An illustration of a tightened stomach.

ESG Stomach Tightening™

Non-surgical, 60-minute weight loss procedure, performed by world-class doctors vetted by the inventor himself.

Authorized by FDA

Featured in top scientific publications

NIH National Library of Medicine PubMed Central American College of Gastroenterology ScienceDirect MDedge iGIE

What is ESG Stomach Tightening?

Rapid results, lasting confidence

ESG Stomach Tightening (or endoscopic sleeve gastroplasty) is a minimally invasive, non-surgical weight loss procedure.

Stomach reduction by 60-75%.
Approximately 8 sutures are placed to create ESG Stomach Tightening. The sutures create internal folds that reduce the stomach’s size by 60-75%. With your newly reduced stomach size, you’ll feel full more quickly and for longer periods.
Non-surgical. No scars.
Performed under anesthesia, an endoscope is inserted through your mouth into your stomach. The procedure leaves no scars.
Quick recovery.
You can go home on the same day. Most patients take 1-3 days off work.
1-year post-procedure average weight loss1
Average weight loss when combined with medications2
5-year post-procedure weight loss
the effects of the ESG procedure have been proven to last for at least ten years and likely even longer
10+ years


Broadening access to innovation

Since its inception, ESG Stomach Tightening™ has redefined non-surgical weight loss. Bariendo is making this innovative procedure more accessible.

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 procedure3 as a minimally invasive, non-surgical alternative for weight loss surgery.

ESG demonstrates 18% body weight loss

A pivotal study4 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 years5. 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 intervention

The FDA authorized the use of Apollo Endosurgery Inc’s devices for ESG6, 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.


Who is ESG Stomach Tightening™ for?

Anyone with a body mass index (BMI) over 30
Anyone with a body mass index (BMI) of 27 - 29.9
plus one of the following conditions: high blood pressure, diabetes, high cholesterol, sleep apnea, and fatty liver disease
ESG Stomach Tightening candidates

Why ESG Stomach Tightening™ works

The science behind ESG's efficacy

ESG Stomach Tightening involves physiological changes to your stomach that lead to enduring results compared to pharmacological or lifestyle interventions.

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 period12


ESG vs. other weight loss solutions

Weight loss solution comparison
ESG Stomach Tightening™
Gastric Balloon
Bariatric Surgery
Gastric Bypass or Sleeve Gastrectomy
Ozempic and Wegovy
Types 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%)

What sets us spart

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.

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.
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 for enhanced 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).
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.

Frequently asked questions

Ready to take the next step?

Start your weight loss journey with doctors trusted by thousands.


  1. Lopez-Nava G, Sharaiha RZ, Vargas EJ, Bazerbachi F, Manoel GN, Bautista-Castaño I, Acosta A, Topazian MD, Mundi MS, Kumta N, Kahaleh M, Herr AM, Shukla A, Aronne L, Gostout CJ, Abu Dayyeh BK. Endoscopic Sleeve Gastroplasty for Obesity: a Multicenter Study of 248 Patients with 24 Months Follow-Up. Obes Surg. 2017 Oct;27(10):2649-2655. doi: 10.1007/s11695-017-2693-7. PMID: 28451929.
  2. Sharaiha RZ, Hajifathalian K, Kumar R, Saunders K, Mehta A, Ang B, Skaf D, Shah S, Herr A, Igel L, Dawod Q, Dawod E, Sampath K, Carr-Locke D, Brown R, Cohen D, Dannenberg AJ, Mahadev S, Shukla A, Aronne LJ. Five-Year Outcomes of Endoscopic Sleeve Gastroplasty for the Treatment of Obesity. Clin Gastroenterol Hepatol. 2021 May;19(5):1051-1057.e2. doi: 10.1016/j.cgh.2020.09.055. Epub 2020 Oct 1. PMID: 33011292.
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