A New Non-Surgical Option at BIDMC Helps You Lose Weight and Keep it Off
SEPTEMBER 13, 2019
Center for Bariatric Endoscopy introduces endoscopic sleeve gastroplasty, a team approach to sustained weight loss
Laurie Busa was looking for a new and more successful way to lose weight. As a cardiovascular technologist at Winchester Hospital, she conducts stress tests to measure heart function--and hoped to serve as a better example of good health for her patients.
"It was always easy for me to shed 25 pounds," Laurie says. "I did it over and over, then I’d gain back 35."
Like many who struggle with obesity, Laurie's weight led to other health concerns, including high blood pressure. So she set a goal: lose enough weight to reduce her dependence on blood pressure medication. To do so, she'd need to lose 60 pounds and keep it off. But she soon learned she would not have to conquer this challenge alone.
A New Approach to Weight Loss
"When we first met Laurie, she had energy and enthusiasm and a real commitment to success," says Jonah Cohen, MD, a gastroenterologist and Director of the Center for Bariatric Endoscopy at BIDMC.
The Center performs endoscopic procedures for weight loss that are less invasive than traditional weight loss surgery, requiring no incisions leading to faster recovery.
Cohen's program is one of the first in New England to perform a procedure known as endoscopic sleeve gastroplasty (ESG). Also known as the “accordion” procedure, ESG uses an endoscope, a small flexible tube with a camera and suturing device attached, to enter the stomach through the mouth. This device allows the doctor to see and operate inside the stomach without any incisions. The doctor sutures the stomach to reduce its shape, which restricts the amount of food it takes to feel full.
"Endoscopy has come a long way in recent years, especially in terms of endoscopic suturing," Cohen says. "For most patients, ESG is an outpatient procedure. For patients to be able to go home the same day after such a life-changing procedure speaks to how far medicine has come."
After the procedure, most patients return to work within several days, and follow a liquid diet for four weeks. ESG typically results in 15 to 20 percent total weight loss, and may also help treat serious weight-related conditions such as diabetes, sleep apnea, high blood pressure and osteoarthritis.
Busa's research into several weight loss options brought her to BIDMC to discuss endoscopic procedures with Dr. Cohen and his team. The team worked together to determine whether ESG could be the right option.
"The evaluation process is extensive," says Colleen Baker, RN, part of the Bariatric Endoscopy team. "We’re making a permanent change to your stomach, so the foundation of success is being ready to make changes to your lifestyle.”
"It felt like it was safer," Busa says about ESG. And, after spending years losing and gaining weight, she was encouraged by the potential for keeping the weight off after the procedure.
"Data shows that for the average patient, weight loss results after the ESG procedure are durable,” says Cohen.
Yearlong Support After the Procedure
Cohen, Baker and Registered Dietitian Leslie Mattimore, work closely with patients for a full year after the procedure to help ensure long-lasting results.
"Our multi-disciplinary team is a key part of the program," Mattimore says. "We take a team approach to help decide what’s best for each patient. We each have our own perspective and bring our own skill set. Our goal is that after 12 months, patients can fly on their own."
"Our team is second to none in supporting patients during the procedure and throughout the rest of their journey," Cohen adds.
Busa credits the support of that team for helping to keep her spirits up after the procedure, even when it came to sticking with the liquid diet for several weeks.
"You know you're going to get through it. The dietitian tries to make lifestyle change doable for you," Busa says. "All of them have been wonderful. I can get in touch so easily when I have questions."
"My greatest satisfaction is working with patients before, during and after their procedure. It’s a great privilege to be part of their journey," Cohen says.
Baker is often excited to see patients return for follow-up visits once they've started to experience weight loss. "When we see Laurie come in, she's glowing."
Since working with Dr. Cohen's team, Busa has lost 54 pounds. And she recently cut her blood pressure medication in half.
"It has been a life-changer, positively. My confidence is so much better, she says. "When I look in the mirror, I see me again."
Is ESG Right for You?
To qualify for endoscopic sleeve gastroplasty (ESG) you should:
- be 18 or older
- have a body mass index (BMI) of 30 or higher
- have tried medical weight loss previously through diet and exercise and have been unable to meet your goals
- be willing to participate in a medically supervised weight loss program
- be willing to remain on a liquid diet for several weeks following the procedure
Conditions that might prevent you from qualifying for ESG include:
- previous gastrointestinal surgery
- a family history of stomach or esophageal cancer
- active smoking, alcohol or substance abuse
- history of disordered eating condition
- a hernia in the esophagus or a structural abnormality in the larynx or throat