Endobariatric Weight Loss Treatment

Endobariatrics refers to a group of minimally invasive procedures that help people with obesity lose weight without traditional surgery. These treatments are done using a flexible tube with a camera, called an endoscope, which is passed through the mouth and into the stomach.

These minimally invasive treatments are performed through the mouth using an endoscope and can help reduce hunger, limit how much food the stomach holds or change how the body absorbs nutrients. Several types of procedures are available, each with its own approach and considerations.

Endobariatric surgery uses endoscopy (a thin, flexible tube with a camera) to access the digestive system without needing to make huge incisions. These treatments can help reduce weight by limiting stomach capacity, delaying digestion or adjusting how the body processes food.

These options are typically considered for individuals who haven't had success with lifestyle changes alone and may not qualify for or want surgery. While results vary, endobariatric therapies offer another approach for managing weight in combination with healthy eating, exercise and medical guidance. Your healthcare team can help determine the option that fits your health needs and goals. Below are the most common types:

Intragastric Balloon (IGB) 

Intragastric balloon weight loss procedure involves the use of a soft balloon placed into the stomach through the mouth and then filled with saline or gas. It takes up space in the stomach to promote a feeling of fullness, helping reduce food intake. Balloons are usually temporary, staying in the stomach for about 4 to 12 months, depending on the type.

Endoscopic Sleeve Gastroplasty (ESG)

This procedure uses sutures placed through an endoscope to reduce the size of the stomach, forming it into a narrow tube or sleeve. It limits the amount of food the stomach can hold and helps patients feel full sooner.

Duodenal-Jejunal Bypass Sleeve 

A sleeve is inserted through the mouth and placed in the small intestine to prevent food from mixing with digestive juices until further down the gut. This delays absorption and may affect hormone signals related to hunger and blood sugar control.

Duodenal Mucosal Resurfacing (DMR)

A special catheter delivers heated water to treat a portion of the duodenal lining. This is being studied as a way to improve blood sugar control, especially in people with type 2 diabetes.

POSE (Primary Obesity Surgery Endolumenal) 

Using specialized tools, folds are created inside the stomach to reduce its size. This is done through the mouth, without external incisions. POSE aims to decrease stomach volume and slow digestion.

Endomina Suturing System 

This endoscopic device places full-thickness stitches inside the stomach to reduce its volume. It's another way to promote earlier satiety and limit food intake.

Endoscopic sleeve gastroplasty weight loss procedure is a non-surgical weight loss option that uses an endoscope to reduce the size of the stomach. Unlike traditional surgery, ESG doesn’t involve any cuts or removal of tissue. Instead, it reshapes the stomach from the inside using stitches, helping people feel full with smaller portions of food.

This procedure may be considered for individuals with a body mass index (BMI) typically between 30 and 45 kg/m², especially if other methods like diet and exercise haven’t worked well. Before the procedure, patients are evaluated by a medical team, which may include a gastroenterologist, dietitian and psychologist. Patients may be asked to follow a special diet and stop eating the night before. The procedure is done under anesthesia or deep sedation, so the patient is not awake or in pain.

A flexible tube with a camera (endoscope) is inserted through the mouth into the stomach. Using a certain device, the doctor places full-thickness sutures along the greater curve of the stomach. These stitches fold the stomach inward and narrow its shape, creating a tube-like sleeve.

The procedure typically takes one to two hours. After monitoring for a few hours, most patients can go home the same day. A clear liquid diet is usually started and gradually advanced over several weeks. By reducing the stomach’s volume, ESG helps limit how much a person can eat and may also slow digestion, which can support weight loss over time. Following ESG, patients are encouraged to continue with a structured nutrition and activity plan and follow-up care is important for long-term results.

Intragastric balloon placement is a minimally invasive weight loss procedure that uses a balloon to help reduce hunger and portion sizes. It’s not a surgery in the traditional sense—there are no incisions. Instead, a soft balloon is placed inside the stomach to take up space, helping patients feel full sooner during meals. The balloon stays in the stomach for a limited time, usually about 4 to 6 months, before it’s removed.

This option may be used for people who haven’t had success with diet and exercise alone and are looking for a temporary, non-surgical approach to weight loss. Before the procedure, patients are evaluated by a healthcare team. A clear liquid diet may be recommended for a few days beforehand and patients are asked not to eat or drink after midnight the night before.

The procedure is done under light sedation or anesthesia to ensure comfort. A deflated balloon attached to a thin tube is guided into the stomach through the mouth using an endoscope (a flexible tube with a camera). Once the balloon is in the correct position, it is filled with saline (sterile saltwater) or gas, depending on the balloon type. The volume is usually enough to fill part of the stomach, creating a feeling of fullness.

The balloon is sealed and detached from the catheter, which is then removed. The balloon stays freely in the stomach. Patients are monitored for a short time and can usually go home the same day. A clear liquid diet is started soon after and gradually transitions to soft and then solid foods over the following weeks.

The balloon remains in the stomach for a few months and is then removed through a similar endoscopic process. The goal of this treatment is to support weight loss efforts alongside diet, physical activity and ongoing follow-up care.

An endobariatric procedure offers non-surgical support for people working to manage obesity. While individual experiences vary, research from clinical studies highlights a few benefits that have been observed in certain patients:

• Minimally Invasive Approach: These procedures are performed through the mouth using an endoscope, so no incisions are needed. This often means shorter recovery time and fewer risks compared to traditional surgery.
• Supports Early Fullness and Reduced Food Intake: Treatments like intragastric balloons and endoscopic sleeve gastroplasty reduce the stomach’s capacity or delay stomach emptying. This can help people feel full with less food.
• Potential Improvement in Certain Health Conditions: Weight loss following these procedures may be linked to improvements in some conditions, such as type 2 diabetes, high blood pressure or fatty liver disease—especially when paired with lifestyle changes.