Weighing Your Obesity Treatment Options: Ozempic, ESG, and More

By: 
Dr. Christopher McGowan
March 28, 2024

Obesity is a chronic, relapsing condition that often needs medical intervention beyond diet and lifestyle changes. In recent years, there’s been an incredible and promising increase in treatment options to help patients lose weight, improve their metabolic health, and lead fuller, happier lives.

But these options can be overwhelming. With so much information out there, how do you choose the treatment option that is right for you? Out of the millions of Americans each year who are eligible for bariatric surgeries such as gastric bypass, sleeve gastrectomy, and adjustable gastric banding, only 1 percent choose to go under the knife. Despite its efficacy, surgery is simply not a desirable option for most people looking to treat their obesity.

That leaves two treatment routes: GLP-1 weight loss medications like Ozempic. Mounjaro and non-surgical procedures such as the endoscopic sleeve gastroplasty (ESG). Let’s take a closer look at each of these options and their implications for patients who want to maintain weight loss over the long term.

There are several weight loss medications currently on the market for treating obesity. Ozempic and Wegovy are both injectable forms of semaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, which increases insulin and insulin sensitivity to improve blood sugar control, curbs appetite, promotes feelings of fullness, and prevents the liver from releasing excess sugar into the bloodstream.

Mounjaro and Zepbound take these benefits one step further, by targeting two major hormones responsible for blood sugar control – GLP-1 and glucose-dependent insulinotropic polypeptide. Because of this dual intervention, patients experience greater weight loss on Mounjaro than semaglutide alone.

However, weight loss medications have significant downsides. For one, they are intended to be used long-term; while they treat type 2 diabetes and obesity, they’re not a cure. Once you stop taking them, your excess weight and chronic conditions will return. In fact, research has proven that after discontinuing these medications, most patients will regain two thirds of the weight they’ve lost within just one year.

Second, they’re very expensive. Many health insurers no longer cover weight-loss medications or only cover a few months’ supply, which again, is not how these medications are designed to be used. Without insurance, Ozempic comes with a hefty price tag of about $935 per weekly dose.

Third, the popularity boom of weight loss medications in recent years has led to shortages and supply inconsistencies that present significant challenges to people who rely on them as maintenance medications.

Luckily, there are safe and effective non-surgical alternatives to weight loss medications. Endoscopic sleeve gastroplasty (ESG) and gastric balloons are non-invasive weight loss procedures that offer similar outcomes to bariatric surgery without the risks and longer recovery times associated with major surgery.

An ESG procedure is performed completely endoscopically, without the need for any abdominal incisions. Your physician will insert an endoscope (a flexible tube with a camera and suturing device on the end) down your throat and into your stomach, suturing your stomach from the inside. The procedure only takes about 30 to 45 minutes and reduces the size of your stomach by 70 to 80 percent. Most patients return home the same day with minimal recovery time and side effects – and are back to their regular routines within days.

Gastric balloons are also a proven weight loss surgery alternative. They’ve been used to treat obesity for 20 years, which has led to significant improvements to their design and efficacy. The procedure only takes about 15 minutes and involves the placement of a small silicone balloon in your stomach that is filled with saline to take up space. The balloon remains in place for six to eight months, leading to rapid, significant weight loss. The procedure can be performed under sedation (without the need for general anesthesia) and is completely reversible.

Gastric balloons make you feel full faster and limit your food intake. The ORBERA® and Spatz3 gastric balloons used by True You Weight Loss are both excellent choices for jumpstarting your weight loss journey.

Overall, endoscopic weight loss procedures have several advantages over anti-obesity medications, including:

Access and affordability

Weight loss medicationsare simply not accessible to most people, either due to their high price tag or the instability of the supply chain. It’s not uncommon for someone to spend thousands of dollars to lose weight on Ozempic, only to gain it all back when they can no longer find the drug at their local pharmacy, or when their health insurance company stops covering it. For most patients, the annual cost of taking popular GLP-1 medications exceeds $15,000.

By contrast, with a non-surgical weight loss procedure, you’re making a one-time investment in results that last. [CS1] There are several financing options available, starting at just $217 per month. This includes unlimited medical follow-up and a year of individualized nutrition counseling – all designed to help support you and ensure long-term weight loss success.

Fewer side effects

Some people experience abdominal pain and nausea for a few days after an ESG or gastric balloon procedure, but usually feel better within a week or two.

Weight loss medications, on the other hand, come with a long list of potential side effects that may or may not subside, including chronic GI symptoms, including nausea, vomiting, diarrhea, and constipation.  In rare cases, these medications can cause medical conditions such as pancreatitis, gastroparesis (or stomach paralysis), bowel obstruction, and kidney and gallbladder problems.

Long-term results

Non-surgical weight loss procedures have an edge over anti-obesity medications for delivering results that last. ESG helps patients lose about 70 percent of their excess weight and contributes to better overall health. Patients experience non-scale victories such as lower blood pressure, better blood sugar control, resolved sleep apnea, improved symptoms of anxiety and depression, more energy and greater confidence. Similarly, non-surgical gastric balloon procedures help patients lose 3-4x more weight than most patients lose with diet and exercise alone – with similar non-scale victories. After a non-surgical weight loss procedure with True You Weight Loss, you’ll receive lifelong aftercare and support to ensure you have the tools to be successful throughout your weight loss journey and beyond.

Best in class expertise and personalized care

Complex endoscopic weight loss procedures require a comprehensive skill set, extensive training and hands-on experience. Dr. Lauren Donnangelo, Dr. Daniel Maselli, and Dr. Christopher McGowan are among the few physicians in the nation who are triple board-certified in internal medicine, gastroenterology, and obesity medicine. They are recognized leaders in the field of endoscopic weight loss, having performed thousands of bariatric endoscopy procedures. Because of this expertise, they are routinely called upon to train and educate other physicians in the technique of endoscopic suturing.

True You Weight Loss is the highest-volume endoscopic weight loss center in the United States – which means we’ve performed more procedures than any other practice in the country. This unrivaled level of experience translates to better outcomes, greater weight loss, and long-term success for our patients. 

Finally, True You Weight Loss offers a personalized approach to care like you’ve never before experienced in healthcare. All patients receive their physician’s personal cell phone number for 24/7 access following the procedure. In addition to ongoing medical follow-up and nutrition counseling, patients have access to our exclusive online support group and Facebook community for long-term success.

If you’d like to learn more about the endoscopic weight loss procedures we perform, please contact us to request a consultation

Dr. Christopher McGowan
Dr. Christopher McGowan
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