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Frequently Asked Questions: Endoscopic Weight Loss Treatment

General
Which endoscopic weight loss procedure is right for me?

Weight Loss Balloons
How do intragastric balloons work?
Are there any side effects I should know about?
Are weight loss balloons safe?
How effective are weight loss balloons?
Am I a candidate for weight loss balloons?

Endoscopic Sleeve Procedure
What happens during an endoscopic sleeve procedure?
Who is a good candidate for an endoscopic sleeve procedure?
What kind of results can I expect with an endoscopic sleeve procedure?
What risks are associated with the endoscopic sleeve?

Aspiration Therapy
What is aspiration therapy and how does it work?
How long does aspiration therapy take?
How well does aspiration therapy work?

Therapies for Weight Regain
What causes weight regain after surgery?
How can endoscopy therapy help with post-bariatric weight gain?

Which endoscopic weight loss procedure is right for me?

The decision to pursue non-surgical weight loss therapy, and which procedure is ideal for each patient, is multifaceted, factoring in a balance of patient comfort with the relative invasiveness of each procedure, any co-morbid medical conditions and the patient's desired weight goals.

For instance, weight loss balloons are ideal for patients looking for a way to jump-start their weight loss with the least invasive, most reversible procedure. This procedure would not be recommended for those with a prior history of stomach surgery, but they might still qualify for endoscopic suturing as an alternative option.

Additionally, weight loss goals are a large factor in deciding the best solution for each patient. While overall weight loss is dependent on several factors, generally the endoscopic sleeve gastroplasty and aspiration procedures appear to result in more weight loss, with emerging data also suggesting that the weight loss may be more long-term.

We recommend that any patient interested in an endoscopic weight loss procedure should come to one of our clinics to discuss the risks and benefits of all the options and personalize their treatment plan.

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Weight Loss Balloons

How do the intragastric balloons work?

These balloons are placed into the stomach in a simple, non-surgical, 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 20-30 minutes, and typically patients are discharged home after two hours of recovery.

Are there any side effects I know should about?

Some patients may experience abdominal discomfort and/or nausea/vomiting for the first 1 to 2 weeks, however this can often be controlled with medications and typically improves after the first week.

Are weight loss balloons safe?

Although the balloons have only been approved in the United States for a little over a year, gastric 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 anytime.

How effective are weight loss balloons?

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

Am I a candidate for weight loss balloons?

The weight loss balloon procedure is designed for patients who are obese, having a body mass index (BMI) of greater than 30, who are not ideal candidates for, or do not desire, bariatric surgery. On a case-by-case basis, we can do these procedures on patients who are overweight (Body Mass Index of 27 or higher).

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Endoscopic Sleeve Procedure

What happens during an endoscopic sleeve procedure?

While you are asleep, the physician places an endoscope into your mouth, advanced down the esophagus and into your stomach. The suturing device is attached to the endoscope and allows the insertion of sutures in a specific pattern to constrict the stomach, resulting in a “sleeve” shape.
This series of sutures is then tightened, constricting the overall usable volume of the stomach. Patients generally go home the same day or the following day after an overnight admission. They are instructed to follow a specific diet for a brief amount of time afterward. Once a patient's stomach volume is restricted, he/she will consume smaller portions of food. In conjunction with diet and exercise, the endoscopic sleeve can result in weight loss ranging from 40 to 60 pounds.

Who is a good candidate for an endoscopic sleeve procedure?

The endoscopic sleeve gastroplasty procedure is designed for patients who are obese, having a body mass index (BMI) of greater than 30, who are not ideal candidates for, or do not desire, bariatric surgery.

What kind of results can I expect with an endoscopic sleeve procedure?

The endoscopic sleeve gastroplasty (ESG) is one of the most effective endoscopic procedures for primary weight loss. On average, patients on average lose 40 to 60 pounds, or nearly 20 percent of their body weight. Recent research has demonstrated that the weight loss achieved with the ESG procedure can last for greater than 2 years. The sleeve also has been demonstrated to improve other medical complications brought on by excess weight, including cholesterol, diabetes and high blood pressure.

What risks are associated with the endoscopic sleeve?

The endoscopic sleeve procedure should be considered internal, endoscopic surgery. The rate of major complication associate with the endoscopic sleeve is very low (2 percent), but some patients might experience abdominal pain, nausea/vomiting and constipation and may need to be observed overnight in the hospital to manage symptoms.

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Aspiration Therapy

What is aspiration therapy and how does it work?

After anesthesia puts the patient 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 percent of your meal into the toilet through this tube. This prevents those calories from being absorbed into the body, but still retains enough food so the body receives the calories it needs to function.

How long does aspiration therapy take?

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.

How well does aspiration therapy work?

By the end of six months of aspiration therapy, patients lose on average about 40 percent of their excess weight.

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Therapies for Weight Regain

What causes weight regain after surgery?

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.

How can endoscopy therapy help with post-bariatric weight gain?

Endoscopic therapies, such as endoscopic suturing, are non-surgical procedures for reducing the size of the stomach pouch or sleeve for patients who have gradually stretched their stomach after weight loss surgery. 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 tightening 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 revision of bariatric surgery 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, that is the time to contemplate scheduling a consultation.

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