TORe (Transoral Outlet Reduction)

An endoscopic weight loss procedure is a non-surgical approach that uses an endoscope for your weight loss treatment, instead of external incisions (cuts). An endoscope is a thin, flexible tube that helps a doctor view your digestive system. Endoscopic procedures are considered very safe and less risky than surgery.

TORe was invented, pioneered, and patented by Dr. Thompson here at Brigham and Women's Hospital. We currently have the largest experience performing this procedure.

What is TORe?

TORe is a revision procedure, meaning it’s only appropriate for certain patients who’ve already had gastric bypass surgery.

TORe is an endoscopic suture treatment for gastric bypass patients who are struggling with weight regain. Weight regain can happen if the gastric outlet and/or pouch stretches. The gastric outlet is the opening between your gastric pouch and your small intestine. TORe works by tightening the gastric outlet with sutures (stitches). This procedure decreases the size of the opening and helps you lose weight.

How is TORe performed?

While under anesthesia, your doctor inserts an endoscope into your digestive tract through the mouth. The endoscope has a suturing device attached to it. Your doctor uses the endoscope to stitch and tighten the gastric outlet to make it smaller. TORe typically takes less than an hour to perform. TORe is a minimally invasive endoscopic procedure, so it doesn’t require any incisions (cuts) on the outside of your body.

How much weight can you expect to lose from TORe?

Your expected weight loss can vary with TORe, and it likely depends on how much weight was regained after your gastric bypass. Many patients achieve a weight that is lower than their lightest weight after gastric bypass. Furthermore, there is long term data demonstrating the durability of this weight loss procedure.

What is recovery like after TORe?

After TORe, you will need to stay overnight at the hospital and take a few days off from work to recover. During recovery, you are first prescribed a special liquid meal plan. Over time, you transition to a soft food plan (including easy-to-eat foods, like oatmeal, bananas, and soft-cooked rice) and then return to normal eating.

Are there any additional health benefits to treatment, besides weight loss?

You might experience better health, like improvements in weight-related health conditions. These can include sleep apnea, high blood pressure, type 2 diabetes, fatty liver and dyslipidemia. Dyslipidemia is when you have abnormal amounts of lipids (fats) in your blood. In some cases, these conditions may even resolve completely.

Am I a candidate for TORe?

You must have had a previous gastric bypass with a dilated outlet to qualify for this procedure. There are no strict body mass index (BMI) criteria for this procedure.

How do I improve my health before the procedure and prepare for TORe?

You can meet with your doctor to ask any questions you may have about TORe. We know it can be depressing or discouraging for some patients to regain weight after a gastric bypass procedure. We offer psychological support to patients who are undergoing revision treatments by collaborating with mental health specialists. We also have dieticians who can work with you before and after the procedure to adopt and maintain a healthy lifestyle.

Do you offer long-term weight management support?

Yes. We take a collaborative approach to treatment that combines the expertise of many different specialists, including dietitians and mental health professionals. Our team-based approach helps us offer a very high quality of care.

Which doctors offer TORe?

Christopher Thompson, MD, MSc, AGAF, FASGE, FACG
Co-director of Center for Weight Management and Wellness
Director of Endoscopy
Director of Bariatric Endoscopy

Pichamol Jirapinyo, MD, MPH, ABOM
Associate Director of Bariatric Endoscopy
Director of Bariatric Endoscopy Fellowship

How do I schedule an appointment to learn more about TORe?

If you would like more information or would like to schedule an appointment with a Brigham doctor, you can call us at 617-525-3597 or fill out our appointment request form.

I’m a physician. How do I refer a patient for treatment?

Physicians who are looking to refer a patient can call 617-525-3597 or email us at

TORe illustration

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