Endobariatric procedures are suitable for patients who are overweight or obese, who have been unable to lose sufficient weight despite dietary changes and exercise, and who are looking for a gentle, non-surgical alternative.

A soft silicone balloon is inserted into the stomach using an endoscope and filled with fluid. It reduces the volume of the stomach and makes you feel full more quickly.

In ESG, the stomach is reduced in size using endoscopically placed sutures. This creates a tube-shaped form ("sleeve") that holds less food and increases the feeling of satiety.

The procedures are minimally invasive, leave no external scars, and have a lower risk and shorter recovery time than surgical procedures.

Weight loss varies depending on the method, initial weight, and patient cooperation. Studies show that ESG results in an average reduction of approximately 15–20% of body weight in the first year.

Success depends heavily on long-term changes to diet and lifestyle. With good aftercare, the results achieved can remain stable. If necessary, follow-up treatments are also possible to tighten the tissue and restore the original effect.

The costs of a consultation are covered by statutory health insurance. However, the costs of endobariatric surgery are not usually covered. Coverage is usually only possible on a case-by-case basis or with private insurance.

Endoscopic sleeve gastroplasty (ESG) is now a recognized part of the therapeutic spectrum for treating obesity. It is considered an effective, safe, and minimally invasive treatment option for selected patient groups, is supported by leading international professional associations, and is performed by us with scientific monitoring:

Assessment by the International Federation for the Surgery of Obesity (IFSO): In 2024, following a comprehensive systematic review and meta-analysis, the IFSO Committee on Bariatric Endoscopy confirmed ESG as an effective and valuable treatment method for obesity. ESG is particularly suitable for patients with class I and II obesity, as well as for patients with class III obesity who are not eligible for surgical bariatric surgery. Studies show significant weight loss with a low rate of serious side effects. The IFSO emphasizes the importance of careful patient selection and strict long-term observation in order to further refine the indications. The IFSO's position is supported by a randomized controlled trial that provides evidence-based support for the safety and efficacy of ESG (IFSO Bariatric Endoscopy Committee Evidence-Based Review and Position Statement on Endoscopic Sleeve Gastroplasty for Obesity Management, 2024).

Assessment by SOFFCOMM: SOFFCOMM (Society for the Future of Functional and Clinical Metabolic Medicine) also endorses ESG as an effective and valuable treatment option for obesity. The professional association emphasizes that individual indication and evaluation of long-term treatment results are crucial for the sustainable success of the method (SOFFCOMM Position Statement on Endoscopic Sleeve Gastroplasty, 2024; J Visc Surg. 2025 Feb;162(1):71-78.)

Joint guideline from ASGE and ESGE (2024): The American Society for Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal Endoscopy (ESGE) published a joint guideline on primary endoscopic bariatric and metabolic therapies (EBMTs) in 2024.
These guidelines recommend the use of EBMTs (e.g., ESG, intragastric balloons, endoscopic gastric remodeling) in combination with lifestyle modifications in patients with a body mass index (BMI) ≥ 30 kg/m²,
as well as in patients with a BMI of 27.0–29.9 kg/m² if they have at least one obesity-related comorbidity (e.g., high blood pressure, type 2 diabetes). This guideline positions endoscopic procedures as an evidence-based, minimally invasive intermediate option between conservative and surgical therapy, thereby expanding the spectrum of personalized obesity treatment (American Society for Gastrointestinal Endoscopy – European Society of Gastrointestinal Endoscopy Guideline on Primary Endoscopic Bariatric and Metabolic Therapies for Adults with Obesity, 2024).

 
In summary, ESG is recognized by international professional societies as a safe, effective, and reversible method. It is particularly suitable for patients with moderate obesity or those who are not candidates for surgical procedures. ESG should always be combined with professional nutritional and lifestyle counseling. Structured follow-up care and long-term support are crucial for the success of the therapy. We provide standardized scientific support for the new procedure. As a member of the ABE, Vivomed is committed to the quality requirements for bariatric and metabolic treatments, particularly with regard to structured patient selection and education, standardized aftercare programs,
multidisciplinary collaboration between gastroenterology, surgery, nutritional therapy, and psychology,
as well as regular evaluation of treatment results in accordance with the guidelines of the International Federation for the Surgery and Other Therapies of Obesity (IFSO).