- Endoscopic: through the mouth, no incisions.
- Zuyderland: Elipse balloon and POSE with a lifestyle coach.
- Vitalys: balloon for one year with COOL and 18 months of guidance.
- Almost never reimbursed; the lifestyle programme is.
- NOK stopped the balloon, preferring medication.
What are endoscopic weight loss treatments?
Endoscopic treatments are done through the mouth with a flexible camera, without cutting into the abdomen. The best-known is the gastric balloon, which takes up space in the stomach for a period. Zuyderland also offers the Elipse balloon, which you swallow as a capsule, and POSE, an endoscopic procedure, both combined with guidance from a lifestyle coach.
At Vitalys the balloon stays in for a year and is combined with the lifestyle programme COOL and eighteen months of guidance, at a cost of 3,995 euros plus a 65 euro intake.
Why coverage is the biggest hurdle
Dutch insurers almost never reimburse the gastric balloon, not even from supplementary insurance; the lifestyle programme around it usually is covered. Commercial clinics mention criteria such as a BMI between 27 and 40 and a weight between 80 and 150 kilograms, and exclude people who had stomach surgery before.
How the field is changing
The Nederlandse Obesitas Kliniek stopped offering the balloon, because in its view weight loss medication leads to more and longer-lasting weight loss with fewer side effects. That shows how fast the non-surgical options are changing.
Before choosing an endoscopic treatment, compare it with covered alternatives: a lifestyle programme, supervised medication and, if you qualify, surgery.
Advantages and points of attention
Advantages
| Advantage | Explanation |
|---|---|
| No incisions | through the mouth |
| Guidance included | lifestyle coach or COOL |
| Temporary balloon | nothing permanent |
| Option below surgery threshold | from BMI about 27 |
Points of attention
| Point of attention | Explanation |
|---|---|
| Not reimbursed | self-pay |
| Weight regain | possible after removal |
| Limited providers | few Dutch clinics |
| Medication alternative | may be more effective (NOK) |
Cost and insurance (2026)
Endoscopic treatments are almost always self-pay in the Netherlands.
| Item | Amount or arrangement |
|---|---|
| Vitalys balloon pathway | €3,995 + €65 intake |
| Balloon range 2026 | about €3,000-€5,000 |
| Lifestyle programme | covered |
Endoscopic options: key figures
| Feature | Value |
|---|---|
| Balloon duration (Vitalys) | 1 year |
| Guidance (Vitalys) | 18 months with COOL |
| Typical BMI range | 27-40 (commercial clinics) |
| Weight range | 80-150 kg (commercial clinics) |
| Reimbursement | almost never |
Endoscopic options at a glance
| Option | Provider (examples) | Note |
|---|---|---|
| Gastric balloon | Vitalys | 1 year, with COOL |
| Elipse balloon | Zuyderland | swallowed as a capsule |
| POSE | Zuyderland | endoscopic procedure with coach |
| Balloon | commercial clinics | criteria vary |
Step by step
- Compare. Endoscopic, medication, surgery.
- Criteria. Check BMI, weight and history.
- Intake. With the clinic.
- Treatment. Balloon, Elipse or POSE with coaching.
- Follow-up. Keep up the lifestyle changes.
Read next
- Gastric balloon — cost and results
- Medication versus surgery — alternatives
- All obesity treatment options — the ladder
- Obesity clinics — providers
Questions to ask a provider
What exactly is included in the price: intake, placement, removal, coaching and follow-up? What are the criteria, and what happens if the treatment does not work for me? Does the clinic work with my GP? Written answers make comparing easier.
After an endoscopic treatment
The lasting result depends on the habits you build during the programme. Plan how you will keep them up after the coaching ends, and keep your GP informed. If weight returns and you meet the criteria, surgery remains possible later.
Balloon, POSE or medication: key differences
A balloon takes up space in the stomach for a limited time and is then removed. POSE is an endoscopic procedure that changes the stomach from the inside without incisions; ask the provider about its expected durability and what happens if results fade. Weight loss medication works on appetite hormones and continues as long as you use it.
All three work best with lifestyle guidance, and none of them is a standard covered treatment in the way surgery is. Compare the total cost, the guidance included and what happens after the treatment ends.
Endoscopic treatment for expats
Some expats have had a balloon or endoscopic procedure abroad. Bring the records to your Dutch GP, including the type of balloon and the dates of placement and removal. If you later consider surgery in the Netherlands, the team will want this information during screening.
Who is an endoscopic treatment suitable for?
Endoscopic treatments are mainly aimed at people with a BMI below the threshold for surgery who are motivated to change their habits and can pay for the treatment themselves. People who meet the criteria for surgery usually benefit more from a covered operation, which gives more lasting weight loss.
People with earlier stomach surgery are often excluded. Discuss your history openly during the intake, and ask the provider for the criteria in writing before paying anything.
If you are considering an endoscopic treatment abroad
Clinics abroad sometimes advertise lower prices. Check whether guidance is included, how removal and complications are handled, and who looks after you when you are back in the Netherlands. Vitalys warns that guidance and aftercare are often missing after treatment abroad. Tell your Dutch GP before and after the treatment.
Keep all records together.
Frequently asked questions about endoscopic options
A treatment through the mouth with a flexible camera, without incisions, such as a gastric balloon or POSE.
Zuyderland offers POSE, combined with a lifestyle coach.
A balloon you swallow as a capsule, offered by Zuyderland with lifestyle coaching.
Almost never. The lifestyle programme around them usually is.
3,995 euros plus a 65 euro intake, including COOL and 18 months of guidance.
Criteria differ; commercial clinics mention a BMI of 27 to 40, a weight of 80 to 150 kilograms and no earlier stomach surgery.
Because it considers weight loss medication more effective with fewer side effects.
A balloon is temporary. Ask the provider about the durability of POSE.
Yes, if you meet the criteria, surgery remains possible.
Compare with covered options and ask each provider what is included and what the criteria are.
Call +31 6 38048347 (Mon–Fri 09:00–17:00) or email info@maagverkleining-info.nl. This page is also available in Dutch.
Sources
- Zuyderland: Elipse balloon and POSE
- Vitalys (Rijnstate): gastric balloon
- Nederlandse Obesitas Kliniek: discontinuation of the balloon
- YourWeightcare: balloon criteria
Search terms leading here: endoscopic weight loss Netherlands, POSE Netherlands, Elipse balloon, non-surgical weight loss procedure.
Author: Gijs Bodenstaff. Last reviewed: September 2026.