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Which Gastric Balloon is Right for You? Understanding the Many Choices

Introduction: Which gastric balloon is right for you understanding the many choices?

Obesity rates are, sadly, going up. Almost 40% of adults in the United States are obese — the highest rate of obese Americans ever recorded and thus leads to higher demand for gastric balloon.

Many people think that going on a diet is the answer and that obesity is a character weakness. But we know that obesity is much more complex.

Genetic, environmental, and behavioral factors, in addition to diet and exercise patterns, all contribute to a person's weight. Sometimes a healthy, balanced diet and exercise program can't help. And obesity is not something you can ignore. It's linked to a host of serious health conditions including Type 2 diabetes, high blood pressure, certain cancers, stroke, and heart disease.

There is some positive news related to the obesity epidemic. There's now a safe, effective, minimally invasive, temporary, and reversible procedure to help you feel fuller and reduce the number of calories you consume.

What are gastric balloons?

Gastric balloons, also called intragastric balloons, are great options for overweight people who are not candidates for gastric surgery or don't want gastric surgery. They're also good for people who want to reduce their weight before gastric surgery to minimize health complications.

Gastric balloons are soft balloons inserted into your stomach or swallowed, and then filled with saline solution, gas, or air so they expand to fill part of your stomach. They're placed in an outpatient procedure, so no surgery is necessary. This balloon reduces the amount of food and calories you consume by taking up room in your stomach and promoting feelings of fullness.

Six months later, the balloon is removed. By then, most patients are accustomed to eating smaller portions and can maintain their weight loss. It's essential to combine a gastric balloon procedure with a healthy eating plan and exercise program.

Currently, there are three FDA-approved gastric balloon options on the market. They're all available here at Healthy Life Bariatrics.

The Gastric Balloon Landscape: An Overview

Gastric balloons are non-surgical, temporary weight-loss devices designed to assist individuals in achieving their weight-loss goals. These balloons are placed in the stomach to create a sense of fullness, thereby promoting reduced food intake and aiding in weight loss.

How is a Gastric Balloon Placed?

The placement of a gastric balloon is a minimally invasive procedure typically performed by a gastroenterologist. During the procedure, a deflated balloon is inserted through the mouth and esophagus into the stomach using an endoscope. Once in place, the balloon is filled with a sterile saline solution, expanding to occupy space in the stomach.

Life with a Gastric Balloon: What to Expect

While the balloon is in place, individuals may experience an altered sensation of fullness, which can lead to reduced calorie intake. This period is crucial for adopting healthier eating habits and establishing a foundation for long-term weight management.

The Removal Process

Gastric balloons are not a permanent solution, and removal is typically recommended after a predetermined period, usually six months. The removal process is similar to placement, involving the use of an endoscope to deflate and retrieve the balloon.

After Removal: Sustaining Weight Loss

Post-removal, maintaining the weight loss achieved during the balloon placement period requires a commitment to a healthy lifestyle. This includes a balanced diet, regular exercise, and ongoing support from healthcare professionals.5

Life with a Gastric Balloon: What to Expect

While the balloon is in place, individuals may experience an altered sensation of fullness, which can lead to reduced calorie intake. This period is crucial for adopting healthier eating habits and establishing a foundation for long-term weight management.

Gastric balloon options

During a comprehensive evaluation, Dr. Babak Moeinolmolki of Healthy Life Bariatrics reviews your health history, discusses the procedure, and determines if you are a good candidate for gastric balloon technology. During the evaluation, he will also recommend the gastric balloon option that is best for you.

Candidates should have a BMI between 30 and 40. In some cases, candidates with a BMI of 27 to 30 will be considered as well. Here's some information to help you learn about your choices.

Re ShapeⓇ Integrated Dual Balloon System

With the Re Shape Balloon System, Dr. Moeinolmolki places a deflated balloon through your mouth into your stomach using small endoscopic instruments. During the procedure, your throat is numbed with an anesthetic spray, and you're under sedation or general anesthesia. Once the balloon is in the right place, it's inflated with air or saline solution. This balloon is removed after six months. Studies show that, on average, people lose about 14-16 pounds with this system. The balloon is designed as a two-balloon system to provide an additional safety feature to the single-balloon system by preventing the balloons from migrating into the bowel by having two balloons. The drawback to this system is that it is a more cumbersome deployment system which makes this balloon less desirable for placement.

OrberaⓇ Gastric Balloon

This balloon system is implemented in the same way as Re Shape but it is a single balloon system. Patients are sedated to promote relaxation while the balloon is inserted through the mouth and into the stomach by endoscopic instruments and then inflated. Studies show that, on average, patients lost almost 22 pounds after six months with Orbera. This balloon has been around the longest > 20 years and it is time tested with regards to results and side effects.

ObalonⓇ Balloon System

This type of gastric balloon technology is the newest one to hit the market. Unlike the other two methods that require endoscopy to insert the balloon into your stomach, the Obalon balloon system requires that you swallow three capsules over one month, requiring an X-ray for each placement. Once these capsules are in your stomach, Dr. Moeinolmolki inflates them with a small catheter. After six months, the balloons are removed by endoscopy while you're sedated, so you don't feel any discomfort. The Obalon Balloon is well tolerated with the least side effects such as nausea or abdominal pain making it a very popular balloon. The drawback of this balloon is that it is most expensive.

For an individualized consultation to discuss which gastric balloon procedure may be best for your health and weight loss goals, call Health Life Bariatrics located in Los Angeles, California, or make an appointment online.

Important to note that the gastric balloon system is designed for short-term weight loss, and works as a tool to enable our patients to control their eating habits. This is a forced behavioral modification tool. Like all the various bariatric surgical methods lack of compliance with proper eating and lifestyle modification habits will result in failure of the system. If you have had previous bariatric surgery, a large hiatal hernia, a history of gastric ulceration, and uncontrolled depression you are not a candidate for this program.

Overview Comparison of Options: Orbera vs Obalon vs Reshape

Orbera

Orbera is a single intragastric balloon system designed to remain in the stomach for six months. It has been FDA-approved and has a track record of aiding in significant weight loss.9

Obalon

Obalon stands out as the first and only FDA-approved swallowable, gas-filled gastric balloon system. The system involves ingesting a series of capsules containing deflated balloons, which are then inflated in the stomach. Clinical trials indicate effectiveness in promoting weight loss.10

Reshape

Reshape integrates dual balloons with a connected design, aiming to maximize the space occupied in the stomach. This system has shown promise in facilitating weight loss and promoting positive lifestyle changes in initial evaluations. Longer-term assessment is warranted.11

Myths and Facts About Gastric Balloons

Myth: Gastric Balloons are Only for the Severely Obese

Fact: Gastric balloons are suitable for individuals with a BMI ranging from 30 to 40, making them a viable option for those who may not qualify for or prefer to avoid surgical interventions.6

 

Myth: Gastric Balloons Are a "Magic Bullet" for Weight Loss

Fact: While gastric balloons can be effective, they are not a standalone solution. Successful weight loss requires a commitment to dietary and lifestyle changes in conjunction with the balloon.7

 

Myth: Gastric Balloons Are Painful

Fact: The placement of gastric balloons is generally well-tolerated, with patients typically experiencing mild discomfort or nausea during the initial days, which often subsides as the body adjusts.8

Conclusion: Which gastric balloon is right for you understanding the many choices?

Gastric balloons offer a non-surgical approach to weight loss, providing a valuable option for individuals looking to kickstart their journey to a healthier life. By dispelling myths, understanding the mechanics, and comparing available options, individuals can make informed decisions with the guidance of healthcare professionals. Remember, the journey to sustained weight loss is a holistic process, and gastric balloons can be a valuable tool when embraced as part of a comprehensive lifestyle change.

References:

  1. Kumar N. Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration. World J Gastrointest Endosc. 2015;7(9):847-859. doi:10.4253/wjge.v7.i9.847
  2. ASGE Technology Committee., Abu Dayyeh BK, Kumar N, et al. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82(3):425-438.e5. doi:10.1016/j.gie.2015.03.1969
  3. Courcoulas AP, King WC, Belle SH, et al. Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study. JAMA Surg. 2018;153(5):427–434. doi:10.1001/jamasurg.2017.5025
  4. Cha R, Marescaux J, Diana M. Updates on gastric balloons and endoscopic bariatric therapies. Curr Opin Gastroenterol. 2015;31(4):352-357. doi:10.1097/MOG.0000000000000186
  5. Parrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017;13(5):727-741. doi:10.1016/j.soard.2016.12.018
  6. ASGE Bariatric Endoscopy Task Force and ASGE Technology Committee., Abu Dayyeh BK, Kumar N, et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82(3):425-438.e5. doi:10.1016/j.gie.2015.03.1969
  7. Keren D, Rainis T. Intragastric balloons for overweight populations-comparison of two balloons and two patient populations. Obes Surg. 2015;25(11):2196-2201. doi:10.1007/s11695-015-1635-9
  8. Mion F, Ibrahim M, Marjoux S, et al. Tolerance, efficacy and safety of intragastric balloon: experience in 81 consecutive patients. Obes Surg. 2013;23(6):816-821. doi:10.1007/s11695-012-0841-8
  9. FDA News Release. FDA approves non-surgical temporary balloon device to treat obesity. Published July 28, 2015. Accessed November 29, 2023.
  10. Sullivan S, Swain JM, Woodman G, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopically placed intragastric balloons in obese subjects: The REDUCE pivotal trial. Obesity (Silver Spring). 2017;25(7):1201-1209. doi:10.1002/oby.21895
  11. Machytka E, Chuttani R, Bojkova M, et al. Elipse, the first procedureless gastric balloon for weight loss: a prospective, observational, open-label, multicenter study. Endoscopy. 2017;49(02):154-160. doi:10.1055/s-0042-118702
  12. O'Brien PE, Hindle A, Brennan L, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg. 2019;29(1):3-14. doi:10.1007/s11695-018-3525-0
Moeinolmolki Author: Babak Moein, MD FACS Social Media and Websites
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