or scars and no hospital stay.
The most important aspect of aftercare from an ESG procedure is strictly adhering to the diet progression guidelines provided by your dietitian. By following the post-ESG diet instructions carefully, you are not only giving your internal sutures and stomach tissue time to heal, but you are also giving your body time to adjust to what will become your “new normal.”
After an ESG procedure, committing to permanent lifestyle changes will lead to greater weight loss and long-term success. Things like consuming smaller portions of food, abstaining from alcohol, listening to your body to tell you when it’s full, eating mindfully, and engaging in physical activity every day will support sustainable weight loss.
What you do in the weeks after ESG can set you up for a lifetime of weight loss success. Let’s take a closer look at recommended care after an ESG procedure:
Diet & Eating After ESG
Post-ESG, your stomach can only hold a few ounces of food, so you will feel fuller much more quickly than before. Your care team will provide a detailed nutrition plan following your procedure to help you transition easily to consuming less food.
Immediately after ESG, providers will typically advise waiting about 4 hours before drinking. Once your provider does a full post-surgery check-up, you will be cleared to go home.
For the following two days, only clear, sugar-free liquids should be consumed. Avoid anything with carbonation and fat, so no soda, seltzer, milk, or protein drinks in these initial days. Sports or electrolyte drinks, clear broth or soup, and herbal tea are all good options.
Drink liquids at room temperature and go slow – gulping can introduce air bubbles to your digestive system, which can lead to discomfort. Liquids that are too hot or too cold can disrupt stomach healing after the sutures are placed.
For the first few weeks after ESG, you cannot tolerate solid foods, but you can start introducing more filling liquids, such as protein shakes, low-fat milk, almond or soy milk, pureed soup, and vegetable juice.
Most people return to work and their normal routine after about three days.
In weeks 2 to 4, you can start introducing pureed foods as long as they are low in fat and sugar. Continue to avoid any carbonated or high-sugar drinks. Milk, fruit and vegetable juices, yogurt, bone broth, and protein shakes are all good food choices at this stage.
After the first month post-ESG, you can start eating a more normal diet. Because you’re eating less food overall, it’s more important to choose nutritionally dense foods. Nutritional deficiencies can negatively impact your reproductive, metabolic, and cognitive health. Also, be careful not to consume too many caloric beverages; liquid calories can add up quickly and sabotage your weight loss efforts.
It’s critical not to overeat after ESG – we tell our patients to eat to satisfaction, not to fullness. It may help to set an eating schedule – aim for three meals and two snacks, spaced about 2 to 3 hours apart.
It’s also crucial to eat slowly and chew food thoroughly – filling your stomach too quickly can lead to discomfort. Using smaller plates can help keep your portions under control. Slowing down and ensuring you chew every bite to an applesauce consistency will help you be very mindful during meals, so you stop eating once your body starts to feel full. For many patients post-ESG, it only takes a few mouthfuls of food to feel satisfied.
Other Tips for ESG Aftercare
Exercise
There are no restrictions to your physical activity after ESG. In fact, low-impact exercise such as walking is encouraged right away, even the day you go home from your procedure. Listen to your body and take your time before resuming any heavy lifting or strenuous exercise. Stick to walking, yoga, pilates, and other low-impact activities for the first week or so.
Focus on Hydration
Keeping hydrated is critical to losing weight and keeping it off long-term. Your body needs plenty of water to function at its best. However, it’s best to consume fluids between mealtimes. Drinking with meals can quickly fill the stomach and lead to nausea.
Work with a Dietitian
Partnering with a registered dietitian throughout your ESG journey will help ensure you’re getting the proper nutrients in the right ratios to ensure you’re not only losing weight but maintaining optimal health. At True You Weight Loss, our dietitians focus on education and motivation – giving every patient the tools and information they need to be successful.
Maintain Follow-up Appointments
Staying in touch with your care team for ongoing monitoring, motivation, and encouragement leads to greater success. Your care team can help you overcome any weight loss stalls you may experience and keep you engaged in your weight loss journey. At True You Weight Loss, our research has demonstrated that those patients who keep in touch with us experience greater overall weight loss.
True You Weight Loss is a nationally recognized leader in ESG; our team has performed thousands of successful bariatric endoscopy procedures. Dr. Christopher McGowan is one of the nation’s few physicians who is triple board-certified in gastroenterology, internal medicine, and obesity medicine.
We have cared for patients from more than 45 states and 10 countries, offering an unparalleled level of personalized care, attention, and support.
Request a free consultation today to learn more about ESG at True You Weight Loss.
