How Do Gastric Balloons Work?

What is a Gastric Balloon?

A gastric balloon is a small, inflatable medical device that is placed during a minimally invasive procedure in the stomach to reduce weight without changing your anatomy. Gastric balloons, such as Orbera, Elipse, and Allurion, are meant for those who need to lose weight before an operation. The Allurion gastric balloon does not require surgery or an endoscopy for placement or removal. Once inside your stomach, the gastric balloon changes the way you eat by restricting the amount of food you can consume at one time. Research has shown that gastric balloons can help you lose around 3 times more weight than diet and exercise alone. Also, the gastric balloon is filled with either a clear saline solution or air. The shape of the gastric balloon depends on the manufacturer, but most have a soft, smooth surface that can help to minimize any discomfort. A gastric balloon is only one part of a weight loss program. It is advisable to have regular checks and support from a multidisciplinary team of healthcare professionals as well as a balanced nutrition and exercise.

How do They Insert a Gastric Balloon?

Gastric balloons are inserted without the need for surgery with general anesthesia. Precautions are taken in case the balloon starts deflating before the recommended period. The patient is given a mild sedative and the throat is sprayed with a local anesthetic. The deflated gastric balloon is put into a capsule, which is pushed into the stomach through the esophagus with the help of an endoscope and balloon placement tube. An endoscope is a long, thin, flexible tube that has a light source and a camera at one end. The camera sends images of the inside of the body to a TV screen. The gastric balloon is essentially a soft, silicone balloon guided into position and once it’s in the right place, it is filled with saline solution until it is about the size of a grapefruit. The whole process takes about 20 minutes, after which the patient can be monitored for a few hours and then go home. The patient has to be under the care of a specialist weight-loss team and return for regular follow-ups every 2 weeks as the stomach may expand over time and the balloon may need to be filled more. This is done by piercing the balloon through the skin with a needle and adding more saline solution. The balloon has to be taken out after 6 months, as the risk of it breaking increases and the stomach will start to naturally push it out of the body. So, the removal process is very straightforward. It will be punctured and then pulled out through the mouth. This is done without anesthetic but a mild sedative can be given to help relax, if needed. For the next couple of days, there may be throat discomfort and patients are asked to have a fluid diet.

How Much Weight Can You Lose With a Gastric Balloon?

Firstly, clinical trials show that, on average, patients who have a gastric balloon lost about 3 times more weight after just 6 months than those who relied on diet and exercise alone. For example, some trials have reported patients who lost up to 10 BMI points, with a weight loss of up to 15.4 kg. In terms of percentage loss, the average patient in the ABTR (Association of British Theatre Nurses) data lost 16.02% of their original body weight after 6 months and 23.25% after 12 months. However, weight loss is dependent on a variety of factors and hence results will vary from patient to patient. For example, most balloons will make you feel full after eating only small amounts of food but, as your body gets used to the balloon, you may find that you regain a normal eating sensation and therefore start eating slightly larger meals. This would slow down your rate of weight loss but, on average, patients can only achieve maximum weight loss when the balloon is in place. It is important to understand that the balloon cannot guarantee any pounds or stones shed but the statistics clearly show that, on average for the main balloon providers, patients can expect a significant weight reduction which is highly motivating for individuals looking to commence lifestyle changes from the first day of the balloon placement until the time of removal. So, knowing the actual numbers of what patients can achieve with the aid of a balloon, it can be a very successful catalyst for patients who are eligible for an Endoscopic Gastric Balloon or an Orbera Managed Weight Loss System.

Who Should Get Gastric Balloons?

Patients who have had failure in losing weight by other means: Some patients have chronic obesity and they have been trying to lose weight but they fail to benefit from other non-invasive methods like drugs, injections, etc. These patients can benefit from gastric balloon treatment. However, it should be kept in mind that gastric balloon is not for everybody who is struggling with some extra weight but it is reserved for those patients who have a body mass index of 30 and over, with or without any co-morbid condition. Also, gastric balloon is not a good option for the patients who, for example, have a history of previous abdominal surgery, inflammatory diseases of the gastrointestinal tract, potential upper gastrointestinal bleeding conditions, being pregnant, severe kidney or liver failure, etc. As well as the patients who have decompensated heart diseases, lung diseases or infectious diseases should not undergo the balloon therapy and in the meantime the patients must not have an addiction to drugs or alcohol. Also, the patients who have allergy to the sedatives or contrast agents which are used during the endoscopic procedures should not pass through this treatment. On the other hand, patients who have had previous abdominal surgery and now have adhesions that may cause twist and blockage; or the patients who have hiatal hernia greater than 5 cm that may cause the balloon to migrate to the esophagus; or the patients that have other anatomic diseases that may cause the balloon to be trapped or tangled, should be carefully evaluated before the placement of the balloon and in many cases these patients cannot be inserted with the gastric balloon due to high risks. Also, the patient should not have any anatomical or physiological issues that will prevent the safe placement or retention of the intragastric balloon in the stomach.

Will a Gastric Balloon Limit my Activities?

A major advantage of gastric balloons is that the recovery process is extremely quick. This means that most people are able to return to their normal daily activities within a few days. However, it is recommended that patients avoid any heavy physical activity or carrying anything heavy for the first 7-10 days after the insertion of the gastric balloon. This is to allow the body to properly adjust to the presence of the balloon without too much movement or exertion. As with any surgery, it’s important that you don’t rush back into activities too quickly. The recovery period is designed to be a gentle way for your body to slowly adjust back to normal daily activities. After this time, patients are able to return to normalities such as work or household chores. It’s important to ensure that you build up activities gradually and don’t jump straight back into an intense fitness regime or very heavy lifting. This is because the body continues to adjust and the new restrictions posed by the balloon may require you to adapt your activities. Although the insertion of a gastric balloon does mean you need to be careful with your activities for a few weeks, many people find that once the recovery period is over, they’re able to be more active than before the surgery. This is because the weight loss prompted by the gastric balloon is a great incentive for many people to start a healthier lifestyle that includes more physical activities. However, as with any surgery, it’s sometimes difficult to gauge how your body may react in advance. Some people find that they’re more tired or they may feel light-headed during sports; it’s important to listen to your body and ensure that you stay hydrated and take rest breaks when you need them.

What are the Risks of a Gastric Balloon?

The risks or side effects associated with the gastric balloon are not common but can be severe and may require further intervention or even surgical removal of the balloon. The most common risk is nausea and vomiting, which affects up to one in three patients. It is caused by the balloon taking up too much space in the stomach or by the balloon bouncing on the lower stomach wall. Your doctor and dietitian will give you nausea and vomiting advice, such as eating more slowly and having smaller meals, but if you are being sick frequently the balloon may need to be removed. Less commonly, the balloon can get stuck in the stomach, either causing a blockage or preventing food from passing into the bowel. This can cause severe, persistent nausea and vomiting, as well as upper abdominal pain and, occasionally, problems swallowing (also called dysphagia). If the balloon has a valve fault it can either cause over-inflation of the balloon, which increases the risk of it bursting and the contents entering the bowel, or it can cause deflation of the balloon and possible discharge through the intestines. Gastrointestinal perforation is a rare but serious risk of the gastric balloon and may be life threatening if not recognised and treated urgently. It is when a tear or hole is made in the wall of the stomach, small bowel or large bowel. This can be due to one of a number of factors, for example, erosion of the gastric mucosa due to direct contact with the balloon, or migration of the balloon or its contents from the normal stomach cavity. Symptoms can be acute (severe) or non-acute and may include severe abdominal pain, persistent nausea and vomiting, or chronic abdominal complaints, and if left untreated in the acute period it may lead to septic shock and death.

Is a Gastric Balloon Worth It?

Weight loss with a gastric balloon tends to be quicker and more immediate than that seen with many other forms of weight loss, even in the first few months. Weight loss is maintained as long as the gastric balloon is in place. There is also a clear correlation between the amount of weight lost with a gastric balloon and the changes in obesity-related conditions. Some patients might ask if they can try to achieve a similar effect by simply eating less, however time and time again studies have shown that rapid weight loss can only be maintained with adjuncts that create a feeling of fullness and reduced hunger – such as a gastric balloon. From a health economics perspective, if you have exhausted all other potential attempts with approaches using diet and lifestyle, placement of a gastric balloon to try to transition to a more aggressive medical therapy option or even suitability for bariatric surgery means that rapid initial weight loss from the gastric balloon may be of benefit. However, it is important to realise that a gastric balloon will not be the most appropriate option for every single individual. The Partnership for Medical Weight Management have looked to define what they describe as ‘acceptable weight loss’. They are a group of medical obesity experts who have produced guidelines to inform and guide both patients and healthcare services on best practice in weight management. ‘Acceptable weight loss’ is defined in the medical literature as 5% to 10% of initial body weight or at least moderate weight loss at 3 months.