Bariatric Endoscopy

What is Bariatric Endoscopy?

Bariatric endoscopy refers to a group of minimally invasive, non-surgical weight loss procedures that are performed through the mouth using an endoscope — a thin, flexible tube with a camera and specialized instruments. These procedures reduce stomach capacity or alter stomach anatomy to promote weight loss, all without the need for surgical incisions.

Bariatric endoscopy bridges the gap between lifestyle interventions (diet and exercise alone) and traditional bariatric surgery (such as gastric bypass or sleeve gastrectomy). It offers a meaningful weight loss solution for patients who have not achieved their goals through diet and exercise but may not be candidates for — or may prefer to avoid — major surgery.

These procedures are performed on an outpatient basis under sedation, with significantly shorter recovery times and fewer risks compared to surgical alternatives.

Types of Bariatric Endoscopy Procedures

Several endoscopic weight loss procedures are available, and Dr. Khan will help determine which option is most appropriate for your individual situation:

Intragastric Balloon

The intragastric balloon is a soft, silicone balloon that is placed inside the stomach through the mouth using an endoscope. Once positioned, the balloon is filled with a sterile saline solution, occupying a significant portion of the stomach. This creates a feeling of fullness with smaller meals, helping you eat less and lose weight.

The placement procedure takes approximately 20 to 30 minutes and is performed under light sedation.
The balloon remains in the stomach for approximately six months, during which time patients typically lose 10% to 15% of their total body weight.
After six months, the balloon is deflated and removed endoscopically in a brief outpatient procedure.
Throughout the treatment period, you will work with Dr. Khan and a nutritional counselor to develop sustainable eating habits that support long-term weight maintenance.

Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic sleeve gastroplasty is a procedure in which the stomach is reduced in size by approximately 70% using sutures placed through the endoscope. The sutures reshape the stomach into a smaller, tubular sleeve — similar in concept to a surgical sleeve gastrectomy, but without any incisions.

The procedure takes approximately 60 to 90 minutes and is performed under general anesthesia.
By significantly reducing stomach volume, ESG limits the amount of food you can eat at one time and slows gastric emptying, helping you feel full longer.
Studies show that patients can expect to lose 15% to 20% of their total body weight within 12 to 24 months.
Unlike the intragastric balloon, ESG results are intended to be long-lasting, as the sutures create a durable reduction in stomach size.

Aspiration Therapy

In aspiration therapy, a small tube (the A-Tube) is endoscopically placed through the abdominal wall into the stomach. After meals, a portion of the stomach contents is drained through the tube, reducing caloric absorption. This approach is used in combination with lifestyle counseling and is approved for patients with a BMI of 35 to 55.

Who is a Candidate?

Bariatric endoscopy may be appropriate for you if:

You have a body mass index (BMI) of 30 or higher and have been unable to achieve significant weight loss through diet and exercise alone.
You have a BMI of 27 or higher with at least one obesity-related health condition, such as type 2 diabetes, high blood pressure, obstructive sleep apnea, or fatty liver disease.
You prefer a less invasive alternative to traditional bariatric surgery.
You do not meet the criteria for surgical bariatric procedures (typically BMI of 35 or higher, or 40 or higher without comorbidities) but still need more than lifestyle changes alone.
You are committed to making lasting changes to your diet and physical activity habits, as endoscopic procedures are most effective when combined with a comprehensive lifestyle modification program.

During your consultation, Dr. Khan will conduct a thorough evaluation of your medical history, current health, weight loss goals, and any prior weight loss attempts to determine whether bariatric endoscopy is the right approach for you.

Benefits Compared to Traditional Surgery

Bariatric endoscopy offers several important advantages over traditional surgical weight loss procedures:

No incisions: All procedures are performed through the mouth using an endoscope, leaving no external scars.
Outpatient procedure: Most patients go home the same day, compared to a hospital stay of one to three days for surgical bariatric procedures.
Faster recovery: Most patients return to normal activities within a few days, compared to two to four weeks for surgical recovery.
Lower complication rate: The risk of serious complications is significantly lower than with surgical approaches.
Reversible or adjustable: Some procedures, such as the intragastric balloon, are fully reversible. ESG can potentially be revised if needed.
Effective weight loss: While total weight loss may be somewhat less than with surgical options, bariatric endoscopy delivers clinically meaningful results that can significantly improve obesity-related health conditions.

What to Expect

Your bariatric endoscopy journey at GastroCares includes the following steps:

Initial consultation: Dr. Khan will review your health history, perform a physical examination, and discuss your weight loss goals. Diagnostic tests may be ordered to evaluate your overall health and ensure you are a safe candidate for the procedure.
Pre-procedure preparation: You will receive specific instructions regarding fasting (typically 8 to 12 hours before the procedure), medication adjustments, and what to bring on the day of your procedure.
The procedure: Depending on the type of procedure, you will receive sedation or general anesthesia. The endoscopic procedure is performed through the mouth with no external incisions.
Same-day discharge: After a period of monitoring in the recovery area, you will be discharged home with detailed instructions for your post-procedure diet and activity level.
Follow-up care: Regular follow-up appointments with Dr. Khan are essential to monitor your progress, adjust your dietary plan, and address any concerns. You will also receive guidance on exercise, behavioral changes, and long-term weight maintenance strategies.

Recovery

Recovery from bariatric endoscopy is significantly faster than recovery from surgical weight loss procedures:

First 24 to 48 hours: You may experience nausea, bloating, or mild abdominal discomfort. These symptoms are normal and typically resolve within the first day or two. Anti-nausea medication will be prescribed to help manage any discomfort.
First week: You will follow a liquid diet, gradually transitioning to soft foods as tolerated. Dr. Khan will provide a detailed dietary progression plan.
Weeks two through four: Most patients transition to a modified regular diet and can resume all normal activities, including exercise.
Ongoing: Long-term success depends on adherence to the dietary and lifestyle plan developed with Dr. Khan and the GastroCares team. Regular follow-up visits ensure you stay on track and achieve your weight loss goals.

Bariatric endoscopy is not a standalone solution — it is a powerful tool that works best when combined with a commitment to healthier eating habits and regular physical activity. Dr. Khan and the GastroCares team will support you every step of the way.