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Intragastric Balloons for Obesity



The idea of placing a balloon in the stomach to induce a sense of satiety and thereby reduce food intake has been around for decades. Following several improvements in the technology and materials of these balloons, they have certainly become safer. But how effective are they and do they have any role to play in obesity management?

This question was now addressed in a meta-analysis by Inaki Imaz and colleagues, who work for the Agencia de Evaluaci√≥n de Tecnolog√≠as Sanitarias, Instituto de Salud “Carlos III”, Ministry of Health and Consumer Affairs, Madrid Spain. (Obesity Surgery).

In their study, the authors focussed on the safety, efficacy, and effectiveness of the most widely used balloon, BioEnterics Intragastric Balloon (BIB(R)), to treat obesity. Data were pooled from 15 studies (3.608 patients) identified by a systematic literature review of Medline, Embase, and other information sources from inception to March 2006. The estimates for weight lost at balloon removal for BIB(R) were 14.7 kg or 12.2% of initial weight. The majority of complications were mild and the early removal rate was only 4.2%. However, there is a paucity of data after balloon removal.

The authors conclude that the use of the BIB(R), within a multidisciplinary weight management program, may be a short-term effective treatment to lose weight.

The question of course is: “Then what?”

Not only is a 12% weight loss unimpressive as this can be achieved by other means, but furthermore, without a clear management strategy that will help keep the weight off, this is just another “yo-yo” diet.

I can perhaps think of situations, where an intragastric balloon may indeed be a valuable option to promote weight loss in a patient too sick to undergo definitive obesity surgery or has medical reasons for being unable to comply with a restrictive dietary regimen. But such patients are likely to be few and far between.

Nevertheless, the BIB is licensed for use in several countries, including Canada, although, to my knowledge it is not covered by any provincial or private health plans.

Personally, I have yet to see a patient, where I would consider an intragastric balloon to be the only or even the best option.

I guess we will need to wait to see where exactly a short-term treatment like the intragastric balloon best fits into a long-term obesity management strategy.

AMS
Edmonton, Alberta

4 Comments

  1. I read this post with particular interest, as early in July at the Prader-Willi USA National Conference, Dr. Crino gave a talk regarding the results of a BIB analysis on Prader-Willi patients in Italy. The work was published in Obesity Surgery, and the abstract is available here: http://www.springerlink.com/content/u724r60q34811g31/
    It was quite shocking to myself, and most other attendees at the meeting that this option was still being considered given some of the outcomes. Specifically, out of only 12 patients examined, one died due to gastric perforation, and another had the BIB removed due to a suspected perforation (which I believe ended up being a large blockage due to a massive bolus of undigested food being unable to pass the BIB). Of the other patients, most had more than one bout with the BIB, with some patients undergoing up to 4 different insertions. The reason? The VERY MODEST decrease in BMI rebounded almost immediately after removal of the BIB. The speaker was unable to answer questions surrounding whether or not the loss was even due to the BIB: prior to insertion, and for several weeks after, a very regimented liquid diet was administered. So perhaps it was not the BIB itself leading to the weight loss, but rather the strict modification in diet/lifestyle needed to facilitate the insertion/recovery period.
    I feel that BIB treatment has not shown positive results for the Prader-Willi population, and coupled with very real and very scary side effects, should only be considered in very extreme cases with no other options available.
    Just some thoughts….

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  2. I was shocked that some of the Med. profession was so against this
    procedure. This is the only procedure that was recommended for
    me to have and safer for me than any of the other bariatrics procedures. Since it has not been approved in the States as yet.
    I was considering Canada for the procedure. I have many health
    issues and was told it is too late for me to try and diet – that the
    weight needs to come off now. I have endured so much pain and I
    was so looking forward to having this procedure!!!!!!!!!. If any
    one knows a more up to date view on this Balloon procedure – Please
    let me hear from you. M.L.Bengtson

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  3. Since my OH walked out in April i have thought alot bout my weight ( just under 15 st ) not that its ever bothered me before but now from a health point of view i feel its time to lose my weight, i have tried for many years to lose a few pounds joining WW and SW many a time but nothing seems to work.
    So i have seriously started thinking bout havong a Gastric Balloon i was hoping some of you might have had experiances with them and could give me some advice

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