Losing weight can be a challenging journey, often filled with frustration when traditional methods like diet and exercise fall short of expectations. For those seeking an alternative approach to jumpstart their weight loss efforts, the intragastric balloon presents a promising option. This article aims to provide a comprehensive overview of the gastric balloon procedure, exploring its benefits and drawbacks to help individuals make informed decisions about their weight loss journey.
What is a Gastric Balloon?
The gastric balloon, also known as an intragastric balloon (IGB), is a non-surgical, temporary weight loss solution designed for individuals with a Body Mass Index (BMI) over 30 who have struggled to achieve lasting results with conventional weight reduction measures. It involves placing a deflated silicone balloon into the stomach, which is then inflated with saline or gas to occupy space, creating a feeling of fullness and reducing appetite. This procedure doesn't make the usual incision or changes that many people associate normal gastric balloon surgery with.
The gastric balloon is a reversible procedure, typically remaining in place for six months. During this period, patients work closely with a healthcare team, including a nutritionist, gastroenterologist, and psychologist/psychiatrist, to develop and implement a personalized weight loss program that includes dietary and lifestyle modifications. The goal is to help patients develop healthier eating habits, control portion sizes, and establish an exercise routine that they can maintain long-term.
The Gastric Balloon Procedure: What to Expect
Before the Procedure
Prior to undergoing the intragastric balloon procedure, a thorough consultation with a healthcare provider is essential to determine suitability. The healthcare provider will assemble a team of caregivers to support the patient throughout the program. This team may include a nutritionist, gastroenterologist, psychologist/psychiatrist, and other specialists who will collaborate to design a personalized weight loss program.
To prepare for the procedure, the healthcare provider will explain the risks, benefits, and alternatives, obtaining informed consent. Patients are often started on acid-blocking medication to prevent acid reflux during and after the procedure. A few days before, a clear liquid diet is required to help empty the stomach, and patients are typically asked to refrain from eating or drinking anything after midnight the night before.
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During the Procedure
The intragastric balloon is typically inserted using an endoscope, a long, flexible tube with a camera attached. The endoscope is inserted through the mouth and guided down the esophagus into the stomach. While most people undergo this procedure while awake, a mild sedative is administered to help them relax.
The gastroenterologist or endoscopic surgeon begins by examining the esophagus and stomach with the endoscope to ensure there are no conditions that could make the balloon unsafe. Once satisfied, they guide the deflated balloon into place.
The balloon is then filled with a sterile saline solution, with the amount varying depending on the type of balloon used. Once filled, the endoscopist detaches the syringe and withdraws the catheter. The valve on the balloon seals to prevent leaks. The filled balloon takes up a significant portion of the stomach, creating a feeling of fullness.
The entire procedure typically takes 20 to 30 minutes. Afterward, patients spend a few hours recovering in the hospital, receiving IV fluids and medication to prevent pain and nausea. Before discharge, the healthcare team ensures the patient is tolerating the balloon and provides dietary instructions to follow in the weeks ahead.
After the Procedure
Following the procedure, the stomach needs time to adjust to the presence of the balloon. Patients start with a liquid diet and gradually advance to pureed foods, followed by a soft diet, and finally, the long-term diet designed by their nutritionist. Close contact with the healthcare team is maintained during this time to manage any physical or psychological side effects that may arise.
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The intragastric balloon typically remains in place for six months. During this time, patients continue to work with their team to make sustainable diet and lifestyle changes. The greatest weight loss typically occurs in the first three months.
Balloon Removal
After six months, a second endoscopic procedure is performed to remove the balloon. Patients receive a sedative and a topical anesthetic or lubricant in their throat to ease the removal. The endoscopist punctures the balloon, suctions out its filling, and then withdraws the deflated balloon.
Types of Intragastric Balloons
Several types of intragastric balloons are available, each with its unique features and benefits:
- Orbera IGB: The first of the new generation of balloons, FDA-approved in 2005. It is a single spherical silicone-made balloon filled with 500 to 700 mL saline solution. It remains implanted for a maximum of 6 months.
- Heliosphere BAG: A single spherical high-volume-capacity, air-filled, polyurethane balloon enclosed in a silicone envelope. It requires endoscopy for positioning and allows 900-1000 mL of air inflation.
- Spatz3® balloon: The first balloon that can be adjusted - increased or reduced - throughout the treatment period. It can safely remain in the stomach for 360 days.
- ReShape Duo integrated dual balloon system: Consists of two independently filled silicone spheres joined by a central, short, non-communicating flexible silicone shaft.
- Obalon®: A thin-walled, 250 mL gas-filled, swallowable IGB, designed to allow easy gastric volume titration, by using additional balloons.
- Elipse balloon: A non-FDA-approved IGB that does not require anaesthesia or an invasive endoscopic procedure for placement or removal.
Pros of Gastric Balloon
The gastric balloon offers several advantages for individuals seeking weight loss:
- Non-Surgical and Minimally Invasive: A major benefit of a gastric balloon is that it does not require surgical procedures. It thus offers an even safer route to those wishing to avoid bariatric procedures that are known to carry associated risks. The procedure is performed endoscopically, without incisions, reducing the risks associated with surgery.
- Short Recovery Time: Recovery time is also significantly shorter in that the procedure does not require incisions. Most patients can resume their normal activities within a few days.
- Successful Weight Loss Outcome: Numerous studies have suggested that 15-20% of a patient’s body weight can be lost within six months of the procedure. Gastric balloon treatment sets the individual up for success concerning healthy control of portion sizes and healthy eating habits. Patients typically experience rapid results, with most losing a significant amount of weight during the first three months.
- Improves Metabolic Health: Weight loss via the gastric balloon may be associated with substantial health improvements, like easier control of blood sugar levels and a lower risk of heart diseases, and generally high metabolism.
- Lower Risk Compared to Surgery: Any medical procedure has some risks, but the gastric balloon’s pros and cons weigh more toward safety when compared to surgical alternatives. There is no cutting, stapling, or rerouting of the digestive system.
- Temporary and Reversible: The gastric balloon is a temporary solution, allowing patients to "jump-start" their weight loss efforts without permanent alterations to their bodies. The balloon is removed after six months, leaving no lasting changes to the body.
- Less Expensive Than Bariatric Surgery: A gastric balloon procedure generally costs between $6,000 and $9,000 compared to the cost of bariatric surgery which in the United States starts between $14,000-23,000.
- Broader Candidacy: Candidates who have lower BMI levels often will qualify for a gastric balloon procedure and can get their weight under control before their BMI elevates. Additionally, patients that are in poor health and may not qualify to undergo a surgical procedure are often candidates for a gastric balloon. This may be used as an interim solution to help patients lose an initial amount of weight before undergoing a surgical procedure.
- Support and Supervision: An additional benefit of a gastric balloon is that the patient receives supervision and support for a full year during their weight loss program even after the balloon is removed after the initial 6 months.
Cons of Gastric Balloon
Despite its benefits, the gastric balloon also has some drawbacks that potential candidates should consider:
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- Vomiting Nausea: The major gastric balloon side effects reported are nausea and vomiting in the immediate days after this procedure. Your body requires this time to understand the presence of an object within the stomach. Adjusting diets and the use of medicines would help avert these discomforts.
- Discomfort in the Stomach: Some patients will experience discomfort like bloating, cramping, and acid reflux from the presence of the gastric balloon in their stomach.
- Probable Early Deflation: Though it occurs rarely, the gastric balloon may deflate early. For this purpose, the person is taken for surgical removal by medical professionals if such an early deflation of the balloon is found.
- A Temporary Procedure: Unlike gastric balloon surgery, which permanently changes the stomach, it is a temporarily effective means of losing some weight. But once removed from the patient’s stomach, the patient leads their healthy life, if not to gain pounds again.
- Lower average weight loss percentages: The average weight loss for patients who undergo a gastric balloon procedure is generally lower when compared to bariatric surgery.
- Weight Regain is possible after the balloon is removed: If patients do not continue to follow the same dietary restrictions after the removal of the weight loss balloon they may begin to gain weight.
- Side Effects: While most of the side effects are temporary and generally only last a few weeks, they can sometimes become chronic and non-responsive to medications (e.g. acid reflux, nausea, vomiting).
- Must Avoid Certain Foods: Similar to after undergoing bariatric surgery, patients must avoid certain foods and beverages after the insertion of a gastric balloon. For example, certain foods such as pasta tend to stick to gastric balloons causing unpleasant side effects.
- Limited Long-Term Effectiveness: Some studies indicate that balloons have limited sustainable effectiveness for the vast majority attempting such therapy, resulting in a return to the previous weight after balloon removal.
Who is a Good Candidate for a Gastric Balloon?
A gastric balloon is very suitable for the population that has a BMI of 30-40; in fact, only for those patients who have not responded to any conventional weight-reduction measures. It is ideal for the population that does not qualify for or does not want bariatric surgery.
However, there are some exclusions. Individuals who have a history of gastrointestinal diseases or who have had surgery on the stomach cannot be part of this program, nor can they if they have severe acid reflux. A weight loss specialist must deem them eligible.
Gastric Balloon vs. Other Weight Loss Options
Gastric Balloon vs. Gastric Sleeve Surgery
Gastric sleeve surgery is one of the most common weight loss surgeries. In this procedure, a surgeon removes part of your stomach. Gastric balloons and gastric sleeve surgery both restrict how much food you can eat. But a gastric sleeve involves surgery and changes the shape and size of your stomach permanently.
While the gastric balloon offers a cost-effective and reversible option, many individuals find they rebound. The gastric sleeve, on the other hand, delivers more substantial and lasting results, making it the preferred choice for those aiming for significant weight loss and improved health.
Gastric Balloon vs. Weight Loss Medications
New weight loss medications help reduce your appetite and food cravings. They can also make you feel fuller. These medications are effective while you take them.