Bariatric surgery is a procedure that can help many people lose weight and maintain a healthy weight. But it’s not the right option for everyone. And in some cases, certain procedures can become less effective over time.
Enter endobariatrics, an innovative field offering alternative treatments that can meet you where you are on your weight-loss journey. Endobariatric procedures are minimally invasive, meaning there are no incisions or scars, and the recovery time is short. Best of all, they’re highly effective — and they can offer long-term results.
I like to talk about endobariatric options when I meet with patients who haven’t found success with traditional weight-loss plans or treatments. Many are surprised and excited to find out that there are more paths that can help them reach their weight and health goals. If you’ve struggled to find the right tools to support you in the past, one of these options could be worth considering.
How endobariatric procedures work
There are a few endobariatric options, and each is done a little differently. But all endobariatric procedures are performed with an endoscope. That’s a long, flexible tube with a camera at the end. While the patient is sedated, the physician gently guides the endoscope down the patient’s throat and into their stomach. There are no incisions, external stitches, or scarring. Most people can resume regular activity within a few days.
Endoscopic weight-loss options
When I talk to my patients about endoscopic bariatric procedures, I share about two minimally invasive options: endoscopic sleeve gastroplasty (ESG) and transoral outlet reduction (TORe). The one that’s right for you will depend on your previous weight-loss history and whether you’ve already tried surgery to lose weight.
I also assure my patients that, as a gastroenterologist specializing in endobariatrics, I collaborate closely with the Temple Bariatric Program’s care team for these procedures.
Endoscopic sleeve gastroplasty
Endoscopic sleeve gastroplasty (ESG) is a weight-loss procedure that reduces the size of your stomach. It can be ideal for patients who haven’t had success with diet or exercise alone and who want to avoid or aren’t eligible for bariatric surgery.
ESG changes the size and shape of your stomach to limit how much you eat. Using an endoscope, your physician will close off a portion of your stomach with stitches. These stitches are all made internally, so you won’t see them from the outside.
ESG makes your stomach smaller and narrower. As a result, you’ll feel fuller faster and stay satisfied longer. Patients who have ESG typically lose 15% to 20% of their weight within 12 to 24 months. They also see significant improvements in obesity-related conditions like high blood pressure, type 2 diabetes, and high cholesterol.
The procedure, which takes less than two hours, is done under anesthesia. Many patients can go home the same day, although your surgeon may want you to stay in the hospital overnight to monitor you.
As you recover, you’ll start off on a liquid diet; then move to eating soft foods. Finally, you’ll start eating solid foods again. As you heal, you may experience temporary nausea, abdominal pain, or fatigue.
Transoral outlet reduction
TORe can help patients who have regained weight after gastric bypass surgery (sometimes called Roux-en-Y surgery). Gastric bypass greatly reduces a person’s stomach size — but over time, the tissue can stretch back out. When that happens, a person may feel hungrier and experience weight regain.
Transoral outlet reduction (TORe) reduces the size of the gastric outlet, or the opening between the stomach pouch and the small intestine. This slows the rate at which the stomach empties, allowing you to stay fuller longer.
The physician applies heat to the edge of the gastric outlet to narrow it, then stitches it internally. And it’s highly successful: Most patients lose about 10% of their body weight or more and continue to maintain the loss beyond five years.
TORe takes about one hour and is performed under anesthesia. Many patients go home the same day, though some may stay overnight for observation. During your recovery, you’ll transition from a liquid diet to soft foods to a normal diet. As with ESG, some nausea or abdominal pain is normal during the healing process.
Is minimally invasive weight loss right for me?
The best way to decide is by having a conversation with your doctor. But in general, good candidates for ESG or TORe:
- Have a BMI between 30 and 50
- Are committed to making healthy lifestyle changes
- Aren’t eligible for traditional weight-loss surgery or prefer minimally invasive surgery (for ESG)
- Had gastric bypass and is now experiencing weight gain
Take the first step toward sustainable weight loss
No matter where you are on your journey, the team of experts at Temple Health are here to help. To find out more about ESG or TORe, call 800-TEMPLE-MED (800-836-7536) to schedule an appointment with Dr. Mayada Ismail or request an appointment online.
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