The Clinical and Metabolic Effects of Intragastric Balloon on Morbid Obesity and Its Related Comorbidities

Abstract

Obesity is becoming increasingly prevalent worldwide, and its metabolic sequelae lead to a significant burden on healthcare resources. Options for the management of obesity include lifestyle modification, pharmacological treatment, surgery, and endoscopic bariatric therapies (EBTs). Among these, EBTs are more effective than diet and lifestyle modification and are less invasive than bariatric surgery. In recent years, there have been significant advances in technologies pertaining to EBTs. Of all the available EBTs, there is a significant amount of clinical experience and published data regarding intragastric balloons (IGBs) because of their comparatively long development period. Currently, the United States Food and Drug Administration (FDA) has approved three IGBs, including Orbera (Apollo Endosurgery, Austin, TX, USA), ReShape Duo (ReShape Medical, San Clemente, CA, USA), and Obalon (Obalon Therapeutics, Carlsbad, CA, USA). The aim of this review is to summarize the available literature on the efficacy of IGBs in weight loss and their impact on obesity-related metabolic diseases.

Status of bariatric endoscopy–what does the surgeon need to know? A review

“…The IGB is the most widely adopted endoscopic method with proven efficacy and safety[ 9 , 10 ]. In a meta-analysis including only randomized studies evaluating fluid filled IGBs, the average difference in BMI loss was 1.41 kg/m 2 with an absolute weight loss of 3.55 kg between the IGB group vs the control group[ 10 ].…”

“…However, most studies do not support the effectiveness of IGBs in long-term follow-up[ 11 ]. Despite being considered a safe method, close monitoring of the patient is essential to avoid serious adverse events (AEs), such as gastrointestinal obstruction, digestive hemorrhage, pancreatitis, gastric necrosis, and perforation[ 9 - 12 ].…”

“…In addition to the efficacy known in the short-term follow-up, this type of IGB has the advantage of a low rate of AEs. It should be noted; however, that fluid filled IGBs possess a higher rate of early withdrawal since the initial volume cannot be changed and patients may be unable to tolerate the balloon due to nausea and vomiting, especially within three days after placement[ 9 - 11 ].…”

Efficacy and safety of intragastric balloon for obesity in Korea

“…Mean TBWL was 10.0 kg, mean %TBWL was 10.8%, and mean %EWL was 43.7%, which was comparable to the previous reports (%TBWL 7%-14%, %EWL 24%-50%). [13][14][15][16] Most patients fulfilled the minimum requirement of weight reduction for EBMT proposed by the American Society for Gastrointestinal Endoscopy (i.e., %EWL ≥25% or total body weight lost ≥5%) during the study period. 17 Although IGB treatment is a minimally invasive and reversible procedure with a good safety profile, various complications have been reported to date.…”

Various Novel and Emerging Technologies in Endoscopic Bariatric and Metabolic Treatments

“…We aim to review the various EBMT techniques, focusing on non-balloon and non-gastroplasty devices, as the use of those devices is well described elsewhere in this issue of Clinical Endoscopy. 7,8 We will discuss the possible mechanisms of action, efficacy, and safety profiles of these EBMT methods.…”