Endoscopic sleeve gastroplasty or ESG, changes the stomach’s structure without surgery. It’s one of several newer or soon-to-be approved less-invasive ways to lose weight — including gastric balloons and capsules — that have expanded obesity treatments. Nearly 40% of U.S. adults are obese, putting them at a higher risk of earlier death, heart disease, stroke, some cancers, and gallbladder disease, among other problems.