The science behind ESG and lasting weight transformation
Your struggle with excess weight isn't personal failure—it's evolutionary biology colliding with modern-day caloric abundance. While GLP-1s temporarily suppress appetite, we permanently modify anatomy to align with biology.
Why our bodies resist weight loss (and always have)
Today's mismatch is stark: calories are everywhere, ultra-processed foods dominate our diet, and sedentary jobs mean calorie intake climbs while calorie output falls. U.S. survey data shows reported daily calorie intake rose ~15% from 1977–1978 to 2017–20181.
The reality? Your body fights weight loss, especially in our modern environment.
For most of human history, scarcity—not surplus—shaped our biology. Your body defends a weight set point: when pounds drop, your basal metabolic rate (BMR, your baseline calorie burn) slows and appetite rises, pulling weight back toward a defended range.
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Why GLP-1 medications stop working when you stop taking them
GLP-1 medications reduce hunger and drive meaningful weight loss—while you're taking them. But when treatment stops, biology rebounds..
GLP-1 medicines are engineered to resist breakdown and provide higher-than-natural receptor signaling. They help you eat less while taking them, but don't permanently reset your defended weight set point. In a major trial, people who discontinued semaglutide regained most of the weight they had lost within one year.4
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How endoscopic weight care fixes physiology without surgery
Modern therapeutic endoscopy reaches the digestive tract through the mouth, enabling targeted, foundational changes to digestive anatomy with no external incisions. While all medical procedures carry risks, these are incisionless with generally short recovery and lower complication rates compared with surgery.
At Harvard Medical School, our co-founder Dr. Christopher Thompson pioneered three core endoscopic weight loss procedures: Endoscopic Sleeve Gastroplasty (ESG)2, Transoral Outlet Reduction (TORe)3, and Sleeve-in-Sleeve (SIS).
ESG—the most studied and widely used—uses internal stitches to make the stomach about 60–70% smaller in roughly one hour. It's been performed in tens of thousands of patients worldwide4, with dedicated ESG device systems receiving FDA authorization in 2022.5
These anatomical changes do more than shrink your stomach. They slow gastric emptying, promote early satiety, and can increase your own GLP-1 hormones. Because they act at the source where appetite and meal size are regulated, results are more durable.6
The success factor: Double the precision and 12 months of high-touch support
Everself ESG, refined over a decade, uses twice the sutures and a precision pattern proven to enhance weight loss and durability. Combined with high-touch, long-term support, it delivers stronger, longer-lasting results.
A proprietary ESG technique with proven efficacy
In randomized trials, standard ESG averages 13.6% weight loss at 12 months. In real-world care, Everself ESG delivers ~18–20%, about 33% more. Every Everself provider is certified in this proprietary technique.
A high-touch support program for long-term outcomes
Research shows the procedure alone isn't enough. Follow-up programs for ESG must include staged diet progression and liquid diets to support healing over the first six weeks and protect the stitches.
Go deeper into the science behind weight loss
Bariendo and Fractyl Health plan for potential GLP-1 off-ramp program pending FDA approval of Revita
Bariendo and Fractyl Health partner for potential GLP-1 off-ramp program with investigational Revita pending FDA approval
Petch Jirapinyo
Co-Founder, CEO
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Our Scientific Advisory Board
Our Scientific Advisory Board guides our progress, establishing the standards to ensure our best-in-class approaches deliver consistent and measurable weight health outcomes.
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Dr. Christopher C. Thompson
Co-founder, Inventor of ESG Stomach Tightening®, Harvard Professor
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Dr. Pichamol “Sigh” Jirapinyo
Co-founder, Chair of North America Advanced Endoscopy Committee ASGE, Harvard Assistant Professor