Not every path to weight loss requires surgery. Endoscopic Sleeve Gastroplasty (ESG) uses advanced endoscopic techniques to reshape the stomach from within, offering a proven, lower-risk way to achieve meaningful, lasting weight improvement.
Weight management can be one of the most challenging health journeys, especially for individuals living with obesity, metabolic conditions, or the emotional toll of repeated weight fluctuations. Thanks to medical innovation, there is now a less invasive option that bridges the gap between lifestyle change and surgical intervention: Endoscopic Sleeve Gastroplasty (ESG).
At Sri Kota Specialist Medical Centre, Dr. James Emmanuel, Consultant Gastroenterologist & Hepatologist, offers ESG as part of a holistic, medically guided approach to weight management, focusing not just on weight loss, but on long-term health improvements and confidence in daily living.
Understanding Endoscopic Sleeve Gastroplasty (ESG)
ESG is a non-surgical weight loss procedure performed from inside the stomach using an endoscope, which is a flexible tube inserted through the mouth. During ESG, sutures are placed to reshape the stomach into a smaller, sleeve-like structure, reducing its volume and limiting food intake.
Unlike bariatric surgery, ESG involves no external incisions or visible scarring, and most patients are able to return to normal activities within just a few days.
By reducing stomach capacity, ESG helps individuals feel full faster and eat smaller portions comfortably. Over time, this supports gradual, steady weight loss, which is more sustainable than rapid weight drop methods.
ESG may also support improvements in blood sugar, cholesterol, blood pressure and liver function.
Multiple peer-reviewed studies report an average of ~15–20% total body weight loss at 12 months when ESG is combined with nutrition and lifestyle support.
Why This Matters Now
Obesity is not simply a cosmetic concern. It is a major global health issue. According to the World Health Organization, adult obesity worldwide has more than doubled since 1990, and adolescent obesity has quadrupled in the same period. In 2022, an estimated 2.5 billion adults aged 18 and above were overweight, and 890 million of them were living with obesity.
In Malaysia, obesity remains a significant public health challenge. The National Health and Morbidity Survey (NHMS) reports that 50.1% of Malaysian adults are overweight or obese, with 30.4% categorised as overweight and 19.7% living with obesity (BMI ≥ 25 kg/m²).
Excess weight is closely linked to conditions such as:
- Type 2 Diabetes
- Hypertension
- High cholesterol
- Heart disease
- Fatty liver disease
- Sleep apnoea
For some, traditional bariatric surgery may be too invasive, medically unsuitable, or simply not the right fit. ESG provides an intermediate, minimally invasive alternative. One that is medically supported and designed for long-term habit building.
What to Expect: The Patient Journey
- Consultation & Assessment Understanding your goals, lifestyle, and medical history is the first step.
- The Procedure Performed under sedation; typically, 60–90 minutes; no incisions.
- Recovery Most patients return to daily activities within a few days.
- Support for the Long Term Sustainable results happen when ESG is paired with:
- Dietitian support
- Behavioural coaching
- Activity planning
- Regular follow-up reviews
At Sri Kota, weight management is treated as a collaborative process and not something patients are expected to do alone.
Who May Be a Suitable Candidate?
ESG may be considered for individuals who:
- Have struggled with weight loss despite lifestyle efforts
- Prefer a non-surgical option
- Want a shorter recovery and no external scars
- Are committed to engaging in follow-up nutritional and lifestyle support
A consultation with a specialist helps determine suitability based on health profile, goals, and expectations.
A Holistic Approach, Expertly Guided
As Dr. James Emmanuel explains, ESG is not just a procedure, it is a pathway.
“ESG offers a meaningful starting point for patients who need medical support in their weight loss journey, but want to avoid surgery. The key to success is ongoing guidance, personalised nutrition, and steady lifestyle change.”
If weight has felt like a difficult journey, you do not have to navigate it alone. Sri Kota’s ESG Package provides medical guidance, nutrition support, and structured follow-up to help you move forward with confidence.
If you have any concern, do contact us at 03-3375 7799 @ ext 7258
by Dr. James Emmanuel A/L Gilbert Fernandez, Consultant Gastroenterologist & Hepatologist