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Frequently asked questions about bariatric endoscopy

• What types of bariatric endoscopic procedures are there?

  ´óÏó´«Ã½ offers four types of bariatric endoscopic procedures. Your doctor will evaluate the specifics of your situation before making a recommendation. Requirements for surgery may not be identical for each person, even if they’re having the same procedure. But there are general requirements you need to meet.

  • Endoscopic sleeve gastroplasty (ESG): During ESG, a doctor sutures (stitches) the stomach to decrease its size. This limits its capacity for food, causing patients to eat less and stay full longer. The procedure is done through the mouth, so no incision is needed. Minimum requirements you need to qualify:
    • Body mass index (BMI) of 30 or more.
    • Other weight loss methods, including diet, exercise and medication, are unsuccessful after at least six months.
    • You’re committed to long-term lifestyle changes such as healthy eating and regular exercise.
  • Intragastric balloon: In this procedure, a balloon is placed within the stomach and filled with saline (salt water). The balloon takes up space in the stomach to help patients feel full while eating less and stay full longer. Doctors remove the balloon after six months, leaving the stomach intact. Minimum requirements you need to qualify:
    • Body mass index (BMI) of 27 or more.
    • Other weight loss methods, including diet, exercise and medication, are unsuccessful after at least six months.
    • You’re committed to long-term lifestyle changes such as healthy eating and regular exercise.
  • Revisional ESG (r-ESG): An r-ESGis done when a patient has either regained weight or lost insufficient weight after a previous ESG or surgical sleeve gastroplasty. The doctor may remove stitches and create a new pattern of sutures. Minimum requirements you need to qualify:
    • You had a previous ESG or surgical sleeve gastroplasty.
    • Your weight loss was insufficient, or your extra weight came back.
  • Transoral outlet reduction (TORe): TORe is a revisional procedure for people who have regained weight after a previous gastric bypass surgery. During the procedure, the doctor decreases the size of the opening between the gastric pouch (created during the bypass) and the small intestine. To access the area, they pass an endoscope through the mouth and then stitch (suture) the bypass opening to make it smaller. This slows down the emptying of food from the stomach, so you feel full longer. Minimum requirements you need to qualify:
    • You had a previous gastric bypass surgery.
    • Your weight loss was insufficient, or your extra weight came back.
• Can I have bariatric surgery while taking GLP-1 medication?

  Research shows that continuing to take GLP-1 medicines leading up to bariatric endoscopy can lead to longer-term weight loss with fewer side effects in some cases. Talk to your doctor to find out if this is a good option based on your individual circumstances. 

• How do I prepare for bariatric endoscopy?

  Before bariatric endoscopy, you may meet with multiple specialists including:

  • Dietician, to go over dietary restrictions to follow one to two days before your procedure.
  • Psychologist, in some cases, to ensure you are mentally prepared for the lifestyle changes the procedure involves.
  • Your doctor, to discuss any medications you are taking and confirm you are ready for the procedure.

   

  Afterwards, you will need to be on a special bariatric diet for a few weeks. The first week you will have liquids only. Then you will be on soft foods for the next two weeks.

• What are the risks of bariatric endoscopy?

  There are very few risks associated with bariatric endoscopy. The rate for major complications ranged from roughly 1-2% according to a 2021 study cited in the National Library of Medicine. Common risks for bariatric endoscopy include:

  • Abdominal pain
  • Nausea
  • Sore throat

   

  These side effects usually last only for a few days. It is also common for people to regain weight after bariatric endoscopy. Some procedures may be repeated in this case.