Non-Surgical Options For Bariatric Weight Loss

Are you considering weight loss options but not quite ready for surgery? This episode of All About Bariatric Procedures is for you! Host Bailey, a nutritionist specializing in bariatric weight loss, takes an in-depth look at non-surgical solutions designed to help individuals lose significant weight, improve their health, and regain confidence—all without undergoing traditional bariatric surgery.

Non-surgical weight loss devices are becoming increasingly popular as they bridge the gap between lifestyle changes and surgical interventions. In this episode, Bailey explores two of the most effective and widely used options: intragastric balloons and the Endoscopic Sleeve Gastroplasty (ESG). Learn how these tools work, who they’re for, and the results you can expect when paired with a comprehensive weight loss program.

Intragastric balloons are temporary devices that take up space in your stomach, helping you feel full faster and eat less. Bailey explains the different types of balloons available, including swallowable options, and discusses the expected weight loss outcomes, side effects, and recovery process. If you’ve ever wondered whether this procedure could be the right fit for you, this episode answers all your questions.

Endoscopic Sleeve Gastroplasty (ESG), often called the "accordion procedure," is another minimally invasive option that reduces the size of your stomach without requiring surgery. Bailey provides a detailed breakdown of how ESG works, its benefits compared to traditional bariatric surgery, and why it’s becoming a go-to choice for individuals with a BMI between 30 and 40. ESG offers the potential for significant weight loss with a shorter recovery time and fewer risks than surgical options.

But that’s not all—Bailey also dives into the exciting future of non-surgical weight loss. Emerging technologies like vagus nerve stimulation, swallowable capsule devices, and gastrointestinal mucosal ablation (GMA) could revolutionize the way we approach weight management. Discover how these cutting-edge solutions work.

To ensure you get the most out of these tools, Bailey emphasizes the importance of pairing them with a holistic approach. From nutrition counseling and portion control tools to behavioral therapy and regular exercise, long-term success requires a commitment to lifestyle changes. These devices are powerful tools, but they work best when integrated into a comprehensive weight loss program.

In the Q&A segment, Bailey addresses some of the most common listener questions:

• How do I know if I’m a candidate for a non-surgical device?
• How much weight can I expect to lose with intragastric balloons or ESG?

Bailey’s answers are packed with practical advice, and expert insights, to help you make informed decisions about your weight loss journey.

This episode isn’t just about presenting options—it’s about empowering you to take control of your health in a way that works for your unique circumstances. Whether you’re exploring non-surgical devices for the first time or looking for ways to enhance your current weight loss plan, this episode offers actionable tips and resources to help you succeed.

If you’re ready to learn about non-surgical solutions that can transform your life, tune in now. As always, Bailey’s approachable style and evidence-based expertise make complex topics easy to understand and apply.

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Transcript

Hello, everyone, and welcome to another episode of All About Bariatric Procedures! I’m your host Bailey Whether you’re considering bariatric weight loss surgery, have already had it, or are exploring all your options, you’ve come to the right place.

Today, we’re diving into an important topic: non-surgical options for bariatric weight loss. Bariatric surgery is a powerful tool, but it’s not the right fit for everyone. Fortunately, there are several effective non-surgical options for those looking to lose significant weight, improve health, and regain confidence. We’ll explore dietary strategies, medications, medical devices, and behavioral therapies that can make a real difference.

Let’s start with the cornerstone of any weight loss journey—nutrition. Creating a sustainable eating plan is vital. The most effective dietary strategies include:

High-Protein, Low-Carb Diets:
Diets like these focus on maintaining lean muscle mass while burning fat. Protein is crucial for satiety, and lower carbohydrate intake can reduce insulin spikes and cravings.

Calorie Deficits:
While it’s not as simple as “eat less, move more,” creating a calorie deficit remains a foundational principle of weight loss. Work with a dietitian to calculate your needs based on your metabolism and activity levels.

Meal Replacement Programs:
Liquid or pre-portioned meal replacements can be helpful for some people. These programs, often medically supervised, ensure balanced nutrition while keeping calorie intake controlled.

Portion Control Tools:
Tools like portion control plates—yes, I recommend them all the time—can help keep your meals balanced and manageable without feeling like you’re "on a diet."

Next, let’s talk about medical options. The FDA has approved several medications for weight loss, and they can be game-changers when combined with a healthy lifestyle. These include:

GLP-1 Receptor Agonists: Medications like semaglutide (known as Ozempic or Wegovy) mimic a hormone that helps regulate appetite and blood sugar. They’re becoming increasingly popular due to their effectiveness.

Phentermine-Topiramate Combination: This medication helps reduce hunger and makes you feel full sooner.

Naltrexone-Bupropion: It works on the brain’s reward system to reduce cravings and overeating.

These medications are not magic pills—they work best when paired with dietary changes and exercise. They also require careful monitoring by a healthcare provider.

If medication doesn’t feel right for you, there are also non-surgical devices that can aid in weight loss:

Intragastric Balloons:
Intragastric balloons are a well-established option for individuals looking for significant weight loss without surgery. Here’s how they work and what you should know:

How They Work:
These are soft, saline- or gas-filled balloons inserted into your stomach endoscopically, typically under mild sedation. Once in place, the balloon takes up space, reducing the amount of food your stomach can hold and slowing gastric emptying. This combination helps you feel full sooner and stay full longer.

Types of Balloons:

Single Balloon Systems: Examples include the Orbera Balloon, which is one large balloon.
Dual Balloon Systems: The ReShape Balloon includes two connected balloons to enhance stability in the stomach.
Swallowable Balloons: The Obalon Balloon doesn’t require endoscopy for placement. Instead, you swallow a capsule that inflates into a balloon once in the stomach.

Who It’s For:
This option is ideal for people with a BMI of 30-40 who have struggled with other weight loss methods. The procedure is temporary, lasting about six months, after which the balloon is removed.

Results and Considerations:
Patients typically lose 10-15% of their total body weight. However, it’s critical to pair the balloon with structured lifestyle changes to maintain results after its removal. Potential side effects include nausea, vomiting, and abdominal discomfort during the initial days.

Endoscopic Sleeve Gastroplasty (ESG):
The Endoscopic Sleeve Gastroplasty, or ESG, is a newer, minimally invasive procedure that has been gaining attention for its effectiveness and safety. Let’s break it down:

What It Is:
Often called the "accordion procedure," ESG uses an endoscope—a thin, flexible tube with a camera and suturing device—to reshape the stomach. The device folds the stomach in on itself and places sutures to hold it in a smaller, tubular shape.

How It Works:

ESG reduces the stomach’s volume by approximately 70%, limiting the amount of food it can hold.
Unlike surgical options like the sleeve gastrectomy, ESG does not involve cutting or removing any part of the stomach, which means it is reversible if needed.
Who It’s For:
ESG is typically recommended for individuals with a BMI between 30 and 40 who have not responded to diet and exercise alone but don’t qualify—or aren’t ready—for surgery.

Results and Benefits:

Studies show that patients can lose up to 20% of their total body weight within a year.
Recovery time is much shorter than surgery, with most patients resuming normal activities within 1-3 days.
Fewer complications are associated with ESG compared to traditional bariatric surgeries.
Long-Term Success:
As with any weight loss procedure, ESG’s success depends on adherence to a comprehensive program, including dietary modifications, regular exercise, and behavioral counseling.

Emerging Non-Surgical Devices
While intragastric balloons and ESG are currently the frontrunners, innovation in non-surgical weight loss technology is booming. Here are a few promising devices and techniques on the horizon:

AspireAssist:
This device allows patients to partially drain the contents of their stomach after meals through a small, surgically placed tube. While effective, it’s considered controversial and is used selectively. Unfortunately this device is no longer available. 

Vagus Nerve Stimulation:
This technique involves implanting a device that sends electrical pulses to the vagus nerve, which plays a role in regulating hunger and satiety. Preliminary studies show potential for sustainable weight loss.

Capsule Endoscopy Devices:
Similar to swallowable balloons, researchers are developing capsules that release medications or expand to occupy space in the stomach, promoting fullness and reducing calorie intake.

Gastrointestinal Mucosal Ablation (GMA):
GMA involves modifying the lining of the small intestine using a non-invasive endoscopic technique. This approach alters hormonal signaling, which can impact appetite and metabolism.

Both options are typically combined with a comprehensive weight loss program, including nutrition counseling and lifestyle changes.

Finally, let’s discuss the mental side of weight loss. Losing weight—and keeping it off—requires more than just changes to your diet or medications. Here are some effective behavioral strategies:

Cognitive Behavioral Therapy (CBT): This type of therapy helps you identify and change unhelpful thought patterns around food, stress, and body image.

Mindful Eating Practices: Learning to tune in to your hunger and fullness cues can transform your relationship with food.

Support Groups: Whether it’s an online community or a local group, having people who understand your journey can provide encouragement and accountability.

One of the most important things to remember is that non-surgical weight loss options take time and effort. The results may not be as dramatic as surgery, but for many people, these methods are safer, more accessible, and highly effective in the long term.

Consistency is key. Don’t let setbacks derail you—progress, not perfection, is what matters most. And remember, weight loss isn’t just about the number on the scale. It’s about improving your health, mobility, and quality of life.

Regardless of the device chosen, success depends on integrating these procedures into a comprehensive program. Here’s why:

Nutrition Counseling:
Devices like balloons and ESG limit how much you can eat, but they don’t dictate what you eat. Nutrition counseling ensures your meals are nutrient-dense and tailored to your needs.

Behavioral Support:
Addressing the psychological aspects of eating is critical. Emotional eating, stress, and habits formed over years don’t disappear with a smaller stomach—they require active management.

Exercise Plans:
Gradually incorporating physical activity ensures not only weight loss but also improved overall health and fitness.

Regular Monitoring:
Follow-ups with your healthcare team help track progress, address challenges, and adjust plans as needed.

Bailey:
These non-surgical devices are fantastic options for people who want effective weight loss tools without undergoing traditional surgery. Remember, the best path forward is the one that fits your unique needs, lifestyle, and health goals. Always consult with a qualified healthcare provider to explore your options and determine what’s best for you.

Let me know answer some questions we have received from listeners about this topic:

First question is from Julie in Kansas City.  She is wonder “How do I know if I’m a candidate for a non-surgical weight loss device?”

Great question! The first step is to determine your BMI and assess your overall health. Non-surgical devices are typically recommended for people with a BMI between 30 and 40 who have tried other weight loss methods without success. However, these options are also evaluated on a case-by-case basis.

Your healthcare provider will look at factors like your medical history, current health conditions, and weight loss goals. For example, people with certain gastrointestinal conditions or who are pregnant are usually not candidates. A consultation with a bariatric specialist will give you a clearer answer.

Question two is from Ben in Ames:
“How much weight can I realistically expect to lose with these devices?”

While results vary, here’s a general guideline:
Intragastric balloons: Most patients lose about 10-15% of their total body weight over six months.
Endoscopic Sleeve Gastroplasty (ESG): Patients can lose around 15-20% of their total body weight within a year.
Keep in mind, these numbers depend on your commitment to lifestyle changes. The devices provide a tool, but consistent efforts with diet, exercise, and behavioral therapy amplify the results.

Question three is from Sheila in Portland.
“Are the procedures painful, and what’s the recovery time like?”

Both intragastric balloons and ESG are minimally invasive, so pain and recovery are usually manageable. Here’s what to expect:

Intragastric Balloons: After placement, you may experience nausea, vomiting, and abdominal discomfort for a few days as your body adjusts. Most people can resume normal activities within a week.
ESG: Patients might feel mild soreness or bloating for a few days, but the recovery is relatively quick. You’ll likely return to work or daily activities within 1-3 days.
Your healthcare provider will prescribe medications to manage any discomfort and provide dietary guidelines to ease you back into eating.

Question 4 is from Mary in Arizona.
“What happens after the device is removed or if the procedure is reversed?”

This is an important question because maintaining weight loss after the device is removed—or if ESG is reversed—requires a strong commitment to the habits you develop during the process.

For intragastric balloons, they are typically removed after six months. At that point, you should have built a foundation of healthy eating and exercise habits. However, some patients may regain weight if they don’t continue these changes.
For ESG, while reversible, it’s designed to be a long-term solution. If reversed, you’ll need to follow a structured weight management program to maintain your results.
Ultimately, ongoing support from a healthcare team, including a dietitian and possibly a behavioral therapist, is crucial to ensure long-term success.

Next question is from Nancy in Dallas.
“Are these procedures covered by insurance?”

Coverage varies widely depending on your location, insurance plan, and the procedure. Intragastric balloons are often considered a cosmetic or elective procedure, meaning they might not be covered. ESG, as a newer technique, is sometimes covered under certain plans if it’s deemed medically necessary.

It’s a good idea to contact your insurance provider to confirm what’s covered and whether you need prior authorization. Some clinics also offer payment plans or financing options to make these procedures more accessible.

That’s all for today’s episode of All About Bariatric Procedures! If you’re considering non-surgical options for bariatric weight loss, I encourage you to speak with a healthcare provider or nutritionist to determine what’s right for you.

If you enjoyed this episode, don’t forget to subscribe and leave a review. Your feedback helps us create content that’s both informative and empowering. And as always, if you have questions or topics you’d like me to cover, feel free to reach out!

Until next time, I’m Bailey, reminding you to take it one step at a time and to celebrate every victory—big or small.