If you struggle with your weight, you just have to watch television (ads for workout programs and diet plans) or stand at the supermarket checkout (magazine headlines about “the best” way to lose the weight and keep it off) to know that weight loss is a goal for a lot of women. There’s good reason for that: More than two out of every three adults in the United States are overweight or obese.

While diet and exercise can help maintain a healthy weight, some people find it hard to achieve weight loss with these methods alone. For individuals with other conditions, including type 2 diabetes, high blood pressure and heart disease, losing the weight can be critical. Weight loss surgery like gastric bypass has long been recommended in these cases. But not everyone wants or is eligible for this type of surgery. What do you do if you need to lose the weight but traditional weight loss surgery isn’t suitable?

That’s where endoscopic weight loss techniques come in. At the Johns Hopkins Endoscopic Weight Loss Program, minimally invasive techniques offer some alternatives to weight loss surgery.

What is Endoscopy?

Endoscopy is a procedure where doctors insert a thin, flexible tube equipped with a camera through your mouth into your digestive tract. This allows them to access your digestive system without open surgery, which carries higher risk. Before the procedure, the doctor provides medication to make patients sleepy so they don’t feel any discomfort. 

Endoscopic weight loss procedures work by allowing doctors to place special devices or medications into the gastrointestinal tract to limit how much you can eat. Experts note that endoscopic weight loss procedures are a great option between medication and surgery, with better results than medication, but which are less invasive than surgery and carry fewer side effects and risks. 

Unlike bariatric weight loss surgery, which can require months of prep and several days of recovery, endoscopy is a one-day procedure. The amount of weight loss isn’t as dramatic as with surgery, but the entire process typically takes just a few hours. 

Insurance may not cover endoscopic weight loss procedures, nor does it cover nutritional counseling that helps keep patients at a healthy weight afterward. 

Gastric Balloon

One of the most common endoscopic weight loss procedures is the gastric balloon. This treatment places a silicone balloon in the stomach to take up volume. With less room in your stomach, you eat less.

Gastric balloons can make you feel fuller longer. The delay in gastric emptying also helps with fullness. Doctors may use a single balloon or a newer model that looks more like a dumbbell.

Doctors leave the balloon in place for about six months and patients can expect to lose up to 15 percent of their body weight. The procedure is approved for people with a body mass index (BMI) of 30 to 40.

It’s not for everyone: People who have a hiatal hernia or previous gastric surgery are not eligible for the gastric balloon. It’s also not good for people with acid reflux, since it can make symptoms worse. 

Endoscopic Sleeve Gastroplasty

During an endoscopic sleeve gastroplasty, a specialist places stitches inside the stomach to reduce its volume by 70 percent. The patient is completely asleep under general anesthesia for the procedure. The stitches last about a year before the body reabsorbs them.

Patients typically lose about 20 percent of their body weight with this procedure, which has more predictable results than a gastric balloon.

Data show that compared to the gastric balloon procedure, which does not work as effectively in all patients, endoscopic sleeve gastroplasty seems to work well in almost everyone.

Gastric Injections

Gastric injections work by freezing the stomach muscles, which slows digestion and helps patients feel fuller faster. This treatment helps with more moderate weight loss goals, typically leading to a 5% to 10% weight loss. 

It’s also one of the least invasive procedures, requiring a single series of injections in the stomach that you can repeat after six months. 

Practitioners say it takes 10 minutes and is completely painless, noting that the injections may be a good option for those pursuing weight losses for cosmetic reasons, such as weight gain after pregnancy.