What is ESG Stomach Tightening?

ESG Stomach Tightening (or Endoscopic Sleeve Gastroplasty) is a minimally invasive, non-surgical weight loss solution. Performed under anesthesia, an endoscope is inserted through your mouth into your stomach.

Approximately 8 sutures are placed to create ESG Stomach Tightening. The sutures create internal folds that reduce the stomach’s size by 60-75%. The procedure leaves no scars, and you can go home on the same day. With your newly reduced stomach size, you’ll feel full more quickly and for longer periods.


On average, patients lose 18% of their body weight1

5+ years

the effects of the ESG procedure have been proven to last for at least five years and likely even longer2

History of ESG 
Stomach Tightening™

Bariendo is dedicated to establishing the global gold standards for this procedure. We collaborate exclusively with top-tier doctors, each personally vetted by the inventor of ESG himself.

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Hear from the inventor of ESG (13:49)

Pioneering a new era of weight Loss

In 2012, Dr. Christopher Thompson, Professor of Medicine at Harvard Medical School and our co-founder, conducted the world’s first ESG Stomach Tightening procedure 3 as a minimally invasive, non-surgical alternative for weight loss surgery.

ESG Demonstrates 18% Body Weight Loss

A pivotal study 4 conducted across various universities and hospitals in the United States showed ESG leading to an 18.6% body weight loss, confirming the procedure’s effectiveness in diverse settings.

ESG confirmed durable for a minimum of 5 years

The effectiveness of ESG in maintaining weight loss was demonstrated over a minimum period of 5 years 5. On average, patients who underwent ESG maintained a 15.9% body weight loss five years after the procedure.

FDA approves ESG as an effective weight loss

The FDA authorized the use of Apollo Endosurgery Inc’s devices for ESG 6, recognizing it as an effective obesity intervention.

Bariendo Established to Facilitate Access to 
ESG Stomach Tightening

Recognizing the necessity for standardized ESG protocols, quality control among doctors, and simplified access to care, Dr. Thompson co-founded Bariendo.

Hear from the inventor of ESG (13:49)

Up to 10 yr durable results

Up to 10 yr durable results

One year after ESG

Five years after ESG

* Timing matters when it comes to combining medications with ESG

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Verfied source

Latest updated:2021 May

Expected results from ESG Stomach Tightening™

  • Highly respected database from the National Institutes of Health

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Avg. body weight loss

Most patients achieve a weight loss ranging from 15-25%, with the average being 18% 7

Avg. weight loss increases to


The average weight loss increases to 24% when this procedure is combined with medications 8

Patients retain an average body weight loss of


Five years out, most patients maintain a significant portion of their initial weight loss, averaging a 16% reduction 9 from their pre-ESG weight

* Timing matters when it comes to combining medications with ESG

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ESG Stomach Tightening candidates

Who ESG Stomach Tightening™ is for

ESG Stomach Tightening candidates
  • Anyone with a BMI over 30
  • Anyone with a BMI of 27 – 29.9 plus one of the following conditions: high blood pressure, diabetes, high cholesterol, sleep apnea, and fatty liver disease

Hear from our ESG Stomach Tightening™ patients

See more success stories

Hear from our patients

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Lost 53 lbs

29% weight loss

After losing 53 lbs on the ESG journey with 
Dr. Jirapinyo, I now sleep better, have more energy to run and stay fit, and feel like a completely new person.


Lost 48 lbs

19% weight loss

I’m 73 and I had tried every single diet imaginable. 
I chose Dr. Jirapinyo because she was recommended by my PCP. It’s been a lifesaver, life-changing for me. I’m so glad I did it.


Lost 40 lbs

18% weight loss

For me it is by far the most positive life changing action I could have taken. I have so much more energy and my general health and wellbeing has improved exponentially.

Why ESG Stomach Tightening™ works

ESG Stomach Tightening involves physiological changes to your stomach, leading to enduring results compared to pharmacological or lifestyle interventions. Research has identified the following interconnected effects of ESG:


Improvements to eating behavior

With a stomach reduced to 3-5 times its original size, ESG Stomach Tightening has been shown to significantly improve three key areas: cognitive restraint, emotional eating, and uncontrolled eating 10


Slowing down gastric emptying

Research indicates that ESG Stomach Tightening extends the time food takes to pass through your stomach (“gastric emptying”) by 50 minutes, helping you feel full for a longer period 11


Increases in satiety hormones

Research indicates that ESG Stomach Tightening extends the time food takes to pass through your stomach (“gastric emptying”) by 50 minutes, helping you feel full for a longer period 12

How ESG Stomach Tightening™ 
compares with other weight loss solutions

Need help choosing? Consult with our specialist

ESG Stomach Tightening™
Gastric Balloon
Bariatric Surgery

(Gastric Bypass or Sleeve Gastrectomy)


(Ozempic and Wegovy)

Type of intervention

Non-surgical. No hospitalization required

Non-surgical. No hospitalization required

Surgery. At least 1 night at hospital

At-home weekly injections

Average weight loss at 12 months





Long-term efficacy

Durable outcomes. Average of 16% weight loss sustained 5 years after ESG 13

Significant weight regain after 12 months 14

Durable outcomes 15

Significant weight regain after discontinuing use. Most gain ⅔ of their lost weight within 1 year 16


60-min procedure. 1-3 days off work

15-min procedure. 1-3 days off work

1-3 days of hospital stay. 2-4 weeks off work

Weekly adherence required

Major complications

Rare (<2%)

Rare (<2%)



Not all ESG is equal

Bariendo’s ESG Stomach Tightening™ utilizes best practice protocols refined through a decade of research with year-long personalized support

View ESG demonstration



We invented the field

We invented the field

Dr. Christopher Thompson, our co-founder, pioneered Endoscopic Sleeve Gastroplasty (ESG) in 2012 and later developed many other endoscopic weight loss procedures. He and our Scientific Advisory Board have carefully selected the most qualified doctors for the Bariendo team.

3500 cases suture procedures
ESG protocols averaging at 8 sutures

Best practice ESG protocols averaging at 8 sutures

Best practice ESG protocols averaging at 8 sutures

While some doctors may use only 2-5 sutures, ours typically employ 8-10 sutures per procedure to maximize weight loss. However, it’s not just the quantity of sutures, but the patterns of their placement that make the difference. All of our doctors strictly adhere to these best-practice protocols.

combination therapy with medications

Combination therapy with medications for enhanced weight loss

Bringing in medications for accelerated weight loss

The emerging field of combining endoscopic procedures with weight loss medications is led by Dr. Jirapinyo, our co-founder. Our comprehensive treatment packages include prescribing a weight loss medication after the endoscopic revision procedure to further augment the amount of weight loss. (The costs of medication are not included; however, the medication may be covered by your insurance).

dedicated care team

Sustainable lifestyle changes through a dedicated care team

Sustainable lifestyle changes through a dedicated care team

Our support doesn’t end once the procedure is complete. For 12 months, you have direct access to a multidisciplinary team consisting of your physician, physician assistant, registered dietitian, exercise coach, and patient liaison. We also provide you with a smart scale that allows our care team to monitor your weight loss journey in real-time.


How long does ESG take?

The procedure itself takes approximately 60 minutes. However, you should plan on spending about half a day with us including preparation and recovery.

What is recovery like after ESG?

Patients go home on the same day. Most take a few days off to recover at home before returning to work. After the procedure, patients follow a full liquid meal plan, which includes protein shakes and similar products, then transition to a soft diet, which includes easy-to-eat foods such as oatmeal and bananas, and then return to regular eating.

Is ESG reversible?

Your doctor can use one of three available suturing or plication devices to perform ESG/EGP. ESG can be reversible, while EGP is typically not. If this is important to you, you should discuss this with your provider prior to the procedure.

What is the difference between ESG & EGP?

ESG folds your stomach outward, While EGP (Endoscopic gastric plication) folds your stomach inward. This is why ESG can be reversible and EGP is typically not. Additionally, some stomachs, depending on their shape and size, may respond better to a specific device. Having access to all three suturing and plication devices allows your doctor to tailor the procedure for best results.

How much does ESG cost?

An ESG procedure costs $11,995, which includes 12 visits with your Bariendo healthcare team. Financing options are available.

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