Obesity care is moving forward in ways never previously seen. While bariatric and metabolic surgery have been available treatment options for more than a decade for patients with severe obesity, current options, including endoscopic procedures have expanded access to treatment to millions more patients. With more treatment options becoming available, insurance companies are catching up and broadening coverage for science-based procedures.

Endoscopic procedures, such as endoscopic sleeve gastroplasty (ESG), provide a minimally invasive option, where doctors use a small, flexible tube through the mouth to work on the stomach without any skin cuts. This helps reduce recovery time and has a lower risk of complications than traditional surgery. Patients can usually return to regular activities within a few days.

As with any obesity treatment, insurance coverage for endoscopic procedures varies. But there is good news as coverage for ESG has shown steady expansion across both government and commercial payers, including Medicare, Medicaid and private plans. 

  • Coverage has grown from approximately 32.8 million lives in 2023 to more than 107 million in 2026, demonstrating rapid adoption in a short timeframe.
  • By 2025, coverage had already reached more than 90 million lives, signaling accelerating momentum.

Coverage growth is being driven by federal initiatives and partnerships, including healthcare professionals and advocates on the front lines of the fight for quality medical treatment for individuals living with obesity. Making it clear that patients with obesity deserve the same dignity and access to effective treatments as any other disease.

There are many safe and effective options for treating obesity and severe obesity. No single approach works for everyone, and what helps one person may not be right for another. Learn more about all available treatment options in our Understanding Your Obesity Treatment Options Brochure. Or watch our Health Talk to learn about endoscopic procedures to treat obesity and see how these options are becoming a real choice for more people every day.