Overview
Obesity poses a substantial global public health challenge and is linked to various health problems, including heart disease, stroke, type 2 diabetes, and specific forms of cancer. Experiencing excess weight or obesity markedly raises the likelihood of developing these conditions and can adversely affect overall health and quality of life.
While diet and exercise are the most common ways to manage obesity, these lifestyle changes are not always effective. For individuals who have been unsuccessful with diet and exercise, weight loss surgery may be an option. Studies have shown that Bariatric surgeries (such as gastrectomy, gastric bypass, and gastric balloon insertion) are associated with improved weight, reduction in obesity chronic conditions, and significantly improved the quality of life of adults.1
In the past few years, the utilization of gastric balloon insertion has surfaced as a substitute for conventional weight loss surgeries, given its lower invasiveness and generally more affordable nature compared to other weight loss procedures.
Typically performed through laparoscopy (keyhole surgery), this method entails inserting a balloon into the stomach to diminish the quantity of food an individual can consume and generate a sensation of fullness. In addition, following the balloon insertion, patients will need several follow-up visits to adjust the size of the balloon, however, the balloon can be removed anytime if it causes problems or not achieving the desired results.2
While gastric balloon insertion is generally safe and effective, it is important to carefully consider a patient's eligibility for the procedure and to manage the risks and side effects associated with it.
In this article, we will explore the benefits, eligibility criteria, risks, and side effects of gastric balloon insertion as a weight loss procedure.
What is gastric balloon insertion?
Gastric balloon insertion is a temporary and minimally invasive procedure used for weight loss. The procedure takes about 20-30 minutes and is carried out using the Laparoscopic method. It involves inserting a deflated balloon into the stomach, which is then filled with saline solution to reduce the stomach capacity, resulting in decreased hunger and food intake.3
Depending on the type of balloon used, the balloon is then removed between 6 months to a year and the patient continues with their diet and exercise program.
There are several types of Gastric balloons:3
Orbera
The Orbera balloon is made of soft silicone and is filled with 400-700 ml of saline solution. It is the most commonly used gastric balloon and has been shown to be effective in promoting weight loss. However, it can only remain in place for a maximum of 6 months due to the risk of spontaneous deflation which can cause a bowel restriction.
Spatz
The Spatz balloon is made of durable resistant material and filled liquid that can be adjusted to control its volume during treatment. It had a one-year indwelling time and a higher risk of gastric ulcers.
Heliosphere newtech
Heliosphere Newtech balloons are filled with air and they are efficient and well tolerated and lighter than other balloons. However, they have the highest rate of spontaneous deflation which can cause many complications.
Reshape
Reshape balloon is a saline-filled double balloon made of two silicone spheres that can remain in the stomach for six months. The FDA approved this balloon in 2015, and it has been found to cause common post-implant symptoms such as nausea, vomiting, and abdominal pain. Early removal was required in 9.1% of cases in the first two months. This was reduced to 7.7% once the balloon volume was adjusted to match the patient's height.
Obalon
Obalon balloon is a swallowable balloon that is inflated with a nitrogen-mix gas and removed after 6 months. It has the best weight results among the other types of balloons with clinical use showing 9.6% weight loss for patients who completed treatment.
Gastric balloon insertion is generally considered safe, but there are some risks associated with the procedure, including nausea, vomiting, and abdominal pain. In rare cases, the balloon can deflate or rupture, which can lead to bowel obstruction or other serious complications. As with any medical procedure, it is important to discuss the risks and benefits of gastric balloon insertion with a qualified healthcare provider.
Benefits of gastric balloon insertion
The purpose of intragastric balloon treatment is to stimulate weight loss and assist with recovery from associated comorbidities with adequate safety. Here are some of the benefits of gastric balloon insertion:
Significant body weight loss
Studies suggest that mean body weight loss among patients ranged between 10.5-13.7kg within 3 months of the balloon insertion, this increases up to 26.5kg after 6 months of treatment.5
Decreases risk of obesity-related illnesses
Obesity is associated with an increased risk of several illnesses, including type 2 diabetes, high blood pressure, and sleep apnea. Gastric balloon insertion can help to decrease the risk of these illnesses by promoting weight loss.5
Alterations in gastrointestinal hormones
The gastric balloon insertion treatment can affect weight changes by interacting with certain hormones that control hunger and fullness. The changes in hormonal physiology might prove an opportunity for long-term weight maintenance.5
Non-surgical approach to weight loss
Unlike other weight loss surgeries, such as gastric bypass or sleeve gastrectomy, gastric balloon insertion is a non-surgical approach that does not require incisions or general anaesthesia. This makes it a safer and less invasive option for patients who are not candidates for surgery.
Lower cost than other weight loss surgeries
Gastric balloon insertion is a more affordable option than other weight loss surgeries, such as gastric bypass or sleeve gastrectomy. This makes it more accessible to patients who may not have the financial means to undergo more expensive procedures and it takes a shorter time for recovery.
In conclusion, gastric balloon insertion is a safe and effective non-surgical approach to weight loss that has several benefits for obese patients. It is more affordable than other weight loss surgeries, improves overall health, decreases the risk of obesity-related illnesses, and has a shorter recovery time than surgery.
Eligibility for gastric balloon insertion
While this procedure is less invasive than other weight loss surgeries, it still requires careful consideration of a patient's eligibility. According to NICE guidelines, here are some criteria for eligibility for gastric balloon insertion:
BMI (Body Mass Index)
Patients with a BMI of 30 or higher are generally eligible for gastric balloon insertion, particularly if they have other comorbidities such as type 2 diabetes.
Weight loss history
Patients must have attempted to lose weight through diet and exercise before being considered for gastric balloon insertion.
Overall health
Patients must be in good overall health and free from any medical conditions that would make the procedure risky.
Psychological evaluation
Patients must undergo a psychological evaluation to ensure they are mentally prepared for the lifestyle changes that come with the procedure.
Commitment to long-term follow-up
Gastric Balloon insertion will require continued follow-up visits and hence patients should be committed to adapting to these long-term follow-ups, this also includes long-term lifestyle changes in terms of diet and physical activity.
However, there are certain medical conditions that may prevent a person from undergoing the procedure, such as pregnancy, large hiatal hernia, active gastrointestinal ulcers and bleeding, coagulative disorders, and cardiovascular disorders.5
Risks and side effects
The weight loss technique of gastric balloon insertion entails positioning a balloon in the stomach to decrease the quantity of food an individual can consume. Although the procedure is typically safe, patients should be informed about potential risks and side effects.1
- Nausea and vomiting: Patients may experience nausea and vomiting for several days after the procedure
- Abdominal pain: Patients may experience abdominal pain or discomfort after the procedure
- Balloon deflation or rupture: In rare cases, the balloon may deflate or rupture, which can cause gastrointestinal obstruction or other complications
- Infection: There is a small risk of infection associated with gastric balloon insertion
- Gastrointestinal bleeding: Patients may experience gastrointestinal bleeding, which can be serious in rare cases
- Acid reflux: Patients may experience acid reflux or heartburn after the procedure
To manage the risks and side effects associated with gastric balloon insertion, patients should follow their doctor's instructions carefully. This may include taking medication to manage nausea and pain, staying hydrated, and avoiding certain foods or activities. In the event of balloon deflation or rupture, patients should seek medical attention immediately.
While the risks and side effects of gastric balloon insertion are relatively rare, patients should still be aware of them before undergoing the procedure. Patients should also discuss any concerns they may have with their doctor before the procedure.
Summary
A gastric balloon insertion is a non-surgical approach to weight loss that involves the placement of a balloon in the stomach to reduce the amount of food a person can eat and create a feeling of fullness. The procedure is generally less expensive than traditional weight loss surgeries and has a shorter recovery time, making it an attractive option for individuals who are struggling with obesity.
The eligibility criteria for gastric balloon insertion include a BMI of 30 or above, a history of unsuccessful weight loss attempts through diet and exercise, and a commitment to making lifestyle changes to maintain weight loss. However, there are certain medical conditions that may prevent a person from undergoing the procedure, such as pregnancy, bleeding disorders, and certain gastrointestinal conditions.
While the risks and side effects of gastric balloon insertion are relatively rare, patients may experience nausea, vomiting, abdominal pain, or balloon deflation or rupture. To manage these risks and side effects, patients should follow their doctor's instructions carefully and seek medical attention if necessary.
The benefits of gastric balloon insertion include a non-surgical approach to weight loss, improved overall health, a decreased risk of obesity-related illnesses, and a shorter recovery time than traditional weight loss surgeries. Weight loss is important for overall health and can improve the quality of life for individuals and adults struggling with weight loss.
References
- Arterburn DE, Olsen MK, Smith VA, Livingston EH, Van Scoyoc L, Yancy WS, et al. Association between bariatric surgery and long-term survival. JAMA [Internet]. 2015 Jan 6 [cited 2023 Mar 30];313(1):62. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2014.16968
- NIDDK. Types of weight-loss surgery - niddk [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2020 [cited 2023 Mar 30]. Available from: https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery/types
- Silva LB, Neto MG. Intragastric balloon. Minimally Invasive Therapy & Allied Technologies [Internet]. 2022 Apr 1 [cited 2023 Mar 30];31(4):505–14. Available from: https://www.tandfonline.com/doi/full/10.1080/13645706.2021.1874420
- NICE. Recommendations | Obesity: identification, assessment, and management | Guidance | NICE [Internet]. 2014 [cited 2023 Mar 31]. Available from: https://www.nice.org.uk/guidance/cg189/chapter/Recommendations#bariatric-surgery-for-people-with-recent-onset-type-2-diabetes
- Kim SH, Chun HJ, Choi HS, Kim ES, Keum B, Jeen YT. Current status of intragastric balloon for obesity treatment. WJG [Internet]. 2016 [cited 2023 Mar 31];22(24):5495. Available from: http://www.wjgnet.com/1007-9327/full/v22/i24/5495.htm