The 4 types of non-invasive weight loss procedures

When people want to lose weight, they may consider weight loss surgery but if this feels too extreme, there are other options that are less invasive. This blog post is going to go through non-surgical weight loss procedures, how much weight you’ll lose and what to consider.

I’m going to cover the:

• Endoscopic sleeve gastrectomy (endo sleeve)
• Intragastric ballon
• Duodenal-Jejunal Bypass Liner (endo barrier)
• Gastric band

The endo sleeve:

The endo sleeve, or endoscopic sleeve gastrolasty, is done with an endoscope, which is a thin tube with a camera on the end that is placed in your mouth, down your throat, and into your stomach. The surgeon sews in the inside of your stomach together, making it smaller and tube shaped. 

This means you'll eat less as your stomach is smaller and you’ll feel fuller quicker. 

You are put to sleep for this procedure and there are no cuts made on the outside of your body. This reduces some of the risks of bariatric surgery but the use of an endoscope is not harm free. Complications can include tears inside your stomach (perforation), infection, and bleeding. You’ll likely be put on an anti-acid medication to try and reduce the risk of some complications happening.

The stitches dissolve over time but it is permanent as scar tissue forms where the stomach was sewn together which helps to keep the shape. If the stitches do fail, they can be tightened again by the surgeon. 

The endo sleeve has between 30-60% excess weight loss, or 14-16% total body weight loss after the first year.

Excess weight is the difference between your current actual body weight and your ‘ideal’ body weight at a healthy BMI. 

The intragastric balloon:

The balloon is a shorter term option where a surgeon uses an endoscope to place a small balloon into your stomach. Once the balloon is in place it is then filled with fluid which causes it to expand. This balloon will stay sitting in your stomach and doesn't move through your digestive system into your bowels.

The balloon sitting in your stomach makes you feel full, so you eat less food. It also slows down food leaving your stomach, so again you’ll feel fuller for longer which helps to lose weight. 

It is normally in place for 6 months and can be replaced with the fluid being drained and balloon removed, before another one is placed if needed. There are risks too like perforations, bowel obstruction and stomach ulcers forming.

The weight loss with a balloon is around 40-60% excess weight loss or 13-23% of total body weight lost.

The endo barrier:

The Endo barrier, (formally known as the duodenal-jejunal bypass liner) is a thin tube like liner that is placed into the first part of your small bowel with an endoscope. The liner is made of a long lasting impenetrable material that is anchored in place just after the stomach.

It works by blocking the food you eat from touching the walls of the intestine, where digestion and absorption of nutrients take place. By bypassing the first part of the intestine, you don’t absorb all the nutrients in your food and so lose weight. 

The Endo barrier mimics a gastric bypass but without the need for surgery, although you will be put to sleep for it to be inserted. It’s also reversible - the liner can be removed. I’ve got a blog post here that goes into the surgical options for weight loss.

As the Endo barrier is non surgical, there’s less risk of complications afterwards but things like ulcers, lacerations and obstructions can still occur. It’s not permanent, and the liner is typically removed after a year. 

The average excess weight loss is between 20-40%. It also has the benefits of improving blood sugars in people with type 2 diabetes so can be used solely for this purpose too.

The gastric band:

Gastric bands are a popular weight loss option and have been around for years. It involves placing an adjustable silicone band around the top of your stomach to create a small pouch. This restricts your food intake and makes you feel fuller quicker, as your stomach capacity has been reduced a lot so you need less to fill it. 

It’s done via keyhole surgery but this is to place the band, there is no cutting or rewiring of the digestive system. The silicone band around your stomach can be adjusted as needed over time.

The band does have a higher complication rate with issues like stomach erosions (the band wears away at your stomach wall), slippages (where the band isn’t in the right place and a larger stomach pouch is created), and reflux.

A gastric band can lead to an average of 14% total body weight loss, or between 40-60% excess weight loss.

Comparing the 4 types of non-invasive weight loss methods:

Weight loss procedure	How it works	What to consider	Average excess weight loss
Endoscopic sleeve gastroplasty	-Reduces stomach size -Feel full quicker and for longer	-Permanent  -Placed under general anaesthetic with an endoscope	30-60%
Intragastric balloon	-Feel fuller quicker and for longer	-Reversible -Maximum 6 months in place -Sedated during insertion with an endoscope	40-60%
Endo barrier	-Malabsorption of food	-Reversible -Placed under general anaesthetic with an endoscope -Maximum 12 months in place -Can improve type 2 diabetes	20-40%
Gastric band	-Reduces stomach size -Feel full quicker and for longer	-Placed under general anaesthetic with key hole incision -Reversible	40-60%

All of these options require making changes to your diet and lifestyle. It's not as simple as having the procedure and carrying on as normal. You'll need to change your diet and eating habits, do regular exercise, and potentially take vitamin and mineral supplementation.

If you don't feel that bariatric surgery is right for you, and you've tried every single diet but nothing works, my e-book How To Lose Weight for Good can help. It has tips on how to build a balanced plate, how to make meal planning easy, and how to reframe your mindset to ditch the all or nothing thinking.

I hope you enjoyed this blog post.

Bye for now 👋

References:

https://www.sciencedirect.com/science/article/pii/S187878862400184X?via%3Dihub 

https://pmc.ncbi.nlm.nih.gov/articles/PMC7939770/ 

https://pmc.ncbi.nlm.nih.gov/articles/PMC12457444/#

https://abcd.care/current/what-endobarrier

https://www.ovid.com/jnls/annalsofsurgery/abstract/10.1097/sla.0b013e3181bdfbff~a-multicenter-randomized-efficacy-study-of-the-endobarrier?redirectionsource=fulltextview

https://pmc.ncbi.nlm.nih.gov/articles/PMC9624146/#s0003

https://pmc.ncbi.nlm.nih.gov/articles/PMC7619233/#S14

https://pmc.ncbi.nlm.nih.gov/articles/PMC7154322/

https://pmc.ncbi.nlm.nih.gov/articles/PMC10215716/