---
title: "Science | Everself"
url: https://everself.com/science/
description: "Your struggle with excess weight isn't a personal failure. Our biology is colliding with modern-day caloric abundance. GLP-1s temporarily suppress appetite. We permanently modify anatomy to align with biology."
---

# The science behind ESG and lasting weight transformation

Your struggle with excess weight isn't a personal failure. Our biology is colliding with modern-day caloric abundance. 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 diets, and sedentary jobs mean calorie intake climbs while calorie output falls. Survey data shows calorie intake rose \~15% from the 1970s to today. \[1]

The reality? Our bodies fight weight loss, especially in our modern environment.

For most of human history, scarcity—not surplus—shaped biology. Your body defends a weight set point: when pounds drop, your basal metabolic rate (your baseline calorie burn) slows and appetite rises, pulling weight back toward a defended range. \[2]

Even more challenging, epigenetic 'tags' on DNA—chemical markers that regulate how genes are read—can shift with weight gain, nudging the body to establish a new, higher baseline and potentially increasing obesity risk in the next generation. \[3]

Body's defended weight set point

Epigenetic weight regulation

## 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.

Appetite control runs through the gut-brain axis—the intestine, pancreas, vagus nerve, and hypothalamus working together. Natural GLP-1 is a hormone your body releases after eating to signal fullness, but it's short-lived and breaks down within minutes.

GLP-1 medications last for days in the body, sending signals that help you feel full. But they don’t permanently reset your body’s natural weight “set point.” Participants who stop meds regain most of the weight they lost. \[4]

GLP-1 gut–brain signaling

Hunger increase from GLP-1 drop

## How endoscopic weight care fixes physiology without surgery

Modern endoscopy reaches the digestive tract through the mouth, allowing precise, foundational changes to digestive anatomy with no external cuts or traditional surgery. While all medical procedures carry risks, these non-surgical interventions offer faster recovery and lower complication rates than surgery.

At Harvard Medical School, our co-founder Dr. Christopher Thompson pioneered three core endoscopic procedures: Endoscopic Sleeve Gastroplasty (ESG) \[5], Transoral Outlet Reduction (TORe) \[6] \[7], and Sleeve-in-Sleeve (SIS) \[8].

ESG—the most studied and widely used—uses internal stitches to make the stomach about 60–75% smaller in roughly one hour. It's been performed in tens of thousands of patients worldwide \[9], with dedicated ESG device systems receiving FDA authorization in 2022. \[10]

These anatomical changes do more than shrink your stomach. They slow gastric emptying, promote early satiety, and may naturally increase your own GLP-1 hormones. Because they act at the source where appetite and meal size are regulated, results are more durable. \[11]

## The success factor: Double the sutures 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%. \[12]

A high-touch support program for long-term outcomes

Long-term success depends on consistent, high-touch support. Studies show frequent follow-up can boost weight loss by about 5% of starting body weight by reinforcing lasting habits. Everself's 12-month program includes more than 15 touchpoints with nurse practitioners, registered dietitians, and care support team, plus a staged diet plan with liquid phases in the first four weeks to support healing and protect sutures after ESG.

## 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.

- ### Dr. Christopher C. Thompson

  Harvard Professor, Inventor of ESG Stomach Tightening, Everself Co-founder

- ### Dr. Pichamol “Sigh” Jirapinyo

  Harvard Assistant Professor, Chair of American Society for Gastrointestinal Endoscopy's Advanced Endoscopy Committee, Everself Co-founder

- ### Dr. Christopher McGowan

  Global leader in endoscopic weight loss, Triple-board-certified in obesity

## Citation

---

1. [Wells HF, Buzby JC. Dietary Assessment of Major Trends in U.S. Food Consumption, 1970-2005. Economic Information Bulletin Number 33. U.S. Department of Agriculture, Economic Research Service. 2008 Mar.](https://www.ers.usda.gov/publications/pub-details?pubid=44220)
2. [Harris RB. Role of set-point theory in regulation of body weight. FASEB J. 1990 Dec;4(15):3310-8. doi: 10.1096/fasebj.4.15.2253845. PMID: 2253845.](https://pubmed.ncbi.nlm.nih.gov/2253845/)
3. [Mahmoud AM. An Overview of Epigenetics in Obesity: The Role of Lifestyle and Therapeutic Interventions. Int J Mol Sci. 2022 Jan 25;23(3):1341. PMCID: PMC8836029. PMID: 35163268.](https://pubmed.ncbi.nlm.nih.gov/35163268/)
4. [Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564. PMID: 35441470.](https://pubmed.ncbi.nlm.nih.gov/35441470/)
5. [Kumar N, Abu Dayyeh BK, Lopez-Nava Breviere G, Galvao Neto MP, Sahdala NP, Shaikh SN, Hawes RH, Gostout CJ, Goenka MK, Orillac JR, Alvarado A, Jirapinyo P, Zundel N, Thompson CC. Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique. Surg Endosc. 2018 Apr;32(4):2159-2164. PMID: 29075966.](https://pubmed.ncbi.nlm.nih.gov/29075966/)
6. [Jirapinyo P, Slattery J, Ryan MB, Abu Dayyeh BK, Lautz DB, Thompson CC. Evaluation of an endoscopic suturing device for transoral outlet reduction in patients with weight regain following Roux-en-Y gastric bypass. Endoscopy. 2013 Jul;45(7):532-6. PMID: 23801313.](https://pubmed.ncbi.nlm.nih.gov/23801313/)
7. [Jirapinyo P, Kumar N, Thompson CC, Law RJ, Muthusamy R, Schulman AR, Sullivan S. Association for Bariatric Endoscopy Systematic Review and Meta-analysis Assessing the ASGE PIVI Thresholds for Transoral Outlet Reduction (TORe). Gastrointest Endosc. 2025 Jul 24. Online ahead of print. PMID: 40711436.](https://pubmed.ncbi.nlm.nih.gov/40711436/)
8. [Jirapinyo P, Siranart N, Thompson CC. Endoscopic versus Surgical Management of Recurrent Weight Gain Following Sleeve Gastrectomy. Gastrointest Endosc. 2025 Nov 8. Online ahead of print. PMID: 41213337.](https://pubmed.ncbi.nlm.nih.gov/?term=pichamol+jirapinyo\&sort=date)
9. [Abu Dayyeh BK, Bazerbachi F, Vargas EJ, Sharaiha RZ, Thompson CC, Thaemert BC, Teixeira AF, Chapman CG, Kumbhari V, Ujiki MB, Ahrens J, Day C, Acosta AJ, Badurdeen D, Buttar NS, Clark MM, Eaton L, Ghanem O, Grothe K, Jirapinyo P, Kellogg T, Klein CL, Mundi M, Storm AC, Rivera AR, Wilson TD, Galvao Neto M, Zundel N, Wilson EB. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomized trial. Lancet. 2022;400(10350):441-451. PMID: 35908555.](https://pubmed.ncbi.nlm.nih.gov/35908555/)
10. [Jirapinyo P, Hadefi A, Thompson CC, Patai ÁV, Pannala R, Goelder SK, Kushnir V, Barthet M, Apovian CM, Boskoski I, Chapman CG, Davidson P, Donatelli G, Kumbhari V, Hayee B, Esker J, Hucl T, Pryor AD, Maselli R, Schulman AR, Pattou F, Zelber-Sagi S, Bain PA, Durieux V, Triantafyllou K, Thosani N, Huberty V, Sullivan S. American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity. Gastrointest Endosc. 2024 Jun;99(6):867-885.e64. Epub 2024 Apr 19. PMID: 38639680.](https://pubmed.ncbi.nlm.nih.gov/38639680/)
11. [Vargas EJ, Rizk M, Gomez-Villa J, Edwards PK, Jaruvongvanich V, Storm AC, Acosta A, Lake D, Fidler J, Bharucha AE, Camilleri M, Abu Dayyeh BK. The Effect of Endoscopic Sleeve Gastroplasty on Gastric Emptying, Motility, and Hormones: A Comparative Prospective Study. Gut. 2023 Jun 1;72(6):1073-1080. Epub 2022 Oct 14. PMID: 36241388.](https://pubmed.ncbi.nlm.nih.gov/36241388/)
12. [Jirapinyo P, Kumar N, Shaikh S, Trasolini R, Ryan M, Thompson CC. Ten Year Efficacy of Endoscopic Sleeve Gastroplasty. Gastrointest Endosc. 2023;97(6):AB34-AB35.](https://www.giejournal.org/article/S0016-5107\(23\)00479-0/abstract#:~:text=Efficacy%3A%20The%20follow%2Dup%20rates,10%25%20TWL%20at%2010%20years.)

## Get started with Everself

- Book a free consultation: https://app.everself.com/signup
- Call (833) 837-7353 or email hello@everself.com
- Everself at a glance, with links to every key page: https://everself.com/llms.txt