Weight Loss Procedure


Everything you need to know about the Endoscopic Sleeve Gastroplasty weight loss procedure, from experts in bariatric surgery.

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Endoscopic Sleeve Gastroplasty (ESG)

Non-invasive surgery which restricts the stomach’s capacity by 80%. This reversible treatment slows the stomach from emptying, keeping you fuller for longer. This offers similar weight loss benefits but without the surgery or scars. It is also a safer, lower-risk procedure performed as a day case in around two hours under general anaesthetic.

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Lowest published complication rates in the UK

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UK’s most comprehensive aftercare package

Health benefits of the ESG


of type II diabetics are cured


of patients with hypertension reduce or stop medication


will have improvement in cholesterol levels


will have improvement in reflux symptoms

The major benefit of the ESG is that it is performed endoscopically with a stitching device placed into the stomach through the mouth. This means that, unlike surgery, there is no cutting or stapling, no scarring and no wounds. Therefore patients benefit from a faster recovery time and lower post-operative risks, both incidence rate and severity.

Studies also show that the rate of complications with ESG is low too. One study showed the post-operative complication rate to be as low as 2.4% (AlQuatani et al December 2018).

Through losing weight ESG patients will enjoy the same benefits that accrue from weight loss with any procedure, including improvements in

Like the gastric band, health improvements will come steadily over time as you lose weight. The sleeve and bypass procedures are a little different because they offer immediate health improvements by changing the anatomy of the stomach. So if you are managing existing health issues associated with your weight, the sleeve or bypass are options you should consider as well as the ESG.

At Healthier Weight we are the first UK clinic to offer the traditional surgical sleeve and a new non-surgical alternative, the Endoscopic Sleeve Gastroplasty (ESG).

What is a ESG

The ESG is an exciting development in obesity treatment that offers people a safe and effective alternative to the established weight loss options. Its main attraction is that it is non-surgical so people benefit from a lower risk profile and faster recovery time.

The technique we use for ESG was developed by Mr Jamie Kelly, Bariatric Surgeon, at our centre of excellence in Southampton. Mr Kelly is a world leader in ESG and sits on the manufacturer’s European Advisory Board. Mr Kelly has developed an ESG technique known as Longitudinal Compression and it’s with this technique that ESG patients can benefit from more sutures than with the traditional technique. Therefore, Mr Kelly’s approach is now shown to deliver better weight loss outcomes and with very low complication rates. You can book to have your ESG procedure in London or Southhampton

UK’s most comprehensive aftercare package

ESG Procedure

Endoscopically procedure using a device called an Overstitch.                       

Dedicated Support

Our range of nutritionists, Health Coaches and support team are here to help every step of the way                  

Weight Loss Tools

Videos and live classes on diet, fitness, retraining behaviours, composition scales and activity tracker.

How does the ESG work?

The ESG works in two ways:

  1. Restriction – The capacity of the stomach is restricted so it holds less, and
  2. It slows gastric emptying. This means the food you eat stays in the stomach a little longer.

The ESG produces a narrower, shorter stomach and leaves a small pouch at the top of the stomach. No stomach is removed and the nerve supply remains intact. The food enters the pouch causing distention. This distention causes the stretch receptor nerves to fire impulses to the brain making patients feel full. The stretch receptors also fire impulses to the bottom of the stomach to delay its emptying. The patient uses the feeling of fullness to portion control and the delayed emptying mean patients feel fuller for longer. The procedure turbo charges the body’s normal physiology without the need to remove any of the stomach. Therefore we do not see the nutritional deficiencies or gastroesophageal reflux seen with other weight loss procedures.

Meet Laura,
A Patient Care Coordinator at Healthier Weight

My role is to support you with starting your weight-loss journey with Healthier Weight. During our conversation, we will explore the choices available to you and address any questions and concerns you may have. When you feel ready to move forward, we will arrange a free, no obligation consultation with one of our surgeons.

Weight loss with the ESG

The weight loss results with ESG are excellent. Initially we were seeing weight loss similar to that for gastric band at 50-60% excess weight loss after 2 years, however the latest results are more encouraging. The Longitudinal Compression technique used is now delivering over 50% excess loss in the first 6 months which is comparable to surgical sleeve and gastric bypass.

We always stress to patients that we need to wait to see long term results, 5 years plus, to be satisfied with the long-term benefits of the procedure but the fact we are seeing over 50% at 6 months and generally 60% at 2 years is very positive. It is too early to tell but we expect that the technique used will encourage enduring weight loss as well as good results for the short term.

As with all weight loss procedures, there is a small proportion (about 10-20%) for whom the procedure is unsuccessful and for whom it is best to consider a surgical procedure.

The evidence we have suggests people can expect to lose about 15-18% of their starting weight (generally half of their excess weight) over a 12-18 month period*. At this stage, because this is still a new procedure, longer term weight loss results are not available.

The weight loss results in the chart below are the published results from a study of 248 ESG patients. They show average total body weight loss (TBWL) as a percentage of the starting weight. Also, we’ve shown how much weight this equates to assuming different starting weights.

In summary, based on the published data you can expect to lose just over half of your excess weight after 24 months. This is similar to the weight loss with a gastric band but as we said above, the latest results with the new technique are comparable to surgical sleeve and bypass.

Weight loss
% of starting weightStart weight 16stStart weight 20st
At 6 months15.2%*34lbs43lbs
At 18 months18.6%*42lbs52lbs

Based on a group of 248 patients with a mean starting BMI of 37.8

Here is a summary of published weight loss data:

ParticipantsAvg weight loss at 2 years
Alqahtani et al160015-20%
Lopez-Nava et al24818.6%
Sharaiha et al9120.9%

In the Lopez Nava study we saw that nearly all of the weight loss was achieved in the first 6 months

ESG Success Stories

Ceri’s Transmission 

Lost 3.5 Stone

“I felt really looked after, so I’m really pleased I went with Healthier Weight” 

Healthier Weight Starter Kit

How much is the ESG?

The price for an ESG may vary depending on location and medical history but the price is very similar to that for the surgical sleeve. This reflects the fact that hospital, surgeon and anaesthetist costs are the same. 

Common FAQs

Here is a rather detailed description of the ESG procedure. Please call if you have any questions about it. 

The ESG is an endoluminal procedure that is performed under general anaesthesia.  It is intended to mimic the sleeve gastrectomy, reducing the gastric lumen (stomach capacity) by 80% using a series of stitch plications along the length of the stomach from the incisura up to and including a portion of the fundus. The procedure involves placement of full thickness stitches using a Helix device.

The suture is carried across from the posterior wall back to the anterior wall and the stitch pattern is repeated, gathered, then ‘cinched’ (stitched).  Stitches on the anterior and posterior gastric walls are commonly placed at approximately mid-wall and 6-8 plications in total are usually made. The stitching approach may vary slightly from surgeon to surgeon. Your operating surgeon can provide more detail on this at your consultation. At the completion of the procedure the “sleeve” lumen is usually 1-1.5 cm in diameter. 

We offer the ESG at Southampton and King Edward VII, London, with Mr Kelly. We were the first centre in the UK to offer this procedure. In time, we expect the procedure to be rolled out to other Healthier Weight centres. Mr Kelly is happy to offer consultations over the telephone or by Zoom but patients would have to travel to Southampton or London for pre-operative assessment and for their procedure. 

The procedure was developed in the United States some years ago and trials have been conducted in the US, South America and Europe. The procedure was launched in the UK in January 2016.

It’s impossible to predict accurately because weight loss results vary by patients. The studies we have available show patients, on average, achieving about 50% excess weight loss. Of course, there are some patients who lose nearly all of their excess and others who lose little. This is true of all the weight loss procedures. For optimal results you will need to make changes to your diet and eating behaviours, and the procedure will support you to make these changes. We would say exactly the same to patients having a gastric band, sleeve or bypass procedure.

We’ve partnered with Ideal4Finance, to enable our patients to spread the cost of their procedure with manageable monthly payments.*

The application process is simple and patients have access to a varied, competitive panel of secured and unsecured lending options offering competitive APRs.

The surgeon is Mr Jamie Kelly. Mr Kelly is a consultant surgeon at Southampton NHS Trust and has his NHS practice at Southampton General Hospital. He is a very experienced bariatric (weight loss) surgeon. He does his private ESG procedures at the local Spire Hospital. Mr Kelly was selected to be the first surgeon for ESG in the UK because of his skill and experience with invasive endoscopic surgery, a field in which he specialises.

What is right for you will depend on your personal circumstances. We will be pleased to talk you through the pros and cons of each procedure in order that you can decide on the option that is best for you. Also, when you come in for consultation we can answer your questions and make sure you are clear on the route that is best for your personally.  

All Weight loss procedures carry an element of risk and ESG is no exception. Early complications of ESG include haemorrhage, anaesthetic reaction, pneumoperitoneum, pneumo thorax, fever, peritonitis and abdominal pain. Beyond 4 days they include pneumoperitoneum and pulmonary embolus/deep vein thrombophlebitis and ‘later’ complications might include pulmonary embolus, abscess and seroma. It’s important to remember that all hospital procedures carry an element of unpredictability, also that over time the complications associated with a procedure, especially a new procedure such as the ESG, may change.

Image of consultant bariatric surgeon, Mr Rishi Singhal

All content on this page is reviewed by a multi-disciplinary team led by Prof Rishi Singhal.

*Weight To Go Ltd is an Introducer Appointed Representative of Ideal. Sales Solutions Ltd, t/a Ideal4Finance. Ideal Sales Solutions Ltd is a credit broker and not a lender. Finance available subject to status

** Monthly Deferred Instalments will be collected via Direct Debit or Credit/Debit cards.  Terms and conditions relating to these recurring payments are included within the credit agreement and procedure terms and conditions supplied at the time of booking.

***Weight To Go Ltd is an Introducer Appointed Representative of Ideal. Sales Solutions Ltd, t/a Ideal4Finance. Ideal Sales Solutions Ltd is a credit broker and not a lender. Finance available subject to status


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