Considering Medical Weight Loss? 5 ESG Clinics in the United States to Know
Medical weight loss now includes more options than diet plans and bariatric surgery. Prescription medications have expanded treatment choices, while bariatric endoscopy has introduced procedures for people who may need additional support but are not necessarily looking for conventional surgery.
Endoscopic sleeve gastroplasty, or ESG, is one of these options. During the procedure, a physician passes an endoscope through the mouth and uses an internal suturing system to reshape the stomach and reduce its available volume. No abdominal incisions are required.
When comparing ESG programs, the procedure is only one consideration. The physician's experience in bariatric endoscopy, nutritional care, follow-up, location and availability of other weight-management treatments can all influence where someone chooses to receive care.
Here are five U.S. programs currently offering ESG.
1. Everself
Everself has a direct connection to the early development of ESG. Co-founder Dr. Christopher Thompson pioneered the first ESG procedure at Harvard Medical School in 2012 and continued his work in bariatric endoscopy and minimally invasive approaches to obesity care.
Everself has since built its weight-management program around endoscopic procedures, medical care and longer-term patient support. ESG patients have access to registered dietitians and clinical follow-up as they adjust their eating patterns and work toward longer-term health goals.
In Tampa, the ESG program is led by Dr. Ali Abbas, a Harvard-trained bariatric endoscopist. Dr. Abbas completed advanced endoscopy training at Brigham and Women's Hospital and previously served as Director of Bariatric Endoscopy at the University of South Florida.
People exploring Everself Tampa weight loss treatments can discuss several approaches, including ESG, gastric balloon treatment, endoscopic revision procedures and medication-based weight management.
Having multiple options available can make the initial consultation more useful. A patient's health history, previous weight-management efforts, goals and preferences can be considered before a treatment plan is developed.
Everself's history with ESG also gives prospective patients a clear starting point for questions about physician experience, procedural care and the support available during the months after treatment.
2. OSF HealthCare Saint Francis Medical Center, Illinois
OSF HealthCare Saint Francis Medical Center in Peoria offers ESG through its weight-management services for patients in Illinois and the surrounding Midwest region.
Interventional gastroenterologist Dr. Jason Bill performs ESG as part of OSF's endoscopic bariatric program. Patients can also receive support through the RiverPlex Weight Management Clinic, where the care team includes gastroenterologists, dietitians, behavioral health specialists and care coordinators.
Nutrition counseling, educational classes and follow-up appointments are available after treatment. These services can help patients adjust to changes in eating and establish routines they can continue over time.
OSF generally considers ESG for people with a BMI between 30 and 50 who have previously tried approaches such as dietary changes, exercise or weight-loss medications without maintaining the results they were seeking. Eligibility is determined through an individual medical assessment.
For people in the Midwest, OSF provides access to ESG within a regional hospital system while keeping nutrition and behavioral care connected with the treatment program.
3. University Hospitals Weight Loss Management, Ohio
University Hospitals in Northeast Ohio offers ESG within its wider weight-management services.
ESG is performed under general anesthesia. The physician passes an endoscope through the mouth and places internal sutures to reshape the stomach and reduce its capacity without making abdominal incisions.
According to University Hospitals, patients generally return home either the same day or the following day. Follow-up may include physician appointments and dietitian consultations to monitor nutrition and progress.
Patients also have access to other weight-management services within the health system. Someone who initially schedules an appointment to discuss ESG may find that medication, another endoscopic procedure or bariatric surgery is more appropriate based on their medical history and goals.
For people in Northeast Ohio, University Hospitals provides a setting where ESG can be discussed alongside other medical and procedural approaches to weight management.
4. WakeMed, North Carolina
WakeMed offers ESG through its advanced endoscopy services in North Carolina.
Gastroenterologist Dr. Dina Ahmad performs endoscopic sleeve gastroplasty along with other advanced procedures, including transoral outlet reduction (TORe), intragastric balloon procedures and therapeutic endoscopy.
Dr. Ahmad completed an advanced endoscopy fellowship at University Hospitals Cleveland Medical Center/Case Western Reserve University after completing her gastroenterology fellowship at the University of Nebraska Medical Center.
When speaking with an ESG provider, patients can ask how much of the physician's practice involves bariatric or advanced endoscopy, how frequently they perform ESG and how follow-up is managed. It is also useful to know who to contact if concerns arise during recovery.
WakeMed gives patients in the Raleigh area access to ESG through a regional healthcare system with advanced endoscopy expertise.
5. Duke GI Endobariatrics Program, North Carolina
Duke's GI Endobariatrics Program offers ESG through its Durham and Raleigh locations as part of its minimally invasive weight-management services.
The program is directed by gastroenterologist Dr. Alyson Johnson. Care may involve gastroenterology, medical weight-loss providers, bariatric surgery, nutrition and psychology depending on the patient's medical history and treatment needs.
Duke also provides endoscopic revision procedures for some people who experience weight regain after previous gastric bypass or sleeve surgery.
During an evaluation, the care team can consider eating patterns, medical conditions, previous weight-loss treatments, earlier procedures and behavioral health alongside BMI and weight history.
Patients in the Carolinas who want to explore ESG can therefore have the procedure considered within a broader endobariatric and weight-management program.
What should you look for in an ESG program?
Start with the physician performing the procedure. Ask about their training in bariatric or advanced endoscopy, experience with ESG and how frequently they perform it. Patients should also understand how the program manages complications and who is available if questions arise during recovery.
Follow-up care is another important part of the decision. ESG reduces stomach capacity, but patients still need to adjust how and what they eat. Access to a dietitian, regular clinical appointments and behavioral support can help with these changes.
Cost should be discussed before scheduling treatment. Insurance coverage for ESG varies, and quoted prices do not always include the same services. Ask whether the cost includes physician fees, anesthesia, facility charges, preliminary testing and post-procedure appointments.
It is also useful to ask about alternatives. Medical weight management can include nutritional support, prescription medications, endoscopic procedures and bariatric surgery. The treatment recommended should reflect the patient's health history and goals rather than a preference for one procedure.
Finding an ESG program that fits your needs
ESG has expanded the treatment choices available to some people living with obesity. The procedure reduces stomach capacity without abdominal incisions and does not involve surgically removing part of the stomach.
The programs in this list offer different types of care. Everself has roots in the early development of ESG and focuses on endoscopic and medical weight management. OSF Saint Francis connects the procedure with its regional weight-management clinic. University Hospitals offer ESG alongside other weight-loss treatments. WakeMed provides the procedure through advanced endoscopy, while Duke incorporates ESG into its endobariatrics program.
Location may influence the decision, but it should not be the only consideration. Physician experience, follow-up care, nutritional support, cost and access to alternative treatments can provide a clearer picture of what each program offers.
Before scheduling ESG, ask enough questions to understand what happens before the procedure, on treatment day and during the months that follow.
A consultation should also help determine whether ESG is appropriate for your medical history and weight-management goals.
The procedure can be one part of a longer weight-management plan, with ongoing medical care and everyday habits continuing well after the endoscopy appointment.
