Intragastric Balloons for ObesityThursday, August 14, 2008
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 Evaluación de Tecnologías 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.