This month’s On the Spot magnifies some of the topics at the intersection of bariatrics and endoscopy, just in time for the 2023 Clinical Congress of the American College of Surgeons! We debate whether endoscopic sleeve gastroplasty will overtake laparoscopic Roux-en-Y gastric bypass; endoscopic revision for previously performed bariatric procedures; whether endoscopic sleeve gastroplasty is less invasive and effective; for whom endoscopic sleeve gastroplasty should be indicated; and the