Intragastric Balloon for Overweight Patients

Abstract

Background and Objectives:Current treatments for overweight adults include reduced-calorie diet, exercise, behavior modification, and selective use of medications. Many achieve suboptimal results with these measures and progress to obesity. Whether the intragastric balloon (IGB), a reversible device approved for treatment of obesity, is a safe and effective option in overweight adults is less well studied. We conducted a study to prospectively analyze the safety and effectiveness of IGB in overweight adults, to compare the results to a simultaneously studied cohort of obese patients, and to share procedural tips for safe IGB placement and removal.Methods:One hundred thirty-nine patients were evaluated in this prospective, nonrandomized study. Twenty-six overweight [body mass index (BMI), 26–30)] and 113 obese (BMI > 30) patients underwent outpatient, endoscopic IGB placement under intravenous sedation. The IGB was filled with a 550–900 mL (average, 640 mL) solution of saline, radiological contrast, and methylene blue, with an approximate final proportion of 65:2:1. The patients were followed up at 1–2 weeks and then monthly for 6 months. At 6 months, they underwent IGB removal via an esophageal overtube to optimize safety, and then they were observed for 6 more months.Results:IGB time was 190 ± 36 d in the overweight patients and 192 ± 43 d in the obese patients. Symptoms of IGB intolerance included nausea and pain, which were transiently present in 50–95% of patients for several days, and necessitated early IGB removal in 6% of patients. There were no procedure-related complications and no IGB-related esophagitis, erosion, perforation, or obstruction. The percentage of excess weight loss (EWL%) was 96 ± 54% in the overweight group and 41 ± 26% in the obese group (P < 0.001).Conclusion:In overweight adults failing standard treatments, IGB placement for 6 months had an acceptable safety profile and excellent weight loss.

Safety, tolerability and efficacy of a novel self‐use biodegradable device for management of obesity

“…Consequently, there are increasing attempts to develop minimally invasive endoscopic procedures such as endoscopic sleeve gastroplasty, aspiration therapy or intragastric balloons that may bridge the gap between medical therapy and surgery . Several efficient intragastric balloons with lower complications rate were introduced . More recently, Food and Drug Administration approved several endoscopic weight loss devices including the Reshape, the Orbera, the Obalon and the AspireAssist .…”

Does combining liraglutide with intragastric balloon insertion improve sustained weight reduction?

“…In standard practices gastroenterologists perform such procedures for patients with BMIs exceeding 35 and generally remove the balloon endoscopically after 6 months. [14] The major limitation of IGB insertion remains weight regain after the balloon is removed, which is reported in up to 35% of patients. [13] Results from this first study to evaluate Liraglutide as an adjunctive therapy for IGB-induced weight reduction demonstrates that endoscopic IGB insertion on average reduces weight by 10.2 ± 6.7 kg at the time of balloon extraction and 2.7 ± 4.1 kg 6 months post extraction, indicating significant weight regain following removal.…”

Medical Devices in Obesity Treatment

“…Indications for an IGB are for weight loss in patients with a BMI > 35 kg/m 2 who have failed lifestyle measures, pharmacotherapy or for whom bariatric surgery is contraindicated. IGB may also be used to aid weight loss prior to bariatric surgery to reduce intraoperative risk [23]. Given the ease of deployment and simplicity, IGB has relatively few contraindications.…”