Endoscopic Weight Loss Therapies

Thanks to advances in endoscopy—the insertion of a flexible tube with a camera at its tip into the mouth and esophagus to see the digestive tract and perform procedures—more people with excess weight, diabetes, and related conditions such as high cholesterol or sleep apnea can receive weight loss treatments that work with diet and exercise to improve their health. If you carry excess weight despite diet and exercise but do not qualify for bariatric (weight loss) surgery, you may be able to have an endoscopic weight loss treatment such as sleeve gastroplasty or an intragastric balloon. NewYork-Presbyterian’s interventional endoscopists have exceptional experience performing these procedures and work as part of a team to help you lose weight and improve your health.

Who Can Have an Endoscopic Weight Loss Therapy?

You may be able to have an endoscopic weight loss procedure if you are obese, but not morbidly obese (body mass index, or BMI, between 30 and 40). Examples include people who have:

  • A BMI of less than 40 without other medical problems.
  • A BMI of 30-35 with high blood pressure, high cholesterol/triglycerides, type 2 diabetes, or sleep apnea.
  • Large amounts of abdominal scarring from injuries or previous procedures, preventing surgeries.

The Advantages of Endoscopic Weight Loss Procedures

Compared to surgical procedures, endoscopic procedures offer an easier recovery, less discomfort, no abdominal scars, and a faster return to your normal daily activities. Many endoscopic treatments are reversible. These approaches allow us to offer solutions to help many more people struggling with obesity.

You can often go home the same day, and you would follow a liquid diet for a brief amount of time after the procedure. An endocrinologist (hormone specialist) and registered dietitian work closely with your team to monitor your food intake and metabolic health before and after these procedures.

Leaders in Endoscopic Sleeve Gastroplasty

NewYork-Presbyterian/Weill Cornell Medical Center was one of the first centers in the country to perform endoscopic sleeve gastroplasty (also called the “scarless sleeve”, endoscopic suturing, endoscopic sleeve, accordion procedure), and published some of the earliest research on the effectiveness of this procedure.

  • How it is performed. During the procedure, for which you would be under general anesthesia, the endoscopist advances an endoscope through your mouth into your stomach, and inserts sutures in a specific pattern from the bottom of the stomach to the top. The sutures are tightened in an accordion-like fashion, reducing the amount of space in your stomach for food.
  • Sleeve gastroplasty effectiveness. Many people lose 30 to 60 percent of their excess body weight within six month to 12 months of the procedure, and typically experience improvements in diabetes, high blood pressure, and sleep apnea.

Endoscopic Intragastric Balloon

The intragastric balloon takes up space within your stomach, limiting the amount of food you can eat during a meal.

  • How it is performed. Balloon placement depends on the type, you may either swallow the balloon or the endoscopist uses an endoscope to advance the uninflated balloon through your mouth and down your esophagus. After the balloon is in place in your stomach, it is filled with saline or a special gas, expanding to the size of a softball or grapefruit.
  • Intragastric balloon effectiveness. Designed for short-term use of six months or less, the intragastric balloon can help you lose more weight than diet and exercise alone. People who receive an intragastric balloon coupled with a healthy diet and exercise program can lose over two times as much weight after a year compared with diet and exercise alone. Many have reported better quality of life, too, including reduced bodily pain and more energy.

Aspire Assist Device

The aspire assist device is a tube inserted in the stomach, that helps you aspirate the food, limiting the amount of the food you absorb after the meals.

  • How it is performed. A thin tube is inserted into the stomach via an endoscope, which connects the inside of the stomach directly to a discreet button on the outside of the abdomen. There is then a tube and device combo which is attached when the “emptying” process begins. The entire device is the size of a smartphone and comes with its own small stowaway case afterward.
  • Aspire assist effectiveness. Patients can expect to lose 25% of their excess body weight at one year.

Investigational Weight Loss Treatments

Several other balloon and other endoscopic weight loss devices are under investigation. These devices include devices that:

  • Restrict food from entering the small intestine
  • Provide a barrier between food and the intestine, improving blood sugar levels in people with diabetes and aiding in weight loss
  • Help people to feel full by putting pressure on the wall of the stomach
  • Allow food to be emptied from the stomach before it can be absorbed

Your doctor will let you know if any of these techniques is an option for you.

Contact

Center for Obesity Surgery
NewYork-Presbyterian/Columbia

Phone: 212-305-4000

Weight Loss Surgery Program
NewYork-Presbyterian/Weill Cornell

Phone: 212-746-5294