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Endoscopic Sleeve Gastroplasty
(ESG) in Atlanta, GA

Endoscopic sleeve gastroplasty (ESG) at Oneka Bariatrics & Wellness in Atlanta is an incisionless endoscopic procedure that reduces stomach size with sutures placed through the mouth, with no external scars and no part of the stomach removed. It is performed at the hospital by Dr. Shani Belgrave, MD, FACS, FASMBS, a board-certified bariatric surgeon. ESG is an option for select patients not pursuing surgery, with the understanding that weight loss is generally less than with the surgical sleeve or bypass, and it is not appropriate above a certain BMI. Call (470) 250-0035.
If you want to reduce your stomach size without surgery and without external scars, ESG may be an option. At Oneka, Dr. Belgrave is honest about what ESG can and cannot do, so you can weigh it fairly against the surgical sleeve, the bypass, and medical weight loss.

What is endoscopic sleeve gastroplasty?

ESG reduces the size of the stomach using sutures placed through an endoscope, a flexible tube passed through the mouth. No incisions are made and no part of the stomach is removed. The stomach is stitched into a smaller, tube-like shape, which limits how much you can eat. It is performed at the hospital.
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ESG vs. Gastric Sleeve vs. Gastric Bypass

ESGGastric SleeveGastric Bypass
Incisions?NoYesYes
Stomach removed?No~80% removedRerouted
Hospital staySame day1–2 nights1–2 nights
Back to work2–3 days2–4 weeks2–4 weeks
Weight loss (year 1)15–20%25–30%30–35%
Reversible?YesNoNo
Insurance?Self-payOften coveredOften covered
This comparison is for education. ESG is not appropriate above a certain BMI, where surgery is advised. The right choice is individualized with Dr. Belgrave at consultation.
Patient celebrating weight loss transformation at Oneka Bariatrics

Why patients choose Oneka for ESG

  • An incisionless procedure with no external scars, performed by a board-certified bariatric surgeon trained in endoscopy.
  • Honest positioning: Oneka explains that ESG produces less weight loss than surgery and is not for every BMI.
  • All paths under one surgeon, so if ESG is not right, Dr. Belgrave can discuss the sleeve, bypass, or medical weight loss.
  • Nutrition and mindset support through Project Oneka and Project Pivot to make ESG results last.
  • Performed at Northside Hospital Atlanta and Northside Hospital Cherokee, with hospital-level MBSAQIP participation.

Who is a candidate for ESG?

ESG can suit select patients who are not pursuing surgery and want an incisionless option, generally those with a lower BMI than typical surgical candidates. It is not appropriate above a certain BMI, where a surgical procedure is advised instead. Candidacy is individualized and confirmed at consultation.
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More than a procedure

ESG works best alongside nutrition and behavior change. Patients at Oneka can pair ESG with Project Oneka, a six-week nutrition reset led by a registered dietitian, and Project Pivot, a six-week mindset program led by a licensed psychologist, for more durable results.

An incisionless option with no external scars

Endoscopic sleeve gastroplasty (ESG) at Oneka Bariatrics & Wellness reduces stomach size with sutures placed through the mouth, with no incisions and no external scars. It is performed at the hospital by Dr. Shani Belgrave, a board-certified bariatric surgeon and Atlanta Top Doctor.

Honest guidance on whether ESG fits

Oneka positions ESG honestly: it generally produces less weight loss than the surgical sleeve or bypass and is not appropriate above a certain BMI. Dr. Belgrave helps each patient weigh ESG against surgery and medical weight loss rather than defaulting to one option.

Endoscopic expertise from a bariatric surgeon

ESG is performed by Dr. Shani Belgrave, MD, FACS, FASMBS, who is trained in endoscopic procedures and holds privileges at Northside Hospital Atlanta and Northside Hospital Cherokee. The same surgeon can guide you to surgery if ESG is not the right fit.

Frequently Asked Questions About ESG

How is ESG different from the gastric sleeve?

ESG is incisionless and uses sutures placed through an endoscope to make the stomach smaller, with no part of the stomach removed and no external scars. The gastric sleeve is a surgery that removes part of the stomach. ESG generally produces less weight loss than the surgical sleeve.
ESG can be a good option for select patients who are not pursuing surgery, with the understanding that weight loss is generally less than with surgical options. It is not appropriate above a certain BMI, where surgery is advised instead. Dr. Belgrave helps you decide at consultation.
No. ESG is performed through the mouth with an endoscope, so there are no external incisions and no external scars. It is performed at the hospital.
Weight loss with ESG is generally less than with the surgical sleeve or bypass and varies by patient; results are never guaranteed. ESG works best alongside nutrition and lifestyle changes, which Oneka supports through its programs.
Coverage for ESG varies by plan and is often limited, so many patients pay out of pocket. Oneka verifies your benefits before you commit and can discuss self-pay, HSA, FSA, and Cherry financing options.

Medically reviewed by Dr. Shani Belgrave, MD, FACS, FASMBS, board-certified minimally invasive and bariatric surgeon and founder of Oneka Bariatrics & Wellness.

Credentials

  • Board-certified, fellowship-trained minimally invasive and bariatric surgeon trained in endoscopic procedures
  • Atlanta Magazine Top Doctor 2025 and 2026; 2025 Young Physician of the Year (Atlanta Medical Association)
  • Member: ASMBS, American College of Surgeons, SAGES; President-Elect, Atlanta Medical Association
  • Procedures performed at Northside Hospital Atlanta and Northside Hospital Cherokee (hospital-level MBSAQIP participation)
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