Frequently Asked Questions
How do I lose weight?
The procedure results in feeling full quicker with reduced food intake and slowed gastric emptying, so that you don’t become hungry for a longer period of time. Your dietitian and a psychologist will meet with you throughout the program to help you implement positive dietary and lifestyle modifications.
How much weight will I lose with an ESG?
Clinical evidence suggests an average weight loss of 19- 24% of starting weight at 18-months to 2 years post procedure. (i.e a 100 kg person would lose 19-24kg on average). Most of the weight loss occurs in the first 6-months after the procedure but can continue out to 2 years post procedure.
The amount of weight loss is dependent on your starting weight and how well you adapt to the lifestyle changes. Your success depends on whether you make the necessary dietary and lifestyle adjustments and how well you apply them. To aid your weight loss, you will be seen by both a dietitian and psychologist who specialise in weight loss management.
How is the procedure performed?
The procedure is performed via a gastroscopy under a general anaesthetic. The procedure takes 1-1.5 hours and you will be able to go home the same day. After general anaesthesia, the gastroscope is passed into the stomach to confirm that there are no contra-indications to proceeding with the ESG. The stomach is then marked to show the orientation of the stomach for the endoscopist during the procedure. The Overstitch device is then attached to the endoscope and placed into the stomach. Approximately 8 stitches are placed in a double layer pattern to reduce the diameter and shorten the stomach.
After the procedure is completed, you will be woken up in the recovery room and monitored for up to 3 hours post procedure before being allowed to return home.
The following day you will return to the Centre for a clinical assessment and to be given intravenous fluids and pain relief as appropriate. If required this can be repeated on day 2 post procedure.
How long does it take to recover after the procedure?
This is a day case procedure. After the procedure most patients return home within 3 hours of the procedure.
The recommendation would be to take up to 10 days off work to allow adequate recovery. It may be possible to return to work sooner if your work does not involve heavy exertion and lifting.
Is ESG Managed Weight Loss proven?
There are multiple clinical reports from around the world, which show very similar clinical outcomes. Weight loss at 18 months to 2 years post procedure is 19- 24% of starting weight. In conjunction with weight loss, there is significant improvement in diabetes control (reduced HBA1c), improved blood pressure, cholesterol profile, and lower liver function tests due to resolution of fatty liver disease.
A recent trial comparing endoscopic sleeve gastroplasty with the surgical alternatives of laparoscopic sleeve gastroplasty (LSG) and laparoscopic adjustable gastric banding (LAGB), showed patients with a BMI <40Kg/m2 all had the same degree of weight loss irrespective of the bariatric procedure performed. However, the recovery from ESG was quicker with significantly fewer complications in the ESG group (2.2% for ESG vs 9.2% for LSG and 9.0% for LAGB).
Are there side effects or complications with ESG?
Cramping or abdominal discomfort (30-50%), nausea (20-30%), reflux and vomiting are common symptoms within the first days after the procedure. Most of these symptoms are mild to moderate in severity. Please use recommended medications and remain nil by mouth for the first 24 hours after the procedure before commencing a liquid diet. If there are significant side effects immediately after the procedure and longer monitoring or hospital care is required, then you will be transferred to the local hospital, usually for an overnight stay. Approximately 4-5% of patients will need to stay overnight in hospital.
The common side effects typically last less than 2-3 days and then resolve.
Are there any risks associated with ESG?
The risks of major complications are low. There have been no deaths documented with this procedure with well over 3000 cases having been performed worldwide. There are risks of bleeding and infection (peri-gastric collection), pneumothorax, pulmonary embolism, however the risk of a significant complication is less than 2-3%. To date, complications that have occurred have been able to be managed with endoscopies, medications or minor procedures. No complication has yet required surgery to resolve, however there is a very small risk that this may be required.
The risk of a significant complication is significantly lower than surgical bariatric treatments and the recovery time from ESG is significantly quicker.
Are there any foods I should avoid with ESG?
You may find it difficult to tolerate some foods and this varies from person to person. Your dietitian will guide you through the initial dietary requirements and then longer term healthy eating to maintain your weight loss.
Can I drink alcohol after ESG?
You should not drink alcohol for the first three months after your procedure. You may feel the effects of alcohol more quickly than before.
Alcohol is very high in calories (particularly alco-pops and stronger wines or lagers) and contains no nutrients. It can also stimulate appetite which is another reason not to drink frequently.
Can I drink carbonated beverages after the procedure?
We advise against carbonated drinks in the first few weeks after the procedure. Carbonation initially causes gastric irritation and can stretch your stomach causing you to overeat. It is recommended that you avoid fizzy drinks, beer, champagne, or sparkling water.
Will I need to take vitamins after my procedure?
Whilst it is not essential, you may wish to take a multi vitamin and mineral supplement in the initial period after your procedure. The reason for this is that during this time you may only manage very small portions and your diet may not be able to provide all the nutrients that you require. As you progress through the stages and start to get into a routine with your meals you should no longer need this supplementation. See section on Vitamin and Mineral supplements.
Do I need to avoid any medications with ESG?
All of the medications that you are taking should be discussed with the gastroenterologist at the initial review. Some medications will require dose adjustment and some medications are not permitted.
Anti-inflammatory medications (non-steroidal anti-inflammatories, NSAIDs e.g. Brufen, Ibuprofen, Voltaren) are not permitted. Blood thinners and anti-platelet agents are not permitted (low dose aspirin 75-100 mg daily is permitted).
Is Psychological Support Available?
Behaviours, thoughts and feelings are associated with overeating. This may have resulted in habits such as large portion sizes, grazing throughout the day, overeating in social situations, or on your own, as well as night eating syndrome. Eating in response to stress, trauma, grief or low mood can also be linked to binge eating, eating for comfort or as a coping strategy and/or a food addiction.
To achieve sustained weight loss these eating patterns are replaced with habits and responses that support you to maximise weight loss and maintain control following the ESG.
Psychological support is valuable both before and after the procedure, and is part of the ESG package. The psychologist will assist you to identify what your triggers are for overeating. An individualised program is developed to help achieve long term weight control.