A device for manipulating gastric tissue with an elongated hollow housing having distal and proximal ends. The housing contains at least one fastener. The fastener includes at least two anchors connected together by a flexible member. The flexible member has a knot disposed thereon. The knot is movable to draw together the anchors and lock them into position with respect to each other. The device also includes a penetrating member disposed at the distal end of the housing, and an actuator for deploying the fasteners distally through the housing and the penetrating member.