The intragastric balloon, which has been available since the 1980s is designed to provide short–term weight loss therapy. The silicone balloon is placed endoscopically (through the mouth and oesophagus under heavy sedation) and filled with liquid so it partially fills the stomach and creates a feeling of fullness. The maximum time a balloon can be left in place is 6 months, after which it must be removed – the risk of balloon deflation and intestinal obstruction (and therefore possible death) is significantly higher when balloons are left in place longer than 6 months.

There are two main indications for using an intragastric balloon that are applied in the UK:

• Pre–surgery for weight loss in severely obese patients prior to obesity or other surgery, in order to reduce surgical risk.
• Weight loss in obese patients who have significant health risks related to their obesity and who have failed to achieve and maintain weight loss with a supervised weight–control programme or who are not candidates for obesity surgery.

The largest study to look at the effectiveness of the intragastric balloon was conducted in Brazil where 323 patients with an average BMI of 43kg/m² had balloons inserted between November 2000 and February 2004¹. The patients in this study lost on average 48% of their excess weight. Overall this study showed a high degree of efficacy of the balloon, together with a low risk of death (there were none) or major side effects. Overall, studies published and presented to date show the excess weight loss after a balloon to be between 25 and 44%².

You should not consider a balloon if you suffer from:

• Inflammatory disease or previous surgery of the gastrointestinal tract
• Alcoholism, drug addiction or psychiatric disorders.
• You are unwilling to participate in a supervised diet and behaviour modification programme.
• You are pregnant or breast–feeding.

Like other weight loss surgeries, the balloon is a tool and works best when you use it properly, following a low calorie diet and maintaining close contact with the health professional team during the time the balloon is in place. Surgeons usually prescribe medication to reduce your stomach acid production whilst the balloon is in place. Whilst most people do not experience any complications, possibilities to be aware of include:

• Intestinal obstruction by the balloon (which could cause death) when a partially deflated balloon passes into the small bowel. If this occurs, surgical or endoscopic removal would be required
• Bleeding or perforation could occur as a result of injury during the balloon insertion or removal, requiring surgical correction.
• Gastric discomfort; nausea and vomiting are common for the first few days following balloon placement but rarely continue in the longer term unless the balloon is causing a blockage. A feeling of heaviness in the abdomen, abdominal or back pain, gastro–oesophageal reflux or indigestion have also been reported.

As the intragastric balloon has not been incorporated in the NICE guidelines for the management of obesity, it is not widely available on the NHS. However, an increasing number of surgeons are now using it and if you think this could possibly be an appropriate treatment for you, look at our surgeon’s directory to locate a surgeon in your area who lists intragastric balloons on their procedures list. If you are considering this treatment privately, expect to pay between £4,000 and £8,000 for a package which comprises the balloon insertion and removal and six months of intervening care with the surgeon and/or dietitian/nutritionist.

1. Doldi BS, Micheletto G, Perrini M. Intragastric balloon (BIB): 4-year experience. Obesity Surgery 2002;12:477
2. Data provided by Inamed UK

from http://www.bospa.org.uk/Information.aspx?Page=8