Obesity is a complex, chronic medical condition, and like all chronic conditions, it requires a long-term strategy rather than a short-term solution.

Dr Peverelle has specialist expertise in providing the full spectrum of medical weight loss options:

  • Prescription tablets eg. Phentop

  • Injectables (eg. Ozempic, Mounjaro)

  • Non-surgical weight loss procedures

For those not wanting surgery, Dr Peverelle offers Intragastric Balloon placement (6 or 12 month options) or Endoscopic Sleeve Gastroplasty (ESG) — a non-surgical alternative to bariatric surgery.

Dr Peverelle is currently the only specialist in Melbourne trained and able to perform the ESG procedure. Taking a holistic approach, he addresses your obesity, metabolic health, gut function, and lifestyle, and helps you to build a personalised plan.

Obesity is not due to a lack of willpower - it is a complex condition which requires a long-term solution.

Non-surgical Weight Loss Procedures

Informational poster describing orbera intragastric balloon, a 6-month weight loss program involving a silicone balloon placed in the stomach, with pros and cons listed.
Information about the Spatz3 Adjustable Balloon, a 12-month intrasgastric balloon for weight loss, including its pros and cons.
Infographic about endoscopic sleeve gastropasty (ESG) as a permanent endoscopic procedure, highlighting pros like durable results, no incisions, and strong metabolic benefits, and cons such as longer recovery time, higher cost, and irreversibility.

Before and After

Intragastric Balloon

Diagram showing a minimally invasive gastric balloon procedure. The left side labeled 'Before' depicts an empty stomach, while the right side labeled 'After' shows a stomach with a filled saline balloon, reducing space for food. The bottom notes that the procedure helps feel full sooner and the balloon is temporary, removed after 6-12 months.

Endoscopic Sleeve Gastroplasty (ESG)

Comparison of stomachs before and after minimally invasive procedure. The 'before' side shows a normal stomach with labels for endoscope, suturing device, and camera; the 'after' side shows a reduced stomach with sleeve created and smaller stomach, indicating no incisions needed.

Non-surgical weight loss procedure comparison

AT A GLANCE

Table comparing features of different weight loss procedures: Orbera (6 months), Spatz3 (12 months), and ESG (permanent). Includes details on duration, reversibility, adjustability, estimated weight loss, anesthesia, hospital admission, recovery time, BMI range, and medication compatibility.
Table comparing features of different weight loss procedures: Orbera (6 months), Spatz3 (12 months), and ESG (permanent). Includes details on duration, reversibility, adjustability, estimated weight loss, anesthesia, hospital admission, recovery time, BMI range, and medication compatibility.

ESG - Your Questions Answered

  • ESG may be an option for adults who: 

    • Have a body mass index (BMI) of 27-30 with another weight-related condition (eg. high blood pressure, cholesterol, fatty liver or diabetes), or a BMI greater than 30.  

    • Have not had success with lifestyle modifications such as diet and exercise 

    • Want a long-lasting solution to their weight 

    • Are looking for an alternative to more invasive bariatric surgery 

    ESG can be part of a plan to reduce the risk of weight-related illness such as high blood pressure, diabetes, fatty liver disease, sleep apnea or heart disease. This procedure is especially effective when combined with exercise and dietary changes. 

  • ESG is most effective when combined with a comprehensive lifestyle program, delivered in partnership with your doctor and allied health team. On average, patients lose approximately 20% of their total body weight following the procedure. Ultimately, the amount of weight you lose and maintain will depend on how closely you follow the advice of your doctor and allied health team. 

  • The ESG takes place in an endoscopy suite while you are asleep under general anaesthesia. It lasts about 90 minutes. 

    The procedure is performed using an endoscope — a flexible tube with a light, camera and a suturing device attached. The tiny camera allows Dr Peverelle to see inside the stomach without making incisions in the abdomen. 

    Lines are drawn along the stomach’s front and back walls, where sutures will be placed. 

    Through the endoscope, approximately 3-5 sutures (stitches) are placed along the inside of the stomach. 

    The sutures are then tightened, drawing the front and back walls of the stomach together to reduce its volume by about 70%. 

    The sutures change the structure of the stomach, leaving it shaped like a tube or sleeve (hence the name sleeve gastroplasty). The sutures do not dissolve — your stomach tissue will heal around them to form the new shape. It is safe for the sutures to remain in your body. 

    With less volume in your stomach, you will feel fuller after eating less food, stay fuller for longer and lose weight. 

  • Yes in general you will be asleep for the procedure. The anaesthetist will discuss the best form of sedation with you on the day. 

  • Yes. The pre-op diet is a low calorie diet designed to shrink the volume of the liver by releasing stored carbohydrates (glucose), thereby making the procedure safer. It also helps to improve recovery time and prime the body for weight loss.  

    Following the ESG, appetite will be suppressed. A modified diet will need to be followed for the first 4 weeks to protect the sutures and allow the body’s natural healing process to take the load off the sutures.  

  • Every medical procedure carries risk and the ESG is no different. The ESG has a 1% total risk of any major complication (bleeding, infection, suture breakdown).  

  • ESG is a day procedure so you will go home the same day. Most people can return to their normal work and life duties after 2-3 days.  

  • You can make an enquiry via the patient enquiry form, or by contacting The BMI Clinic directly on 1300 859 059.