After ESG and Pregnancy, Women Can Still Maintain Weight Loss

Dr. Christopher McGowan
May 29, 2024

Obesity poses significant health risks for women of reproductive age, but should you consider a non-surgical weight loss procedure if you plan to get pregnant in the future?

Non-surgical weight loss procedures, including endoscopic sleeve gastroplasty (ESG), are safe and effective for many adult women, regardless of their reproductive status. The healthier you are when you become pregnant, the lower your chances for pregnancy complications and the higher your chances are for a healthy birth and baby.

Weight loss achieved through an ESG procedure can lead to improvements in your overall metabolic health that actually make it easier to get pregnant.

Weight Loss Helps Support Healthy Pregnancy

Achieving a healthy weight is a key component of preparing your body for pregnancy.

In fact, losing weight before becoming pregnant is usually recommended for women with a BMI over 30, as obesity can pose a number of health risks and negatively impact fertility. Excess fat cells in the body produce excess estrogen, which can disrupt ovulation cycles and make it harder to get pregnant. Infertility rates are three times higher among obese women. Obesity also increases the risk of polycystic ovarian syndrome (PCOS), which causes insulin resistance, irregular periods, and infertility.

Women with a high BMI also face greater risks of miscarriage and obesity-related conditions, such as diabetes and high blood pressure, which can make your pregnancy high-risk.

Should I Have ESG Before Pregnancy?

Doctors generally recommend waiting at least 6 and up to 18 months after an ESG procedure before becoming pregnant. This allows your body plenty of time to heal and for your weight loss and body composition to stabilize. Obesity affects your endocrine, vascular, and cardiac systems, all of which are also impacted by pregnancy. Giving the body time for these systems to normalize will help support a healthy prenatal period.

After ESG, pregnant women are less likely to develop gestational diabetes and pregnancy-induced hypertension. They also face lower obesity-related pregnancy risks, including preeclampsia, premature birth, and stillbirth. Fewer pregnancy complications also correlate to lower C-section rates.

Does ‘Baby Weight’ Ruin Weight Loss Progress Post-ESG?

During pregnancy, weight gain is inevitable and necessary to support the growing fetus. It’s also especially important during this time to follow a nutrition plan closely; pregnant women are more likely to develop nutritional deficiencies, which can be exacerbated by ESG.

But pregnancy doesn’t have to signal the end of your weight loss journey.

Managing weight during pregnancy is always a consideration, as obesity can pose health risks in an expectant mother, but a healthy amount of weight gain is critical to support a growing fetus.

To lose weight after pregnancy, women who have had an ESG procedure should follow the same guidelines as any other postpartum woman: go slow, listen to your body, and focus on good nutrition.

Guidelines for Safe and Effective Weight Loss After ESG and Pregnancy


It’s important to nourish your body with healthy foods after pregnancy to fuel the body’s healing and support the demands of new motherhood, especially if you’re breastfeeding. Breastfeeding women need to consume about 300 more calories per day to offset the additional calories burned in milk production. Post-ESG, this may mean adding one small meal or snack to your daily routine, rather than increasing the size of your other meals. You don’t want to risk unpleasant side effects from getting too full at once. Hydration is also critical for breastfeeding and to promote postpartum healing. If you’re not breastfeeding, it’s safe to resume your post-ESG diet soon after birth.


Focus on walking and gentle movement in the weeks after birth. Pregnancy is hard on the body, and the postpartum period can also be taxing, especially if you’re not getting adequate sleep. Give yourself plenty of time to heal before resuming any strenuous exercise. Most doctors advise a six-week postpartum check-up, which is a good time to ask about resuming your regular exercise routine. For women who’ve had a C-section, healing takes longer. Always follow your doctor’s guidance about when it’s safe to exercise.

After you’re fully healed, focus your exercise routine on core strengthening. Pregnancy stretches your abdominal muscles, which can lead to some weakening. Core strength is essential to support your postpartum body – it provides stability for all the movement you do, including all the extra bending, swinging, and bouncing that comes with having a brand new bundle of joy.

Remember that it can take several months after birth or after breastfeeding for your hormone levels to go back to normal. Hormonal fluctuations can lead to fluid retention and make it harder to drop extra pounds. Once you get out of the postpartum period, however, you should expect to return to your pre-pregnancy weight, as long as you’re following your nutrition and exercise plan.

In fact, research has found that women who undergo ESG before becoming pregnant achieve similar weight loss outcomes after birth as their non-pregnant counterparts.

Is ESG Before Pregnancy Right For You?

True You Weight Loss is one of the highest volume endobariatric weight loss centers in the United States – and our medically-guided model is ideal for women navigating important life milestones like pregnancy who also want to achieve and/or maintain a healthy weight.

Our team of outstanding physicians – Dr. Lauren Donnangelo, Dr. Daniel Maselli, and Dr. Christopher McGowan – are recognized industry leaders in endoscopic weight loss procedures like ESG. They are among an elite few doctors in the U.S. who are triple board-certified in internal medicine, gastroenterology, and obesity medicine.

They offer the highest level of concierge care, including 24/7 physician access, so you always have the support you need.

Weight loss can make getting pregnant, giving birth, and taking care of a new baby easier on your body and mind. Let us help you on your journey; contact us today torequest a consultation.

Dr. Christopher McGowan
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.

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