Mayo Clinic's approach


Mayo Clinic's campus in Arizona has collaborations between specialties to help people with obesity gain control of their weight through multiple types of interventions in nutrition, medication, endoscopic procedures or surgery.

A team of specialists works together to develop treatment plans tailored to each person's needs and goals. Your team can include health care professionals, coordinators and dietitians from gastroenterology and hepatology, endocrinology, general surgery, community internal medicine, psychiatry and psychology, and other specialties as needed.


Mayo Clinic's campus in Florida has a dedicated Bariatric Center to help people with obesity gain control of their weight.

A team of specialists works together to develop bariatric treatment plans tailored to each person's needs. Your team can include bariatric specialists from endocrinology, general surgery, psychiatry and psychology, community internal medicine, dietetics, and other specialties as needed. The program also includes wellness coaching.


Mayo Clinic surgeons and gastroenterologists in Rochester, Minnesota, perform thousands of weight-loss surgeries and procedures each year. To date, Mayo Clinic endoscopists have performed hundreds of endoscopic sleeve gastroplasties.

Mayo Clinic in Rochester, Minnesota, is accredited as a comprehensive bariatric surgery center by the American College of Surgeons. Mayo Clinic in Rochester, Minnesota, also has met Medicare's facility standards for bariatric surgery.

The Mayo Clinic bariatric care team in Rochester, Minnesota, consists of experts from endocrinology, endoscopy, dietetics, gastroenterology and hepatology, general surgery, psychiatry and psychology, and other specialists as needed. The program also includes wellness coaching.

Cost estimates

For questions about the cost of endoscopic sleeve gastroplasty, call Mayo Clinic's Estimating Service at 507-284-4024.

Expertise and rankings

Innovative procedures

Mayo Clinic surgeons and gastroenterologists are involved in developing the latest in weight-loss surgeries and endoscopic procedures, such as endoscopic sleeve gastroplasty and intragastric balloons. They are currently investigating multiple new endoscopic treatment approaches to weight loss and metabolic disease, such as fatty liver disease and type 2 diabetes.

Mayo Clinic's Weight Regain Clinic is also offering a new endoscopic procedure to patients who had gastric bypass surgery in the past but have experienced weight regain. The procedure is called transoral outlet reduction endoscopy (TORe).

The TORe procedure uses a minimally invasive endoscopic suturing device to reduce the size of the gastric pouch and outlet to improve the feeling of fullness and aid in weight loss.

Endoscopic Sleeve Gastroplasty (Gastric Sleeve)

When it comes to weight loss, you have many choices. But if we look closely at these options, you see that many centers develop expertise in just one aspect of weight loss. Mayo Clinic has always taken a comprehensive approach to health care. So with this in mind, we've developed clinical expertise that's combined with cutting edge research to create a team that consists of endocrinologists, dietitians, health care coaches, psychologists, gastroenterologists, and surgeons who will guide you through your entire journey, giving you the best chance of losing weight and keeping it off.

Or will take a different approach. Basically by saying that we need to introduce tools to help you be successful to a diet and physical activity program. The reason why we believe that tools are essential for weight-loss is because your body usually adapts to our weight-loss program. If it's only based on a diet and exercise program, many things in their body that makes it difficult to sustain that weight loss. And more importantly, it makes it difficult to fight back what your body is designed to, your body designed to save energy. So if we don't introduce a tool to help us with our diet program and that exercise program. You should, people tend to feel very frustrated with not eating enough calories. They feel a lot of hungry and appetite and moody and so on. So they usually fail their diet. But it's not because the patient doesn't lack motivation or doesn't want to lose weight, usually because your body is fighting against us. So this is where we introduce tools. We have three tools are the essentials. We have medications, endoscopic procedures, and we have surgery.

So endoscopic procedures are the new kids on the block for weight-loss tools to help us with diet and exercise program. They are usually better than medications and sometimes they can be as good as bariatric surgery. The advantages of an endoscopic procedure is that is an outpatient procedure, so no need to stay overnight. There's no scars like in surgery. All of this is done by endoscopy. They're usually safer with less complications. Patients tolerate this better. And usually the way that they work is by helping the patient by either decreasing they're hungry and appetite levels by making you feel full. By either producing an occupying the space in the stomach like in the example with the balloons. Or in the example is leave. By making you feel full, by reducing the size of your stomach.

Let's talk about a new procedure called endoscopic sleeve gastroplasty. With this procedure, basically we're decreasing the size of their stomach by suturing it from inside to the size of a banana. So we're taking the stomach, which is the sites, It's a big sack and reducing it to a size of a banana. How we do this? We do this endoscopically through the aid of an endoscope. Basically it's a long camera that goes from your mouth and allow us to do an intervention inside of your stomach. On top of the long camera, we have a sewing machine that allow us to take your stomach and invaginated on itself in order to reduce capacity by about 80 percent. So once this procedure is done, the stomach is a smaller size, so it only could accommodate smaller meals, but also the rate by which the meal empties from the stomach is decreased. So a smaller meal last for much longer period of time, producing satiety for long periods of time. So a patient could follow a low-calorie diet without feeling hungry all the time. This procedure is designed to be permanent. That means the sutures we do not remove. However, things could stretch in the long-term. And if that were to happen, we could easily go back and reinforce or re tighten things up with a with a similar endoscopic procedure. Unlike surgical options, we're not removing any parts of the stomach. The stomach stays there, but we're just invaginated. Therefore, the risks with the procedures are rare. There are some abdominal pain and nausea that happens within the first week or so, but most of these are managed with pain medication and nausea medications, the vast majority resolve within the first week. Serious risks like bleeding, infection, or tears in the stomach or very unlikely. You might be asking, how much weight do I expect to lose with this procedure? Usually on average, people have lost about 18 to 20 percent of their total body weight loss at one year after the procedure. The key to the success of this procedure as to any other procedure is adopting a healthier lifestyle for longer-term. And to allow it to that, we'll have you participate in a lifestyle intervention program that we help you to learn how to adapt a healthier lifestyle and along the longer-term by meeting with our psychologist and nutritionist over the 12 months after this procedure is performed.

For many people, it's not a knowledge deficit that's getting in the way of them being successful with managing weight. It's often about habits or behaviors. And many of us do things that we know are not good for us, but we continue to do them anyway. And we can help you try to understand a little bit better what some of the triggers are for those behaviors. Some of the consequences and help you really make those behavior changes more in the long term. Also, a lot of people struggle with maintaining motivation over the long-term to eat healthy or to be more active. And so psychologists can really help you tap into what motivates you to try to stay healthy. Additionally, some people struggle with stress or depression or addiction to alcohol or tobacco that can interfere with their ability to be successful. And as psychologists can really help you address and treat those things so that you can be more successful in the long term.

An endoscopic procedure causes changes in how your body handles food and nutrients which require changes on your part to, for example, initially it's important to have a liquid diet to help with healing. Longer term will want to work with you to optimize your nutrition intake, will also work with you to identify incorrect eating habits that can sabotage weight loss efforts. And it will be important for you to increase your daily activity. Will also provide you with information on foods and eating patterns that can help you feel full while lowering your calorie intake. And we'll be here along the way to help provide some coaching and support as you progress on your weight loss journey.

Comprehensive, holistic care

Before arriving at Mayo Clinic, you'll receive support and resources for your wellness journey, including detailed instructions and expert guidance to prepare you for what's to come. After arriving, you spend about one week at Mayo Clinic in Rochester, Minnesota, to prepare for the procedure and yearlong journey ahead. This time includes consultations with endocrinologists, gastroenterologists and psychologists.

You also spend two days at the state-of-the-art Mayo Clinic Healthy Living Program facility. During this time, you work with a health coach, exercise physiologist and dietitian to create a detailed health plan for achieving your wellness goals.

Mayo Clinic has created an affordable financial bundle that includes the cost of the procedure itself plus a 12-month program done in coordination with a healthy-living coach.

Nationally recognized expertise

Mayo Clinic in Rochester, Minnesota, ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Arizona, and Mayo Clinic in Jacksonville, Florida, are ranked among the Best Hospitals for digestive disorders by U.S. News & World Report. Mayo Clinic Children's Center in Rochester is ranked the No. 1 hospital in Minnesota, and the five-state region of Iowa, Minnesota, North Dakota, South Dakota and Wisconsin, according to U.S. News & World Report's 2023–2024 "Best Children's Hospitals" rankings.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

More information about billing and insurance:

Mayo Clinic in Arizona, Florida and Minnesota

Mayo Clinic Health System

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

Sept. 29, 2023
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  3. Yoon JY, et al. The efficacy and safety of endoscopic sleeve gastroplasty as an alternative to laparoscopic sleeve gastrectomy. Clinical Endoscopy. 2021; doi:10.5946/ce.2021.019.
  4. FAQs of bariatric surgery. American Society for Metabolic and Bariatric Surgery. Accessed June 15, 2023.
  5. Weight loss (bariatric) surgery. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed June 15, 2023.
  6. Marshall S, et al. Matched endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy cases: Formative cohort study. JMIR Formative Research. 2022; doi:10.2196/29713.
  7. Brunaldi VO, et al. Endoscopic sleeve gastroplasty: A narrative review on historical evolution, physiology, outcomes, and future standpoints. Chinese Medical Journal. 2022; doi:10.1097/CM9.0000000000002098.
  8. Health Education & Content Services. Endoscopic sleeve gastroplasty for weight loss. Mayo Clinic; 2019.
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Endoscopic sleeve gastroplasty