Gastric Balloon: Viable Alternative to Weight Loss Surgery?

[Alex Brecher 10,516]

The gastric balloon is a newer approach to weight loss. It is an alternative to Weight Loss Surgery for obese patients whose BMI’s may be too low to qualify them for Weight Loss Surgery. It can also be an option for you if you do not want surgery because of its risks or because you want a completely irreversible treatment.

How It Works

The gastric balloon is placed in your stomach to partially fill it. This helps make you feel full so you are inclined to eat less and lose weight. The program depends on your readiness to make changes in your eating behaviors, and you are likely to be more successful if your doctor works closely with you during the time you have the balloon inflated to establish healthier nutritional habits.

Like weight loss surgery, the gastric balloon is a tool for weight loss that depends on behavior change. Patients are supposed to have nutritional counseling and learn new eating habits during the months they have the balloon in place. Orbera also promotes establishing a sustainable exercise routine, managing your appetite, and learning how to keep yourself motivated.

The Procedures for Implanting and Removing the Balloon

It usually takes less than 30 minutes to get a gastric balloon implanted. The procedure is endoscopic, not surgical. You receive an anesthetic for your throat, and then swallow a deflated balloon attached to a catheter or small tube.

The surgeon places the balloon using endoscopic instruments, such as a probe with a camera, and then inflates the catheter with saline solution or air. You can go home within hours after your balloon is filled. For 1 to 3 days, you follow a liquid or soft foods diet.

You may have multiple balloons inserted over the course of your treatment. For example, Obalon’s 12-week program includes up to three balloons, each with a size of 250 cc (about 1 cup), for a possible total of 750 cc. Other company’s balloons may be larger, such as 400 cc.

To remove the balloon, the surgeon gives you a sedative. The process takes only a few minutes, and you will be sedated for only about 30 minutes.

Differences from Weight Loss Surgery

In general, the gastric balloon is an obesity treatment designed for lower-BMI patients than weight loss surgery. In general, you are eligible for the gastric balloon starting at a BMI of 27. In contrast, health insurance plans that include weight loss surgery set eligibility for reimbursement at a BMI of 40, or a BMI of 35 with an obesity-related comorbidity, such as type 2 diabetes or hypertension. A BMI of 27 is not even considered “obese,” but rather categorizes you as “overweight.”

Unlike Weight Loss Surgery, the gastric balloon is not intended to be permanent. The Orbera and ReShape Duo intragastric balloons can be used for up to 6 months.

Manufacturers of the gastric balloon claim it can help you lose about 10 to 15 kg (20 to 35 lbs), at the rate of about 1 kg (2 lbs) per week.

In comparison, Weight Loss Surgery patients may lose about 80 to 100 lbs. (35 to 45 kg) in their first year after surgery, which is also a rate of about 1 kg/week. They have continued effects of the surgery (e.g., restriction from a smaller pouch/sleeve) after that time, since surgery is permanent.

Effectiveness and Safety

The gastric balloon can help you lose weight at a steady rate for the months or year you have it in place. It can also help encourage you to establish healthy eating patterns. Some research studies have also found reductions in visceral (or abdominal or belly) fat (that’s the unhealthiest kind of body fat). Patients who are most compliant and lose the most weight are also likely to see improvements in type 2 diabetes, hypertension, and fatty liver.

The gastric balloon has fewer risks than surgery. It can lead to gastroesophageal reflux disease (GERD). Nausea and vomiting are among the more common side effects. Pregnant women, individuals with psychological disorders, and individuals who are misusing drugs should not get a gastric balloon.

A Few Different Versions

Multiple companies make versions of the gastric balloon. For example, Apollo Endosurgery, makers of the lap-band, make the Orbera gastric balloon. Obalon sells its gastric balloon in Europe and Mexico. A smaller medical device manufacturing company, ReShape Medical, makes the Reshape Duo balloon, which was approved by the FDA yesterday!

[samelton68 64]

This is very interesting, I would think the costs are substantially less too

[Alex Brecher 10,516]

This is very interesting, I would think the costs are substantially less too

Not sure about cost but I think they're anywhere from $5,000-$7,500. Don't quote me on the price because I'm not certain. The only issue is long term weight loss viability. Most people take off a very decent amount of excess weight with the Balloons, but we're going to need to see how long they'll be able to keep it off.

[JamieLogical 8,727]

I wanted to mention that the BBC show, Fat Doctors, has shown the gastric balloon as a safer option for people with very high BMI or high risk factors for surgery. They use the balloon as a temporary treatment to help get a patient's weight down to a safer level, then remove the balloon and perform actual weight loss surgery on them (usually RNY) once their risk factors for undergoing anesthesia have been reduced.

[Dawn306 50]

Alex, I wonder if the doctors in Mexico (who advertise on this site) are up to date on this procedure? Do you know if they have any experience with it? I would be afraid of the balloon moving, and blocking off the entrance of food into the stomach from the esophagus. Or what if you go on a plane, and the decreased pressure caused it to expand and block it?

My BMI is 32, and I am booked for gastric sleeve (self-pay). My husband is afraid of long term complications. I wonder if this balloon would be a better option for me?

[Alex Brecher 10,516]

I wouldn't get a Balloon in Mexico if you can't get there in a jiffy. You should use a local doc for this procedure. There are a few awesome Mexican docs that actually proctor and are teaching US surgeons and have been doing balloons for quite a long time.

[Croaker 26]

Just to note, the study published regarding the Reshape demonstrated increased weight loss over those who didn't have it, yet we aren't talking about huge amounts. Despite the above quoted weight loss average from the company, the study showed those who received the balloon lost on average 14 pounds over six months, compared to 7 pounds for those who underwent the procedure but didn't have the balloon placed (the placebo group).

So, does it help with weight loss? Yes. But 7 pounds more over the placebo group over a six month period isn't exactly going to get anyone from morbid obesity to a healthy weight.

[Alex Brecher 10,516]

The Orbera Gastric balloon has just been approved by the FDA:

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm457416.htm

[VSGAnn2014 12,992]

Just to note, the study published regarding the Reshape demonstrated increased weight loss over those who didn't have it, yet we aren't talking about huge amounts. Despite the above quoted weight loss average from the company, the study showed those who received the balloon lost on average 14 pounds over six months, compared to 7 pounds for those who underwent the procedure but didn't have the balloon placed (the placebo group).

So, does it help with weight loss? Yes. But 7 pounds more over the placebo group over a six month period isn't exactly going to get anyone from morbid obesity to a healthy weight.

Sheesh! Not very impressive.

[Alex Brecher 10,516]

Just to note, the study published regarding the Reshape demonstrated increased weight loss over those who didn't have it, yet we aren't talking about huge amounts. Despite the above quoted weight loss average from the company, the study showed those who received the balloon lost on average 14 pounds over six months, compared to 7 pounds for those who underwent the procedure but didn't have the balloon placed (the placebo group).

So, does it help with weight loss? Yes. But 7 pounds more over the placebo group over a six month period isn't exactly going to get anyone from morbid obesity to a healthy weight.

Sheesh! Not very impressive.

What are your thoughts on the ORBERA™ Intragastric Balloon US Pivotal Trial Results ? http://www.reuters.com/article/2015/05/18/tx-apollo-endosurgery-idUSnBw185339a+100+BSW20150518