woman-happy-after-exerciseIf you need help losing weight but want to avoid or do not qualify for bariatric surgery, a nonsurgical endobariatric procedure may be the ideal solution. It may also be helpful for people who need to lose additional weight while on weight loss medications or those who can’t tolerate glucagon-like peptide-1 (GLP-1) or other weight loss prescriptions.

These nonsurgical weight loss procedures are performed using an endoscope, a small, flexible tube with a light at the end which is inserted through the person’s mouth to provide the doctor with direct access to the stomach. Depending on the endobariatric procedure selected, different techniques will be used to reduce the size of stomach, change the way food is processed or reverse and/or correct a previous weight loss procedure.

Benefits of endoscopic weight loss procedures

Nonsurgical weight loss procedures have multiple benefits. There are no incisions, and recovery is easier than it may be for bariatric surgery. Some endobariatric procedures can also be reversed in the future, again using a nonsurgical process.

  • Most endobariatric procedures take just 1-2 hours, and most people go home the same day.
  • The majority of people fully recover in a week or less.
  • Depending on the type of endobariatric procedure performed, weight loss averages can be up to 10%-20% in the first year.
  • In addition to weight loss, individuals may also see improvements in associated conditions, such as diabetes, high blood pressure and fatty liver disease.
  • As is true across the nation, medical insurance may not cover the cost of an endobariatric procedure.
    • In most cases, costs must be paid out-of-pocket with detailed estimates shared in advance. Ask us about payment options.
    • Insurance may apply for certain people with obesity-related conditions, in which case we will seek coverage approval.
    • If you do meet the criteria for potential insurance coverage, we will send documentation to your insurance company to support justification of the procedure as a life-saving medical intervention.
  • If you choose a nonsurgical weight loss option, you’ll have the option to receive the same comprehensive care provided to those who receive bariatric surgery. This includes support from a team of experts in nutrition, psychology, exercise physiology, endocrinology and any other medical specialties you may need for long-term success and better health.

Why choose Ohio State for your nonsurgical endobariatric procedure?

  • We were the first and still one of only a few health care centers in central and southern Ohio offering nonsurgical endobariatric procedures, and our providers are well-renowned endobariatric experts.
  • As a program within one of the nation’s largest academic health care centers, we can help with all the challenges and complications of weight loss, including the long-term support you may need to make positive lifestyle changes.
  • Whatever your health concerns, we can refer you to a team of experts in nearly any medical specialty, offering care at convenient locations that are close to home.
  • Even when your care is handled by different specialists, we coordinate treatments and communicate across teams, so you receive personalized care that’s matched to your needs.
  • If we decide together that surgery is a better solution for you, we can easily refer you to our experienced team of surgeons who perform more than 600 bariatric surgeries each year, of which 95% are minimally invasive. To be considered for bariatric surgery, you must have a body mass index (BMI) of 35 or more. To learn more, view this video.

Who qualifies

If you have a BMI of 30 or higher, you may benefit from a nonsurgical endobariatric procedure if one or more of the following is true:

  • You’ve been unable to lose weight or maintain weight loss with diet and exercise alone.
  • You’ve been on weight loss medications, such as GLP-1 inhibitors, and are not reaching your weight loss goals or can’t tolerate the medication.
  • You’re not a candidate for bariatric surgery.
  • You qualify for, but don’t want, bariatric surgery.
  • You’ve had previous weight loss surgery but have regained the weight despite meeting the recommended diet and exercise goals.
  • You’ve developed a complication from or did not benefit from a prior bariatric procedure.

Similar to bariatric surgeries, endoscopic weight loss procedures require a commitment to a healthier lifestyle, which include changes to a person’s diet and regular exercise to help them achieve long-term weight-loss success.

Endobariatric options

The endoscopy specialists at Ohio State offer different nonsurgical weight loss options. They can answer questions about each procedure and provide a recommendation on which might be best for you.

Endoscopic sleeve gastroplasty

An endoscopic sleeve gastroplasty (ESG) uses sutures, which are placed using an endoscope, to reduce the size of the stomach up to 70%. You’ll feel fuller more quickly, which makes it easier to restrict calories.

Gastric balloon placement

Among the more common endobariatric procedures, this treatment involves placement of a small gas- or fluid-filled balloon that takes up approximately 1/3 of your stomach. This makes you feel fuller, your stomach empties more slowly and the levels of key hormones that help with weight loss increase. The balloon remains in your stomach for six months and is then removed with a short endoscopic procedure. During the time the balloon is in place (and after removal), you’ll receive diet and exercise coaching from our team of experts.

Revision of prior weight loss procedures

If you’ve already had weight loss surgery but did not lose or regained weight, there are several nonsurgical procedures that may provide the lasting results you want.

Transoral outlet reduction (TOR-e)

If you’ve had gastric bypass surgery, weight regain can happen when the gastric pouch and/or gastric outlet (the opening between your gastric pouch and small intestine) expands over time. A TOR-e involves placement of stitches to retighten these areas. If the gastric pouch is large enough, a pouch reduction is typically done at the same time.

Revision of sleeve gastrectomy

Sometimes called a “re-sleeve” or “sleeve-in-sleeve” (SIS), this nonsurgical procedure further reduces the size of an already existing gastric sleeve. This is done by using the flexible endoscope to place stitches in new tissue folds that will make the sleeve portion of the stomach narrower.

Revision of endoscopic sleeve gastroplasty (RE-ESG)

Although rare, if sutures break following an endoscopic sleeve gastroplasty, we can restore the tissue folds and reinforce the area with new stitches that are placed using a nonsurgical endoscope.

Endoscopic management of surgical complications

With our wide variety of endoscopic devices and techniques, including suturing, stents and clips, we can diagnose and manage your gastrointestinal concerns after surgery, such as gastrointestinal strictures, fistulas, leaks or perforation. Using endoscopic ultrasound, we can also help manage bile duct, pancreas and gallbladder issues after gastric bypass surgery.

Our Team

Where will I be seen?

For initial physician consultation and follow-up appointments, you'll be seen at Martha Morehouse Outpatient Care or Doan Hall/University Hospital. For outpatient endobariatric procedures, you'll be seen at University Hospital.

Will my insurance pay?

When considered medically necessary, some insurance companies may pay for bariatric procedures. If you are required to self-pay, you will be given an estimate before the procedure, and we can work with you to establish a payment schedule.

All procedures include one year of aftercare, including support from a dietician and exercise physiologist.

General self-pay guidelines (as of October 2024) are:

  • Endoscopic sleeve gastroplasty: approximately $12,462
  • Endoscopic revision of prior bariatric intervention: approximately $11,445
  • Gastric balloon placement (and removal 6 months later): $6,700

Steps to get started

We are happy to answer any questions you might have about endobariatric weight loss procedures. To see if nonsurgical weight loss is right for you, we can also schedule an evaluation appointment.

Please call us at 614-293-6255 to schedule a consultation.

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