What Is ESG Max?
ESG Max (Endoscopic Sleeve Gastroplasty Max) is a nickname given to an advanced, non-surgical weight loss procedure that builds upon the well-established Endoscopic Sleeve Gastroplasty (ESG). It introduces an innovative enhancement: Gastric Fundal Mucosal Ablation (GFMA)—a technique that targets the stomach’s hunger-producing zone to further support metabolic health and long-term weight loss.
Understanding the Basics: What Is ESG?
ESG is a minimally invasive endoscopic procedure that reduces the size of the stomach by placing sutures from the inside. This results in a sleeve-like stomach that holds less food and slows emptying—helping you feel fuller, sooner and with fewer calories.
Unlike surgical sleeve gastrectomy, ESG involves no external cuts, no removal of stomach tissue, and typically has a quicker recovery.
What’s New in ESG Max?
The “Max” in ESG Max refers to the addition of Gastric Fundal Mucosal Ablation (GFMA). This is where the upper part of the stomach—the fundus, which is the primary site of ghrelin (the hunger hormone) production—is gently ablated (burnt in a controlled way) using argon plasma coagulation (APC) or a similar endoscopic method.
By reducing ghrelin levels, GFMA helps to:
- Reduce appetite
- Suppress hunger cravings
- Support long-term satiety and metabolic improvements
Why the Gastric Fundus Matters?
The gastric fundus plays a major role in regulating appetite and satiety through hormone signalling. Ghrelin is known to stimulate appetite and increase food intake. By targeting this area, ESG Max aims to address not just the physical volume of food intake, but also the biological drive to eat.
Benefits of ESG Max
- Non-surgical and incision-free
- Targets hunger at its hormonal root
- Enhances traditional ESG outcomes
- Faster recovery compared to surgery
- May improve diabetes and metabolic markers
Is ESG Max Right for You?
ESG Max is best suited for individuals who:
- Have a higher starting BMI, requiring more than 20% total body weight loss to reach target weight
- Want to maximise the effectiveness of an endoscopic approach
- Are looking for a non-surgical option that also addresses hormonal drivers of obesity
- Have metabolic conditions like type 2 diabetes or insulin resistance
The Procedure: What to Expect
ESG Max is performed under General Anaesthesia via an endoscope inserted through the mouth. The procedure takes about 90–120 minutes and involves:
- Ablating the fundal mucosa using APC to reduce ghrelin production
- Placing endoscopic sutures to reduce the stomach size
- One night hospital stay for hydration and comfort
Most patients return to normal activities within a few days.
Results So Far
Early studies suggest that ESG Max may result in:
- Greater weight loss than ESG alone
- More appetite suppression
- Enhanced metabolic control in conditions like type 2 diabetes
More research is underway, but outcomes are promising.
