ESG (Endoscopic Sleeve Gastroplasty)


ESG, Endoscopic Sleeve Gastroplasty, is a non-surgical, incisionless, minimally invasive procedure that allows your gastroenterologist to reduce the overall size of the stomach to promote weight loss. Done under sedation, as an outpatient, the procedure is well tolerated and patients return to a normal routine after a few days of at-home recovery.

Who It's For

ESG is ideal for patients who have a BMI of at least 30 and have not been successful with diet and exercise alone. It is also a solution for those who don’t want to undergo gastric bypass or those whose physical condition makes them ineligible for surgery. The most important criterion is to be committed to the program and follow instructions for the prescribed period of time. We recommend ESG for individuals who are looking for a long-term weight loss solution.

How The Procedure Works

ESG is a completely endoscopic procedure, performed from inside the stomach and without the need for abdominal incisions. Your physician will advance an upper endoscope (a camera attached to a flexible tube) through your mouth and into your stomach. The endoscope is equipped with a suturing system that allows placement of stitches in the stomach. The procedure takes approximately 30 to 45 minutes. After the procedure, the stomach is 70-80% smaller in size, which limits the amount of food that is eaten before feeling full, limits the amount of calories absorbed by the stomach, and also prolongs the time food remains in the stomach, extending the feeling of fullness.

How Much Weight You'll Lose

ESG is currently the most effective non-surgical weight loss procedure available, producing an average of 20% total body weight loss at 1 year. Though results may vary for each individual undergoing ESG, most patients will lose 70% of their excess weight, or more. Off the scale victories also include improved blood pressure numbers, better blood sugar control, and improvement in sleep apnea.

Commitment to the program is the single greatest factor in success. Follow your doctor’s recommendations carefully and make thoughtful decisions on nutrition and exercise. Your True You physician will partner with you to help you achieve your weight loss goals.
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Why Choose True You for ESG?

Endoscopic Expertise
ESG is one of the most technically challenging endoscopic procedures and requires a high level of endoscopic skill. Dr. McGowan, a board-certified gastroenterologist and endoscopist, is a leader and educator in the field of endoscopic weight loss, and regularly trains physicians from around the nation in the technique of endoscopic suturing.
Bariatric Excellence
WakeMed Cary Hospital, where Dr. McGowan performs ESGs, is an accredited Comprehensive Center for Bariatric Surgery, Blue Distinction Center for Bariatric Surgery, and Cigna Center of Excellence in Bariatric Surgery. Though your ESG is a same-day, outpatient procedure, you will have the backing of a comprehensive, knowledgeable, and award-winning bariatric center.
24/7 Physician Access
Whether you live in North Carolina, or are traveling from another state, you will receive the highest level of concierge care, with 24/7 direct access to your physician via personal cell phone, text, email, and video chat. We remain committed to your success throughout your weight loss journey.


ESG Base Package: $9,995
The ESG Base Package includes an initial physician consultation, a comprehensive bariatric nutrition consultation, the ESG procedure itself, six months of nutrition follow-up, and a quarterly physician follow-up.
Enhanced ESG Recovery Package: $10,995
The Enhanced ESG Recovery Package includes all components of ESG Base, PLUS: 90-day complication coverage policy; post-procedure home nurse visit and IV hydration; and, a fitness tracker and app access.
Long-Term ESG Success Package: $11,995
The Long-Term ESG Success Package includes all components of ESG Base and ESG Enhanced Recovery, PLUS: unlimited nutrition visits; athletic lab consultation with customized exercise plan; enrollment in medical nutrition therapy; 12-month re-suturing coverage (if documented suture failure, and per MD discretion).

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