Endoscopic intragastric balloon: a gimmick or a viable option for obesity?

Abstract

Worldwide, the prevalence of obesity has doubled since 1980 in 70 countries. More than one in three adults now suffer from overweight or obesity. Health problems related to obesity include orthopedic problems, psychiatric conditions, metabolic and cardiovascular diseases, and of increasing concern, cancer.Thus, obesity has an enormous impact on the individual's wellbeing as well as on society's workforce and health care expenses. Medical efforts are ongoing to find safe and effective treatment options for obesity and its metabolic implications. At present, available treatment options include lifestyle interventions, pharmacotherapy, endoscopic applications, and bariatric surgery. Within the range of endoscopic treatment options, the intragastric balloon is the most widely used device. The idea is simple: the gastric volume is reduced by a balloon that is in most cases implanted by an endoscopic procedure similar to a gastroscopy.During the past decades, different models have been developed, which we will briefly introduce in this review. We aim at reviewing the pathophysiology underlying the effect of endoscopic intragastric balloon on weight loss and metabolic changes. We will assess expected short-term and long-term benefits for the patient, and we will discuss common side effects as well as rare complications. We will compare endoscopic intragastric balloon to conservative treatment options with or without pharmacological support on the one hand and to the spectrum of bariatric surgery on the other hand. In most patients, obesity must be considered a chronic disease that requires a lifelong treatment concept. In view of current treatment options for obesity, we will discuss whether endoscopic intragastric balloon is a viable treatment option, and who may be the right patient to benefit from it.

Acute Necrotizing Pancreatitis Following Intragastric Balloon Insertion

“…Some common side effects of the intragastric balloon are nausea, the feeling of satiety, and gastric erosions. More severe side effects, such as obstruction or perforation, are infrequent [ 8 ].…”

Clinical Use of a Real-World Low Carbohydrate Diet Resulting in Reduction of Insulin Dose, Hemoglobin A1c, and Weight

“…The LCD enabled the participants to achieve control of their T2DM while simultaneously reducing or stopping their insulin consumption and losing weight. This intervention was more successful than any other medication for T2DM, and the weight loss was also greater than, even that of, intragastric balloon procedures ( 14 ).…”

Overview on the endoscopic treatment for obesity: A review

“…All balloons are removed endoscopically six months after the placement of the first balloon. The anticipated TBWL is 7.1%[ 62 ]. In one study, a swallowable gas-filled IGB device was deemed safe after six months and resulted in double the weight loss than a sham control, with significant weight loss maintenance at 48 wk[ 63 ].…”

“…Prior to the treatment, the average weight and BMI of participants were 93.8 kg and 35.2 kg/m 2 , respectively. After the procedure, these values decreased to 80.6 kg and 29.8 kg/m 2 after 8.2 mo and to 82.4 kg and 30.4 kg/m 2 on the last day of follow-up after 12.9 mo[ 62 ]. In another study, the weight reduction at IGB (Orbera) removal after 6 mo and at IGB (Orbera 365) removal after 12 mo was retrospectively examined.…”