Assessment of Weight Loss After Non-Adjustable and Adjustable Intragastric Balloon Use

Abstract

BACKGROUND: Intragastric balloon (IGB) use is indicated for patients whose BMI precludes the option of bariatric surgery or who need to lose weight prior to undergoing surgery. It is a minimally invasive procedure and currently there are two main models of IGBs in use, the non-adjustable intragastric balloon (NIB), implanted for six months, and the adjustable intragastric balloon (AIB), implanted for up to 12 months. OBJECTIVE: Analyze clinical characteristics between patients receiving non-adjustable gastric balloon and the adjustable (prolonged implantation) intragastric balloon. METHODS: This was a cross-sectional study of 470 patients diagnosed as obese or overweight who had balloon implantation from October 2011 to July 2018. The associations between percentage excess weight loss versus clinical and demographic variables were calculated using the chi-squared test. Independent samples were submitted to the Student’s t test to determine the quantitative variables, with a confidence interval of 95%. Calculation of excess weight was based on an estimated ideal weight that would correspond to a BMI of 24.99 kg/m2. RESULTS: A total of 414 patients completed the treatment achieving an average total body weight loss (%TBWL) of 15.4±7 with the NIB and 15.5±9.6 with the AIB. Overweight patients achieved higher excess weight loss (%EWL) values using AIBs (157.2±82.5) and obese patients did so with NIB use (56±29.7). Women achieved higher %EWL values (65.6±62.2) than men (48±27.1). Individuals who attended >4 consultations with a nutritionist (60.8%) achieved TBWL >18%. All of those P-values were <0.001. CONCLUSION: Obese individuals and women registered the greatest weight losses. Overweight patients achieved greater losses using AIB and obese patients did so using NIBs. NIB use was associated with higher EWL percentages. Nutritional accompaniment had a positive impact on the %TBWL.

Six intragastric balloons: Which to choose?

“…85.2% of successful responders, n = 162, had attended the maximum of six interviews, whereas the 83.8% of the 105 poor responders attended fewer than four interviews[ 13 , 85 , 96 ]. Similar results were reported by Schwaab et al [ 72 ]: patients with more than four consultations achieved notably higher %EWL values (more than 18%, P < 0.001).…”

“…Schwaab et al [ 72 ] 2020 published a cross-sectional study of 470 overweight or obese patients who were treated by either a non-adjustable IGB (Orbera), 326 subjects implanted for 6 mo; or an adjustable balloon (Spatz) in 144 subjects for up to 12 mo. A total of 414 out of 470 individuals completed the treatment period.…”

Experiencia con el uso de balón intragástrico de contenido líquido para el manejo de la obesidad de riesgo bajo y moderado en un centro de referencia colombiano

“…Spatz por hasta 12 meses, y se logró una pérdida de peso corporal total 15,5 ± 9,6% (28) . En cuanto al BIG Elipse, un metaanálisis por Ramai y colaboradores evaluó 7 estudios con 2152 pacientes, y se demostraron resultados similares, con un porcentaje de pérdida total de peso del 12,2% (IC 95%: 10,1-14,3; índice de inconsistencia [I 2 ]: 94%) y porcentaje de pérdida de peso excesivo del 49,1% (IC 95%: 30,6-67,5; I 2 = 97%) (29) .…”

Bariatric and Metabolic Endoscopy: A New Paradigm

“…A more recent, cross-sectional study showed that obese patients achieved greater WL with nonadjustable IGB, whereas overweight (BMI . 27) achieved greater WL with adjustable IGB (42). Additional prospective studies are needed to quantify the advantages of adjustable balloons in terms of WL and address safety concerns of catheter impaction as was seen in previous generations of devices (39,43).…”

“…Retrospective studies and case series showed that down-volume adjustment might alleviate balloon intolerance, whereas up-volume adjustment may contrast the plateau effect facilitating additional WL ( 38 – 40 ) and provide a further delay of gastric emptying ( 41 ). A more recent, cross-sectional study showed that obese patients achieved greater WL with nonadjustable IGB, whereas overweight (BMI > 27) achieved greater WL with adjustable IGB ( 42 ). Additional prospective studies are needed to quantify the advantages of adjustable balloons in terms of WL and address safety concerns of catheter impaction as was seen in previous generations of devices ( 39 , 43 ).…”