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What are three barriers to the growing demand for endoscopic sleeve gastroplasty (ESG)?

In the arena of obesity and weight management and treatment, there are many ways to achieve results. However, there is a growing need for those who are afflicted by overweight and obesity and need to lose weight fast for their health and wellness. While many nonsurgical treatments are available for weight loss and management, none provide as dramatic results as endoscopic sleeve gastroplasty, also referred to by its acronym ESG. Patients with excessive weight gain need an efficient and effective way to drop the pounds to get them where they need to be, allowing them the ability to exercise and lead more active lifestyles. Dr. Alexander Shapsis is a board-certified gastroenterologist and Obesity Medicine Specialist in the Brooklyn, New York, and Coral Springs, Florida, areas and provides ESG. But what barriers make it difficult for other practices to embrace this technique? Let’s look closer at understanding ESG and the barriers to adopting it across the United States.

Obesity and Weight Management in Brooklyn Area

Endoscopic sleeve gastroplasty: What is it?

Dr. Shapsis and his team at EndoSlim Clinic of Atlantic Gastroenterology describe endoscopic sleeve gastroplasty (ESG) as a minimally invasive weight loss procedure involving using an endoscope to reduce the stomach size without incisions or permanent changes to the digestive tract. The procedure works by creating a “sleeve” in the stomach, which limits its capacity and allows patients to feel full after eating smaller portions.

ESG has been gaining popularity as an alternative to more traditional weight loss surgeries, such as gastric bypass or laparoscopic adjustable gastric banding. It offers similar results with less risk and complications, making it an attractive option for those looking to lose weight quickly and safely.

However, despite its effectiveness, ESG has not yet become widely adopted by other medical practices, and this is often due to three common barriers: 

  1. Reimbursement milestones. The newly obtained Category 1 CPT code for ESG, which takes effect from January 1, 2026, is a noteworthy advancement in the field, backed by industry brands like Boston Scientific. This milestone underlines the critical clinical importance of ESG and paves the way for doctors, hospitals, and outpatient clinics to get reimbursements. Following this achievement, the focus now shifts towards scaling the endoscopic sleeve gastroplasty process to cater to the increasing demand.
  2. Physician expertise. The complexities of the ESG procedure require practitioners to possess specialized capabilities and education, and the surge in demand has revealed a significant scarcity of proficient service providers. This deficiency has emerged as a crucial impediment. It is critical that ESG methods are simplified to widen their outreach and empower more doctors to administer the treatment safely and efficiently.
  3. Multidisciplinary treatment centers. The number of multidisciplinary obesity care facilities armed with the capability to conduct ESG is continuously growing. These facilities are considered essential in providing more holistic care. However, they encounter challenges in addressing the escalating needs, necessitating more streamlined, efficient processes that uphold the expectations of ESG results.

Where can I learn more about endoscopic sleeve gastroplasty?

Endoscopic sleeve gastroplasty continues to be in demand. Dr. Alexander Shapsis at EndoSlim Clinic of Atlantic Gastroenterology has the experience and training necessary to provide this treatment to those struggling with weight loss and weight management. Call 718 521-2840 to contact one of his four locations throughout Brooklyn, New York, and Coral Springs, Florida, to request an appointment.

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