What To Expect Before and After an Endoscopic Sleeve Gastroplasty or ESG Stomach Tightening

Discover what to expect during and after an endoscopic sleeve gastroplasty (ESG Stomach Tightening) procedure, a minimally invasive weight loss solution.

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Embarking on the journey towards a healthier you is an exciting and transformative experience. In recent years, medical breakthroughs like endoscopic sleeve gastroplasty (ESG) or Stomach Tightening have revolutionized the weight loss landscape, offering minimally invasive solutions for those striving to combat obesity and improve their quality of life.

If you’re considering this revolutionary procedure, it’s essential to know what to expect before and after an ESG weight loss procedure to help you make an informed decision and prepare for the road ahead. We discuss the crucial steps you need to take before the surgery and guide you through the post-operative care process to ensure a seamless transition into your newfound wellness.

What Is Endoscopic Sleeve Gastroplasty?

An ESG or endoscopic sleeve gastroplasty is a non-surgical procedure designed to assist overweight and obese patients struggling with weight loss.

Using an endoscope, a trained medical professional will place around eight sutures to tighten the stomach from the inside. This procedure can reduce stomach size by up to 75% with no scars. Most patients losing an average of 18% of weight following the procedure.

What To Know Before Your ESG Weight Loss Procedure

Before undergoing an ESG weight loss procedure, it’s helpful to educate yourself on the procedure, from how it’s conducted, who qualifies and other important details such as recovery time and post-treatment best practices.

How Endoscopic Sleeve Gastroplasty Is Done

An ESG is considered an outpatient, non-surgical procedure that can take approximately 45 minutes to one hour on average.

After you’ve received general anesthesia, your doctor will insert a flexible endoscope with an attached camera and suturing device into your mouth. The camera will guide the endoscopist to place sutures in strategic areas of the stomach. This process will change the structure of the stomach, making it smaller in the size of a banana.

Following the procedure, you may be monitored for two hours before you can be discharged. Most patients are released the same day and require someone to pick them up and drive them home.

Do I Qualify for an ESG?

The ESG weight loss procedure is recommended for anyone with a body mass index (BMI) over 30. If you have a BMI of 27 to 29.9, you may also be an ESG candidate if you have medical conditions such as high cholesterol, diabetes, high blood pressure, and fatty liver disease. Prior to the procedure, a blood test is necessary to ensure a safe operational environment for the providers. This pre-procedure evaluation is crucial for assessing your overall health and preparing for a successful ESG treatment.

Process of ESG Preparation

The first step to undergoing an ESG is to schedule an initial consultation. You will discuss your medical history, health status, and what you hope to achieve from this procedure there. You will also be required to get a blood test. Your medical provider may require signed medical clearance from your primary healthcare provider.

Prior to the procedure, your provider may choose to prescribe medications such as PPI to help regulate stomach acid production.

Depending on your health condition, your ESG specialist may provide instructions regarding your dietary restrictions before the procedure. Most patients are advised to practice a clear liquid diet one day before the procedure, and stop eating and drinking completely after midnight before their procedure. Because ESG is an outpatient procedure, ensure that you have someone to pick you up from the medical facility.

What To Know After Your ESG Weight Loss Procedure

Most patients experience a quick recovery period, and go back to work within 2-3 days. Since no incisions were made, there is no risk of scarring. Although results can vary for patients, most patients can notice an average of 18 to 20% of weight loss. Here’s what you can expert immediately after the ESG procedure:


Post-ESG, medication is generally not a necessity. However, your provider may prescribe certain medications to alleviate any discomfort experienced shortly after the procedure. A sense of discomfort is typically brief, with most patients returning to their normal activities within 2-3 days.

Additionally, around 90 days post-procedure, your provider might consider prescribing weight loss medications. This is done to enhance the weight loss potential of the ESG procedure, ensuring you gain the maximum benefit from this treatment.

If you have an existing condition related to being overweight, the procedure and your medication could improve conditions such as gastroesophageal reflux disease, high blood pressure, and cardiovascular disease.

Diet and Nutrition

Immediately after the procedure, you’ll be advised not to eat or drink for the rest of the day. It’s commonly advised to undergo IV hydration the following day. This step is essential for proper hydration and to assist in the recovery process. From there, the best practice protocol is for you to be on a liquid diet for six weeks before progressing to soft foods for another two weeks and a regular diet after that. This process helps your stomach adjust to its new size, and the sutures take time to stabilize. It’s worth noting that, although adhering to a liquid diet for six weeks might seem daunting, many patients find it manageable due to a significant reduction in hunger sensations following the procedure.

Once you’ve recovered from the procedure, you must commit to a healthy diet to maintain your weight loss goal. ESG is beneficial for improving eating behaviors, but it ultimately depends on what kind of food you consume. Your doctor may recommend seeing a registered dietitian to develop a diet that accommodates your needs. At Bariendo, we offer our patients a complimentary 12-month personalized coaching program following their ESG procedure. This is part of our commitment to providing comprehensive care and support throughout their weight loss journey.

Exercise and Lifestyle Activity

There are no restrictions after your procedure, so you can resume your everyday routine. Patients are advised to avoid abs or intense aerobic exercises for six weeks, but are encouraged to start resistance training and light aerobic exercises immediately after the procedure.

As with your diet, you should also incorporate regular exercise into your routine. This promotes a healthier lifestyle that maintains your weight loss goals.

Find Tailored Weight-Loss Solutions From Bariendo

An endoscopic sleeve gastroplasty offers a minimally invasive, effective, and sustainable solution for those struggling with obesity. Patients can ensure a smooth journey toward a healthier and happier life by understanding the process and setting realistic expectations for pre-operative preparations and post-operative care.

Bariendo has helped many individuals with their weight loss journey. Led by world-class bariatric endoscopists, we offer personalized, sustainable weight loss solutions with year-long support to keep you on track. Schedule your free consultation with Bariendo’s specialists today.

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