A Nonsurgical Weight Loss Solution

Endoscopic therapies are powerful, nonsurgical procedures that can facilitate or enhance weight loss. Though not a cure for obesity, endoscopy, when used properly, can provide an effective way to achieve and sustain weight loss. Patients lose an average of 8% to 20% of their total body weight.

Endoscopic Sleeve Gastroplasy (ESG)

Intragastric Weight Loss Balloon

Aspiration Therapy with AspireAssist

Bariatric Revision — Procedures for Weight Gain After Bariatric Surgery

At the University of Chicago Medicine, we partner with our patients to provide tailored, comprehensive care before, during and after a procedure. Our team provides individualized guidance on lifestyle changes, and our dietitians ensure our patients receive adequate nutritional intake to enhance their success and minimize the risk of nutritional deficiency.

Dr. Christopher Chapman with an endoscopic sleeve gastroplasty (ESG) patient
Dr. Christopher Chapman with an endoscopic sleeve gastroplasty (ESG) patient

What is Endoscopic Therapy? 

Endoscopic therapy uses flexible scopes that are introduced into natural body openings (such as the mouth or throat) without requiring an incision. These endoscopes are often used with both traditional open and minimally invasive procedures to diagnose and treat conditions. This allows patients to heal more quickly, with less pain, so they can return to normal activities faster.

UChicago Medicine has a highly specialized interventional endoscopy program, the Center for Endoscopic Research and Therapeutics (CERT), which ranks among the top in the country as a leader in progressive treatment techniques. The Center for Endoscopic Treatment of Obesity is part of our greater CERT program, bringing that same expertise and innovation to help manage obesity.

Benefits of Nonsurgical (Endoscopic) Obesity Treatment

Patients who choose endoscopic weight loss techniques have several advantages over alternative weight loss options, such as:

  • Faster recovery: Most patients go home either the same day or the following day after the procedure.
  • Incision-free: Endoscopy is performed by inserting the scope through the mouth and into the stomach.
  • Reversible: Physicians do not permanently remove or rearrange the intestinal tract for certain procedures.
  • Improved co-morbidities: Studies have shown weight loss endoscopy can reduce health risks associated with diabetes, high blood pressure, elevated cholesterol, sleep apnea and acid reflux.

Types of Endoscopic Procedures for Weight Loss

As one of the only programs in Chicago currently offering the endoscopic sleeve gastroplasty (ESG) procedure, our Center for the Endoscopic Treatment of Obesity offers patients the latest treatments for nonsurgical weight loss. In addition to performing a wide variety of procedures to best meet our patients' needs, we also offer clinical trials, enabling them to benefit from novel treatment solutions not yet widely available on the market.

We offer several options for patients considering nonsurgical assistance with weight loss, and it's important to know what's available and what to expect.

Endoscopic Sleeve Gastroplasty (ESG) Procedure

The ESG procedure is one of the most effective endoscopic procedures for primary weight loss. On average, patients lose 40 to 60 pounds or nearly 20% of their body weight.

Recent research has demonstrated the weight loss achieved with the ESG procedure can last for more than two years and can improve other medical complications brought on by excess weight, including high cholesterol, diabetes and high blood pressure.

Learn more about endoscopic sleeve gastroplasty

Intragastric Balloon (IGB) Weight Loss Procedure

Often referred to as the “weight loss balloon,” these durable, saline or gas filled balloons are temporarily placed in the stomach for six to eight months to assist healthy weight loss. The shape and volume of the stomach balloon (about the size of a grapefruit) takes up approximately one third of the space in your stomach and encourages smaller portion sizes while helping you feel full. With this approach, patients can experience up to three times the weight loss of diet and exercise alone.

How does an intragastric weight loss balloon work? infographic

In order to provide our patients with the most advanced care, UChicago Medicine is participating in clinical trials, including a weight loss balloon trial. Patients who are interested in pursuing weight loss balloons should talk to their physicians about qualifying for or getting more information about this clinical trial.

These balloons are placed into the stomach in a simple, nonsurgical outpatient procedure. During the procedure, a deflated gastric balloon is inserted through your mouth, down the esophagus and into your stomach. A syringe is then used to fill the balloon with a sterile saline solution to about the size of a grapefruit. The entire procedure takes only about 20 to 30 minutes, and typically patients are sent home after two hours of recovery.

Some patients may experience abdominal discomfort, nausea or vomiting for the first one to two weeks. However, this can often be controlled with medications and typically improves after the first week.

Weight loss balloons have been used for more than 20 years with over 220,000 gastric balloon procedures successfully performed in more than 80 countries. Serious complications are extremely rare, and balloons can be removed at any time. In 2018, the FDA released a safety alert, warning health care providers that there were several patient deaths associated with intragastric balloons. At our practice, we make patient safety the first priority. We believe patient selection and supervision, as well as endoscopist training, can keep our patients safe. Additionally, extensive data reports that the mortality rate with an intragastric balloon is significantly below 1% and ranges between 0.03% to 0.08%.

Weight loss balloons, and all endoscopic therapies, should be considered a tool to help assist with weight loss. Each patient must learn to use the tools effectively to ensure maximum results. The number of pounds lost with the weight loss balloon varies from patient to patient, depending on his or her individual body and lifestyle changes, as with any weight loss endeavor. However, on average, patients can expect to lose approximately 20 to 40 pounds.

Aspiration Therapy with AspireAssist

Aspiration therapy with the AspireAssist is a FDA-approved weight loss solution that reduces the calories absorbed by the body, allowing you to make progressive, healthy changes to your lifestyle.

What is aspiration therapy weight loss? infographic

With AspireAssist, a small tube is placed in your stomach that allows you to aspirate (or evacuate) up to 30% of a meal after eating, preventing those calories from being absorbed into the body and resulting in weight loss.

After anesthesia puts you to sleep, your physician uses an endoscope to place a thin tube in your stomach that connects the inside of your stomach to a small, discrete button on the outside of your abdomen. After each meal, you connect a small handheld device to the button, which allows you to empty up to 30% of your meal into the toilet through this tube. This prevents those calories from being absorbed into the body, but you still retain enough food so the body receives the calories it needs to function.

After eating, patients must wait 20 to 30 minutes before beginning aspiration. Patients can expect aspiration to take between 5 to 10 minutes before the process is complete. The food being emptied from the stomach can be drained directly into the toilet, so patients can perform aspirations in private.

By the end of one year of aspiration therapy, patients lose on average nearly 15% to 20% of their total body weight. However, some patients have had significant success losing over 100 pounds.

One of the most significant advantages of aspiration therapy for weight loss is the ability to control your weight loss journey. This means that depending on the situation, you can decide when to use the device. For example, in some social settings, you may decide not to use the device or want to eat a regular sized portion. In these times, we would suggest trying to eat a lower calorie meal.

An additional benefit is that aspiration therapy is generally considered a reversible option. Once patients have lost a sufficient amount of weight, the device can be removed. However, the site of the tube entrance into the stomach will leave a small scar on the skin.

Bariatric Revision Procedures for Weight Gain After Bariatric Surgery

Although bariatric surgery is often a highly effective tool for weight loss, sometimes patients experience weight re-gain or need bariatric revision. If this occurs, endoscopic bariatric therapies, including endoscopic suturing, are available to help patients by nonsurgically reducing the size of their residual stomach or surgical connection site to assist in losing weight that has been regained.

Some bariatric surgeries reduce the size of the stomach. This helps patients feel full more quickly and eat smaller meals. Over time, the stomach can begin to stretch, enabling the patient to eat more before feeling full and can lead to weight gain.

Endoscopic therapies, such as endoscopic suturing, are nonsurgical bariatric revision procedures for reducing the size of the stomach pouch or sleeve for patients who have gradually stretched the stomach after weight loss surgery such as Roux-en-Y gastric bypass or sleeve gastrectomy. These incisionless procedures place a scope through the mouth and into the stomach once a patient is under anesthesia. Sutures are put in place internally to tighten the stomach or the surgical connection site where it has stretched. This can restore that feeling of fullness and encourage patients to eat smaller meals again.

Patients who undergo endoscopic bariatric revision procedures lose 30 to 40 pounds on average. For maximum results, patients should consider therapy before a significant amount of weight is re-gained. When patients feel loss of restriction, notice an increased tolerance of larger meals, or start regaining weight, it is time to contemplate scheduling a consultation.

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