Weight Doctors® hydroGMA Alone or combined

Two levers that complement each other

The principle is the same for both paths: hydroGMA dampens hunger by ablating the mucosa of the gastric fundus in order to reduce the production of the hunger hormone ghrelin. The difference lies in whether hydroGMA stands on its own or is combined with a Weight Doctors SLEEVE®.

Many people with significant excess weight are caught between two options: GLP-⁠1 therapy has to be used regularly and often long term, and gastric sleeve surgery is a final surgical step. The combination of hydroGMA and Weight Doctors SLEEVE® is a path in between.

The two act at different points: the SLEEVE reduces the stomach from the inside with sutures – similar to a conventional stomach reduction, but without an abdominal incision and without removing tissue. It deliberately spares the upper area of the stomach, the gastric fundus; this is exactly where hydroGMA acts. In this way a smaller stomach volume meets less hunger.

Which path suits you?

Whether hydroGMA alone is enough or the combination is the more sensible path depends on starting weight, goal and medical history. hydroGMA alone is often the right way in if you want a gentle, endoscopic procedure without surgery – whether it is sufficient for your goals, we clarify in the consultation. The combination with the Weight Doctors SLEEVE® is an option if a stronger effect is desired and the prerequisites are met.

These four profiles show who each path often suits – the binding assessment is always made in person:

Path 1: hydroGMA as monotherapy

In monotherapy, as part of a gastroscopy, usually under sedation, only the mucosa of the gastric fundus is ablated. It is the gentlest path: without external incisions, as a rule as an outpatient and with a short recovery.

Path 2: hydroGMA plus Weight Doctors SLEEVE®

After the combined procedure, for safety reasons we currently usually keep you for one night of observation in the Weight Doctors® Nationalklinik in Wertheim. With growing experience, outpatient treatment is conceivable in future.

How the combination works in practice

Both technologies of the Weight Doctors SLEEVE® are an option for the combination, OverStitch NXT™ or pose® 3.0 Double Helix:

What the studies show about the combination

So far the data come from small pilot studies without large comparison groups. In a study published in 2026, ten participants first received a mucosal ablation of the gastric fundus and six months later an endoscopic stomach reduction. After a total of 18 months, the average weight loss was 22.5% of starting weight.

This figure needs to be put in context: according to the same authors, endoscopic stomach reduction alone already achieves 13.6–16.2%; what share is due to the mucosal ablation cannot be quantified without a control group. Fasting ghrelin measured over time approached the baseline value again. And because the study examined a treatment staggered over time, the results cannot automatically be transferred to the combined procedure in a single session.

Results vary from person to person and depend significantly on nutrition and exercise – there is no guarantee. More in the article hydroGMA and endo sleeve.

Does the effect wear off? A repeat is possible

The ghrelin-producing cells can grow back over time – the feeling of hunger may then return. In this case a second hydroGMA is possible in principle, regardless of whether you first received the monotherapy or the combination.

Because of the limited data, there are as yet no generally valid recommendations on when a second treatment makes sense and how often it can be repeated. We discuss the course individually with you – in the check-ups and with our 360-degree aftercare.

What does the treatment cost?

hydroGMA is a self-pay service; we will tell you the price on request. The Weight Doctors SLEEVE® is available from €5,500. We discuss your cost framework openly in the consultation.