Surgery for weight loss remains a key strategy for treatment of obesity, but more options are emerging for management of this disease. The CADC's weight loss surgery program works alongside medical and nutritional strategies, with multiple specialists working together to decide the best course of action for each patient. In certain patients where diet and exercise are unsuccessful but surgery is not recommended or not an option, endoscopic options for treating obesity are available.
One such treatment is the intragastric balloon system, where an endoscopist places and inflates a small balloon within the stomach, reducing the volume of food that can fit into the stomach at a given moment. Designed for short-term use of six months or less, the intragastric balloon can help patients lose more weight than diet and exercise alone.
The intragastric balloon procedure is designed for patients who are not morbidly obese, but also may not be able to undergo bariatric surgery. Patients must meet the following criteria to be considered for an intragastric balloon:
- Patients must have a body mass index (BMI) between 30 and 40
- Candidates may not have had prior gastrointestinal or bariatric surgery
- Candidates must be unable to lose weight through diet and exercise
- Candidates must be willing to continue diet and exercise after the procedure, supervised by a healthcare provider
- Candidates for this procedure cannot have certain comorbidities, including hiatal hernias, motility disorders, bleeding or clotting disorders, structural abnormalities or masses in the esophagus or stomach, psychiatric illness, most liver diseases, or various other conditions
- Candidates for this procedure cannot take various medications that irritate the stomach, including aspirin, anti-inflammatory drugs, or anticoagulants
How the Intragastric Balloon Works
The intragastric balloon takes up space within the stomach, limiting the amount of food a patient can consume at any given meal. To place the balloon, a specially-trained gastroenterologist uses an endoscope to advance the uninflated balloon through the mouth and down the esophagus. After the balloon is in place, it is filled with saline, expanding to the size of a softball or grapefruit. Patients are placed under sedation for the balloon placement, and generally go home the same day as the procedure. Patients must follow a liquid diet for a brief amount of time after the procedure before resuming food consumption.
Both our gastroenterologists who place intragastric balloons and our bariatric surgeons work closely with a team of other providers including an endocrinologist and registered dietitian to monitor one’s food intake and metabolic health before and after the procedure. Diet and exercise are crucial after the procedure, even after the balloon is removed at the six-month mark.
Intragastric Balloon Outcomes
Clinical studies of the intragastric balloon indicate it can help patients lose more weight than with diet or exercise. Studies on this weight loss strategy indicate that patients who receive intragastric balloon coupled with behavior modifications such as improved diet and exercise can lose over two times as much weight after 12 months than people who simply follow behavior modifications. Patients losing more weight with the intragastric balloon also reported better quality of life on several metrics versus non-balloon patients, including bodily pain, social functioning, role functioning and vitality.
The CADC values the ability to provide as many available treatment options to its patients as possible. Alongside bariatric surgery and endoscopic sleeve gastroplasty, the intragastric balloon offers another option to patients needing weight reduction. The support of a multidisciplinary team at NewYork-Presbyterian/Weill Cornell Medical Center allows for more successful outcomes for patients.