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ESG for Obesity: Class 1 & 2 Management in Dallas




ESG for Obesity Management in Dallas, TX

ESG for Obesity Management in Dallas, TX
ESG for Obesity Management in Dallas, TX

Obesity management may include lifestyle changes, medications, or surgery. Lifestyle modification may not be enough for significant weight loss in certain patients, which is where invasive approaches come in.

Studies have shown that endoscopic approaches are part of the most effective, well-defined, and efficient interventions for managing obesity. The endoscopic approaches to obesity management are numerous ranging from the newer and less invasive techniques that require no skin incisions to older techniques that offer a faster recovery.

In appropriately selected patients, endoscopic approaches are safe and have a high rate of success in promoting weight loss as part of an overall weight management program.

The common endoscopic approaches to weight management include Endoscopic sleeve gastroplasty (ESG), Gastric bypass revision / Transoral outlet reduction (TORe) and Roux-en-Y gastric bypass surgery.

ESG is a minimally invasive weight loss procedure that uses an endoscopic suturing device to reduce the stomach’s size and volume.

The principle behind this approach is to significantly reduce the size of your stomach so that it can only take small volume of food. You will feel full when you eat little portion of food. Hence, your body will absorb fewer calories and you will experience weight loss over time.

ESG is a minimally invasive procedure in comparison to laparoscopic sleeve gastrectomy (LSG) because while ESG uses suturing devices to constrict and reduce the size of the stomach, LSG reduces the size of the stomach by surgically removing part of the stomach, making ESG reversible for most patients.

Gastric bypass revision / Transoral outlet reduction (TORe) is an approach used for people who have regained weight after gastric bypass surgery. This endoscopic procedure aims to reduce the size of the opening between the stomach pouch and the small intestine to slow stomach emptying and help you feel fuller longer.

Gastric bypass is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the new pouch to the small intestine. All these approaches are carefully considered before the most suitable option is recommended for the patient.

Endoscopic Sleeve Gastroplasty as an Early Tool Against Obesity

Endoscopic sleeve gastroplasty provides an option for patients seeking significant weight loss with fewer adverse events than regular bariatric surgery. This endoscopic procedure when presented early to patients as a weight loss can also help to prevent obesity.

Endoscopic sleeve gastroplasty for obesity management has a lower adverse event rate when compared to bariatric surgery and also offers better weight loss results than most existing pharmacotherapies. There’s evidence that endoscopic sleeve gastroplasty is a safe and effective treatment option for weight loss when used in combination with lifestyle changes.

ESG facilitates safe and effective weight loss in adults suffering from obesity no matter its class within a year, which is stabilized at years two and three. ESG should be considered for patients with obesity and also as an early tool against obesity.

Endoscopic Sleeve Gastroplasty for Treatment of Class 1 and 2 Obesity

Obesity is a global health concern with massive socio-economic burdens. It is considered a great risk factor for important chronic diseases, including type 2 diabetes, heart disease, fatty liver disease, and multiple cancers. Experts often rely on body mass index (BMI) to determine if a person is overweight or obese.

The classification of obesity includes overweight (not obese) if BMI is 25.0 to 29.9, class 1 (low-risk) obesity if BMI is 30.0 to 34.9, class 2 (moderate-risk) obesity if BMI is 35.0 to 39.9 and class 3 (high-risk) obesity if BMI is equal to or greater than 40.0.

ESG is a safe procedure that results in significant weight loss with improvements in comorbidities. ESG is a promising weight loss intervention for patients with class 1 or class 2 obesity.

Managing Obesity With Endoscopic Sleeve Gastroplasty

Managing Obesity With Endoscopic Sleeve Gastroplasty
Managing Obesity With Endoscopic Sleeve Gastroplasty

Endoscopic sleeve gastroplasty (ESG) is a procedure performed using endoscopic suturing devices. It is a non-surgical weight-loss procedure that involves the placement of sutures inside the stomach to shrink and reduce its size by up to 75%.

The significant reduction in the size of the stomach reduces the quantity of food that the stomach can take. This leads to a significant reduction in the amount of calories that the body is able to absorb, thereby leading to weight loss over time.

During an ESG procedure, sutures are placed into the stomach via an endoscope. The endoscope is inserted through the throat down to the stomach. The sutures which are placed in the stomach shrink the stomach and reduce its size up to 75%.

ESG is ideal for individuals with a body mass index of 30 and above. Unlike bariatric surgery such as laparoscopic sleeve, ESG does not involve incisions. There are usually no severe complications or adverse events after undergoing ESG.

Reported severe adverse events associated with this procedure are seen in only 2% of cases and include bleeding, perforation, and fluid collecting in the perisplenic area that responds to interventional radiology drainage.

Approximately 10% to 15% of patients experience nausea and some abdominal pain as side effects of this approach to obesity management.

How Does Endoscopic Sleeve Gastroplasty Compare With Other Endoscopic Approaches For Obesity Management?

ESG produced an average total excess fat loss of 40% within a year of follow-up. This weight loss result is significantly greater than the weight loss observed after conventional bariatric surgery.

Endoscopic sleeve gastroplasty also seems to be superior to gastric balloons in sustaining weight loss at 5 years, according to certain studies. ESG is especially appealing to a large number of the population because it is less invasive and is associated with a lower risk profile. However, this procedure isn’t the most suitable option for those who are morbidly obese.

Endoscopic Sleeve Gastroplasty Significantly Reduces Body Mass Index and Metabolic Complications

In addition to the weight loss benefits of endoscopic sleeve gastroplasty, the procedure also helps reduce BMI and metabolic complications.

The metabolic complications of obesity consist of insulin resistance, often resulting in β-cell failure, impaired glucose tolerance and type 2 diabetes, dyslipidemia, hypertension, and premature heart disease. The end result of these metabolic complications is cardiovascular disorders and stroke.

With ESG, there are reduced markers of hypertension, diabetes, and hypertriglyceridemia and you get to enjoy a better quality of life.

How Should Patients Who Fail To Achieve Adequate Weight Loss With Endoscopic Sleeve Gastroplasty Be Treated?

It’s possible for patients to not achieve desired weight loss with ESG, patients like these are recommended to consider other options. There are a lot of other alternatives to ESG. One is opting for the multidisciplinary weight-loss approach that includes nutritional counseling.

This is both for patients who have used this approach prior to the ESG procedure and those who have not. Besides this lifestyle modification approach, there’s also the pharmacotherapy option. Several FDA-approved medications can be used as an adjunct or primary intervention for weight loss in obese patients.

These medications include single agents or combinations of agents ranging from metformin, phentermine, topiramate, and liraglutide. Finally, patients may also be recommended to consult a bariatric surgeon to consider weight loss surgery, if necessary.

Endoscopic Sleeve Gastroplasty (ESG) for High-Risk Patients, High Body Mass Index kg/m) Patients, Contraindications for Abdominal Surgery

While there is more evidence supporting the efficacy of ESG in class 1 and 2 obese patients in comparison to that of morbidly obese patients, a few researchers have evaluated the safety, feasibility, and efficacy of endoscopic sleeve gastroplasty for high-risk, high body mass index patients, and patients contraindicated to abdominal surgeries.

According to the results of this study, it’s safe to say that ESG might be the new best treatment option available for the therapy of patients with high-risk obese patients, and patients contraindicated to abdominal surgery.

Safety and Efficacy of Endoscopic Sleeve Gastroplasty for Obesity Management

Safety and Efficacy of Endoscopic Sleeve Gastroplasty for Obesity Management
Safety and Efficacy of Endoscopic Sleeve Gastroplasty for Obesity Management

Obesity is usually treated with lifestyle or pharmaceutical interventions prior to conventional surgeries like laparoscopic sleeve gastroplasty. Since endoscopic sleeve gastroplasty appears to be a promising alternative, the minimally invasive procedure is now being considered first before for weight loss.

A lot of people are still not clear about the safety and efficacy of the procedure. Even with limited research available, experts are still leaning toward the fact that the procedure is both safe and effective.

It also helps that it’s associated with fewer adverse events than LSG. ESG may potentially serve as a successful treatment for the majority of patients with BMI correlating to that of obesity class 1 and 2.

What Are The Effects Of Endoscopic Sleeve Gastroplasty On Obesity-Related Comorbidities?

ESG has a good outcome in promoting weight loss and reducing the comorbidities associated with obesity such as type 2 diabetes, sleep apnea, high blood pressure, coronary heart disease, and stroke. ESG helps to facilitate weight loss which invariably addresses these comorbidities.

It helps to improve the health and quality of life of patients with obesity-related comorbidities.

Best Doctor for Endoscopic Sleeve Gastroplasty Treatment in Dallas, TX

Endoscopic Sleeve Gastroplasty (ESG) is a non-surgical procedure that you can undergo for weight management in Dallas. However, you need to partner with the best doctor for a successful outcome.

The best doctor for endoscopic sleeve gastroplasty in Dallas is Dr. Prashant Kedia.

Dr. Kedia is a highly specialized endoscopist. He’s committed to providing result-oriented ESG procedures for patients who are obese or overweight in the Dallas/Fort Worth area, Texas.

Schedule a consultation with Dr. Kedia today to learn more about ESG and kick-start your weight loss journey.



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