UT Health Physicians
MyChart

Bariatric Endoscopy

Doctor speaking with bariatric endoscopy patient

 

Bariatric endoscopy is a treatment for obesity without traditional surgery. It is an option for patients who are not a good fit for or decline surgery. Bariatric endoscopy is minimally invasive and requires no external incision. You can return home the same day and recover more quickly.

Obesity rates in South Texas are much higher than the national average with nearly 47% of residents being extremely overweight compared to 34% nationwide. Supporting our community in overcoming this epidemic, UT Health San Antonio offers some of the region’s most advanced bariatric endoscopy procedures.

What is bariatric endoscopy?

Bariatric endoscopy is a minimally invasive weight-loss treatment for people with obesity. It is done using an endoscope, a long, thin tube with a camera on the end. Doctors place internal sutures in the stomach through the endoscope to perform the procedure. It has significantly fewer side effects and a lower risk than bariatric surgery.

Why choose us for bariatric endoscopy in San Antonio

There are several reasons to choose UT Health San Antonio for bariatric endoscopy, including: 

  • Advanced endoscopy close to home: Bariatric endoscopy is done by our nationally and internationally known endoscopists in UT Health San Antonio’s Advanced Interventional Gastroenterology (AIG) Clinic.
  • Clinical collaboration: Our advanced endoscopy doctors work with a team of clinicians, including endocrinologists, surgeons, dieticians and psychologists, when necessary, to take a comprehensive approach to your care.
  • Insurance coverage: At UT Health San Antonio, we work with many insurance plans. Before your procedure, our team will check your insurance and let you know what is covered. At most other centers, bariatric endoscopy is not usually covered by insurance.
  • Ongoing support: You will continue to receive direct, one-on-one support for a full year after your procedure to guide you on your path to recovery.

What to expect with bariatric endoscopy

After the procedure, patients typically lose 15-17% of their body weight within one year.

You will have a follow-up appointment after the procedure, so your care team can review any pain or side effects you may have. Your care team will continue to follow up with you periodically for the next year after your procedure. They will help you adjust to new eating and exercise habits so you can maintain success in your weight loss journey.

Frequently asked questions about bariatric endoscopy

  • What types of bariatric endoscopic procedures are there?

    UT Health San Antonio offers four types of bariatric endoscopic procedures. Your doctor will evaluate the specifics of your situation before making a recommendation. Requirements for surgery may not be identical for each person, even if they’re having the same procedure. But there are general requirements you need to meet.

    • Endoscopic sleeve gastroplasty (ESG): During ESG, a doctor sutures (stitches) the stomach to decrease its size. This limits its capacity for food, causing patients to eat less and stay full longer. The procedure is done through the mouth, so no incision is needed. Minimum requirements you need to qualify:
      • Body mass index (BMI) of 30 or more.
      • Other weight loss methods, including diet, exercise and medication, are unsuccessful after at least six months.
      • You’re committed to long-term lifestyle changes such as healthy eating and regular exercise.
    • Intragastric balloon: In this procedure, a balloon is placed within the stomach and filled with saline (salt water). The balloon takes up space in the stomach to help patients feel full while eating less and stay full longer. Doctors remove the balloon after six months, leaving the stomach intact. Minimum requirements you need to qualify:
      • Body mass index (BMI) of 27 or more.
      • Other weight loss methods, including diet, exercise and medication, are unsuccessful after at least six months.
      • You’re committed to long-term lifestyle changes such as healthy eating and regular exercise.
    • Revisional ESG (r-ESG): An r-ESGis done when a patient has either regained weight or lost insufficient weight after a previous ESG or surgical sleeve gastroplasty. The doctor may remove stitches and create a new pattern of sutures. Minimum requirements you need to qualify:
      • You had a previous ESG or surgical sleeve gastroplasty.
      • Your weight loss was insufficient, or your extra weight came back.
    • Transoral outlet reduction (TORe): TORe is a revisional procedure for people who have regained weight after a previous gastric bypass surgery. During the procedure, the doctor decreases the size of the opening between the gastric pouch (created during the bypass) and the small intestine. To access the area, they pass an endoscope through the mouth and then stitch (suture) the bypass opening to make it smaller. This slows down the emptying of food from the stomach, so you feel full longer. Minimum requirements you need to qualify:
      • You had a previous gastric bypass surgery.
      • Your weight loss was insufficient, or your extra weight came back.
  • Can I have bariatric surgery while taking GLP-1 medication?

    Research shows that continuing to take GLP-1 medicines leading up to bariatric endoscopy can lead to longer-term weight loss with fewer side effects in some cases. Talk to your doctor to find out if this is a good option based on your individual circumstances. 

  • How do I prepare for bariatric endoscopy?

    Before bariatric endoscopy, you may meet with multiple specialists including:

    • Dietician, to go over dietary restrictions to follow one to two days before your procedure.
    • Psychologist, in some cases, to ensure you are mentally prepared for the lifestyle changes the procedure involves.
    • Your doctor, to discuss any medications you are taking and confirm you are ready for the procedure.

     

    Afterwards, you will need to be on a special bariatric diet for a few weeks. The first week you will have liquids only. Then you will be on soft foods for the next two weeks.

  • What are the risks of bariatric endoscopy?

    There are very few risks associated with bariatric endoscopy. The rate for major complications ranged from roughly 1-2% according to a 2021 study cited in the National Library of Medicine. Common risks for bariatric endoscopy include:

    • Abdominal pain
    • Nausea
    • Sore throat

     

    These side effects usually last only for a few days. It is also common for people to regain weight after bariatric endoscopy. Some procedures may be repeated in this case.