The Orbera Managed Weight Loss System is an FDA-approved, non-surgical approach to weight loss designed to enhance weight loss and aid in the treatment of obesity. It involves the temporary placement of an intragastric balloon in the stomach. This article provides a detailed overview of the Orbera system, including the procedure, benefits, risks, and what to expect throughout the program.
What is the Orbera Weight Loss System?
The Orbera system is a comprehensive weight loss program that utilizes an intragastric balloon to help individuals lose weight without surgery or long-term drug therapy. The Orbera balloon itself is a soft, stretchable silicone device that is temporarily inserted into the stomach. The system includes a 12-month program that provides education and support, from the time of implantation to six months after the balloon is removed. The balloon's primary function is to occupy space in the stomach, creating a feeling of fullness and helping individuals eat smaller portions.
How Does the Orbera Balloon Work?
The Orbera balloon works by taking up space in the stomach, which helps individuals feel full faster and reduces the amount of food they can comfortably consume. The balloon slows down the emptying of the stomach through the pylorus, which further contributes to the feeling of fullness. This, in turn, helps individuals reduce their calorie intake and lose weight.
For the process to be successful, the Orbera balloon must be used in combination with a proper diet, exercise, and behavior modification program. This comprehensive approach helps individuals adopt healthier eating habits that will allow them to lose weight and maintain that weight loss in the long term.
Who is a Good Candidate for Orbera?
Orbera could be an effective solution for individuals who have struggled to lose weight through diet and exercise alone. The most common measurement used to determine if a person is overweight is Body Mass Index (BMI). If you have a BMI of 30 or more, Orbera could be a viable option.
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However, the procedure may not be advised for individuals with certain medical conditions. A consultation with a healthcare provider is essential to determine if you are a good fit for the intragastric balloon system. The healthcare provider will assemble a team of caregivers, including a nutritionist, gastroenterologist, and psychologist/psychiatrist, to support you through the program.
The Orbera Placement Procedure
The Orbera balloon is placed in the stomach through an upper endoscopy procedure, typically conducted at a hospital or outpatient center. Here's a step-by-step breakdown of the process:
- Preparation: Patients change into a gown, and their belongings are stored in a secure area. A local, liquid anesthetic may be gargled or sprayed on the back of the throat to numb it and calm the gag reflex.
- Sedation: An intravenous (IV) needle is placed in a vein in the arm to administer sedatives, helping patients stay relaxed and comfortable during the procedure. Most patients fall asleep with sedatives.
- Endoscopy: While the patient is sedated, the doctor and medical staff monitor vital signs. The patient lies on their side on an examination table. An endoscope is carefully fed down the esophagus and into the stomach and duodenum.
- Examination: A small camera mounted on the endoscope transmits a video image to a video monitor, allowing close examination of the intestinal lining. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to see. The doctor will carefully examine the upper gastrointestinal tract to ensure it is safe to place the balloon.
- Balloon Insertion: The uninflated balloon is inserted alongside the endoscope through the mouth and passed down into the stomach.
- Inflation: Under camera view, the balloon is inflated with a sterile saline solution until it reaches the desired size, typically between 400 to 700 cc, about the size of a grapefruit.
- Deployment: The deployment system is detached from the balloon, leaving it in the stomach.
- Recovery: After the procedure, patients are moved to a recovery room where they wait about an hour for the sedative to wear off.
The entire procedure typically takes about 20 to 30 minutes.
What to Expect After the Procedure
After the Orbera balloon is placed, patients can expect a period of adjustment as their stomach gets used to the device.
Initial Discomfort
In the beginning, patients often experience nausea and vomiting. This can be managed with anti-nausea medicines prescribed by the doctor. Other common side effects include abdominal or back pain and acid reflux. These side effects are temporary and normal.
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Dietary Progression
Your stomach will need time to adapt to the balloon before you resume your regular diet. You’ll start with a clear liquid diet for the rest of the day and gradually advance to pureed foods, followed by a soft diet, and finally, the long-term diet designed by your nutritionist.
Ongoing Support
You’ll stay in close contact with your healthcare team during this time. They’ll support you through the physical and psychological side effects while you’re adjusting.
The Orbera Removal Procedure
The Orbera balloon stays in place for six months. After this period, it must be removed through another endoscopic procedure. The removal process is similar to the placement procedure:
- Preparation: Patients are given a sedative and a topical anesthetic or lubricant in their throat to ease the removal.
- Endoscopy: The endoscopist inserts an endoscope through the mouth and into the stomach.
- Deflation: The balloon is punctured, and the saline solution is suctioned out.
- Removal: The deflated balloon is then withdrawn from the stomach.
Expected Weight Loss with Orbera
Patients treated with Orbera can expect to have significant weight loss during the six months the balloon is in place. By adhering to the Orbera Managed Weight Loss Program, patients can lose an average of 2.2 pounds per week, or a total of 22 to 33 pounds. Some patients may experience even more significant weight loss, with clinical trials showing participants losing an average of 21 pounds, with some achieving as much as 115 pounds.
The greatest weight loss typically occurs in the first three months after balloon placement.
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Benefits of the Orbera System
- Non-Surgical: Orbera does not involve surgery or long-term drug therapy, making it a less invasive option for weight loss.
- Temporary: The balloon is only in place for six months, reducing the risk of long-term complications.
- Significant Weight Loss: Patients can experience significant weight loss during the treatment period.
- Comprehensive Support: The Orbera system includes a 12-month program with a dietitian-directed diet and behavioral support to help patients achieve long-term success.
- Improved Health: Losing weight can lead to improvements in overall health and quality of life.
Risks and Side Effects
As it is a non-invasive procedure, there are very minimal risks involved. However, like any medical procedure, there are potential risks and side effects associated with the Orbera system. These include:
- Nausea and vomiting
- Abdominal or back pain
- Acid reflux
- Balloon leakage (rare)
These side effects are typically temporary and can be managed with medication.
Preparing for the Orbera Procedure
Before undergoing the Orbera procedure, it's essential to consult with a healthcare provider to determine if you are a suitable candidate. If you are, your healthcare provider will assemble a team of caregivers to support you through the program.
Medical Evaluation
You’ll undergo a thorough medical evaluation to ensure you don’t have any conditions that could make the balloon unsafe.
Dietary Preparation
A few days before the procedure, you’ll be put on a clear liquid diet to help empty your stomach. The night before, you’ll be asked not to eat or drink anything after midnight.
Medication
Your healthcare provider will often start you on acid-blocking medication to prevent acid reflux during and after the procedure.
Long-Term Success After Orbera
The Orbera system is designed to help individuals lose weight and maintain that weight loss over the long term. To achieve this, it's crucial to continue working with your healthcare team after the balloon is removed. This includes:
- Following a healthy diet
- Engaging in regular exercise
- Adopting positive behavior modifications
By making these lifestyle changes, you can retrain yourself to notice when you’re getting full and sustain your weight loss over the long term.
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