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Success rates of intragastric balloon treatment according to (a) % total weight loss, (b) % excess weight loss, and (c) body mass index (BMI) < 30 kg/m² at the end of the study
Source publication
Background
Obesity is an important risk factor for several chronic diseases and also is associated with worse quality of life. Intragastric balloon (IGB) is an effective method for weight loss. Although changes in lifestyle are critical to weight loss during and after IGB therapy, only a few studies evaluated dietary intake and none evaluated chang...
Citations
... Excess weight loss of 38.5% was the results for the study by Al-Sabah et al. 3 , which is lower than the values in the current study, while Guedes et al. 17 reported percentage of EWL of 56.04±4.90, which is higher than ours. Al-Sabah et al. 3 also found statistically significant differences between gender regarding percentage of EWL, while we did not 35 . ...
BACKGROUND
Obesity is associated with different medical conditions, such as cardiologic, respiratory, gastrointestinal, and genitourinary, and constitutes a severe health problem.
AIMS
This study aimed to evaluate the use of intragastric fluid-filled balloon in the reduction of weight and other measurements related to body composition.
METHODS
This is a retrospective, monocentric study involving all patients who opted for the intragastric balloon Spatz® placement from January 2018 to July 2019, with fulfillment of inclusion and exclusion criteria. The patients were analyzed after 6 and 12 months after the intragastric fluid-filled balloon placed.
RESULTS
A total of 121 subjects were included in this study, with 83 (68.6%) females and 38 (31.4%) males. The mean age was 36 years and height was 1.64±0.09. Weight mean and standard deviation was 89.85±14.65 kg, and body mass index was 33.05±4.03; body mass index decreased to 29.4 kg/m² with a mean weight of 79.83 kg, after 12 months of follow-up. There were statistical differences between body mass index and the 12 months in fat percentage, fat-free mass (kg), visceral fat area, and basal metabolic rate. There was a significant variation according to gender, with males having highest reduction. The percentage of excess weight loss was 46.19, and the total weight loss was 9.24 at the end of the study.
CONCLUSIONS
The study demonstrated a benefit of intragastric fluid-filled balloon on weight loss after 12 months. At the end of treatment, body mass index and the measurements of body composition were significantly lower. Men benefited more than women from the treatment.
HEADINGS:
Endoscopy; Body mass index; Digestive system; Body weight; Obesity
... The remaining 58 articles were evaluated for inclusion by reviewing their full-text and resulted in the exclusion of 42 records for the following reasons [1]: they were not the original study -but systematic reviews of the literature (n = 8) [2] and did not include any psychological predictor or outcome measure (n = 34). References for the 16 remaining articles [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] and retrieved systematic review/meta-analysis [14,36,41,42,[60][61][62][63] were further screened for relevant records, but none was found. In accordance with the PRISMA guidelines [64], the flowchart presented in Figure 1 provides step by step details of the study selection process. ...
... Selected studies were published between 2001 [51] and 2018 [53,54]. Seven out of 16 investigations used a prospective comparative design [48-50, 55-57, 59], while the remaining 9 records employed a prospective single-group observational design type. ...
... Three studies [45,50,59] aimed at assessing the predicting role of anxiety [45] and depression [45], binge eating disorder (BED) [45,59], HRQoL [45], and motivation to change [50] on IGB outcomes, while 12 articles [44,46,47,49,[51][52][53][54][55][56][57][58] investigated the impact of the IGB treatment on psychological indices including anxiety [44] and depression [44], HRQoL [44, 47, 52-54, 56, 58], and QoL [55,57]. Satisfaction with treatment was also explored in 1 record [51]. ...
Introduction:
Optimizing maintenance of weight loss for people with obesity following intragastric balloon (IGB) therapy hinges on the degree to which health care providers can recognize both the impact of emotional problems and mood difficulties on their capacity to self-manage, and requirements for additional support. However, there is limited research on the psychological correlates of IGB therapy. This systematic review, for the first time, attempts to identify and synthesize the empirical evidence for the reciprocal influence between psychological variables and IGB outcomes.
Methods:
A literature search was performed in the PubMed, SCOPUS, MEDLINE, and Google Scholar databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least 2 reviewers. The selected articles were assessed for quality using the Strengthening the Reporting of Observational Studies Epidemiology (STROBE) checklist. Data were extracted to address the review aims and presented as a narrative synthesis. The review protocol was preregistered (Prospero CRD42019121291).
Results:
A total of 16,179 titles, 14,369 abstracts, and 51 full-text articles were screened, of which 16 studies were included. Findings suggest that female gender, older age, basic educational level, and single/divorced civil status, together with lower levels of depression, binge eating, higher perceived quality of life, and motivation to change were predictors of enhanced IGB treatment outcomes. Dissatisfaction with treatment was higher in those with impaired obesity-related social-life difficulties. The IGB treatment was effective in reducing weight and improving depression, anxiety, eating disorder symptoms, and the overall life quality of patients with obesity - mainly within 6 months from the device positioning and in conjunction with conventional therapies.
Discussion/conclusion:
In line with the available literature on obesity and bariatric surgery interventions, poor mental health appears to be an important barrier for successful weight loss among patients with obesity undergoing IGB treatment. In order to improve the efficacy and effectiveness of the IGB therapy, more comprehensive and standardized studies are needed to provide insight into the psychological mechanisms maintaining weight management issues.
... Gadd et al [79] tried to analyze the impact of endoscopic bariatric procedures, IGBs included, in the improvement of quality of life (QoL) and mental health, assessed by using a validated tool. Twenty studies published between 2008 and 2019 with a total number of 876 participants (77% female) were included, evaluating five different endoscopic procedures. ...
Endoscopically placed intragastric balloons (IGBs) have played a significant role
in obesity treatment over the last 30 years, successfully bridging the gap between
lifestyle modification/pharmacotherapy and bariatric surgery. Since they provide
a continuous sensation of satiety that helps the ingestion of smaller portions of
food, facilitating maintenance of a low-calorie diet, they have generally been
considered an effective and reversible, less invasive, non-surgical procedure for
weight loss. However, some studies indicate that balloons have limited
sustainable effectiveness for the vast majority attempting such therapy, resulting
in a return to the previous weight after balloon removal. In this review we try to
summarize the pros and cons of various balloon types, to guide decision making
for both the physician and the obese individual looking for effective treatment.
We analyzed the six most commonly used IGBs, namely the liquid-filled balloons
Orbera, Spatz3, ReShape Duo and Elipse, and the gas-filled Heliosphere and
Obalon - also including comments on the adjustable Spatz3, and the swallowable
Obalon and Elipse - to optimize the choice for maximum efficacy and safety.
... The 20 studies were published between 2008 and 2019 with a total number of 876 patients (77% female). Intragastric balloons were the predominant endoscopic therapy (n = 14) [2,20,[33][34][35][36][37][38][39][40][41][42][43][44][45], followed by aspiration therapy (n = 2) [46,47], TOGA (n = 2) [12,48], ESG (n = 1) [13], and TPS (n = 1) [49] (Table S2). ...
... All studies in the meta-analysis were neutral quality except two studies [2,20]. Studies reporting the most significant changes in QoL and mental health were rated neutral [34,40]. All studies reported a significant decrease in weight as changes to total body weight, BMI, TBWL%, or EWL%. ...
... All studies reported a significant decrease in weight as changes to total body weight, BMI, TBWL%, or EWL%. The two studies (Guedes et al. [40] and Deliopoulo et al. [43]) with the largest improvements in mental health also had the greatest weight loss; however, associations with strength of weight loss and change in mental health were not consistent thereafter. The largest improvements in QoL did not coincide with the highest mean weight loss. ...
Quality of life and mental health are important outcomes of bariatric therapy. This review aimed to determine endoscopic bariatric procedures’ impact on postprocedural quality of life and mental health. Four electronic databases were systematically searched. Studies with adults > 18 years who underwent an endoscopic bariatric procedure and reported pre- and postprocedural quality of life and/or mental health using a validated tool were included. Meta-analyses were conducted using RevMan and study quality was assessed. Twenty studies evaluating five different endoscopic procedures were included (N = 876 total sample size). Intragastric balloon placement was associated with a large improvement in postprocedural quality of life and mental health. Endoscopic bariatric therapies may improve short-term quality of life and mental health alongside weight loss and comorbidity improvement.
... The 20 studies were published between 2008 and 2019 with a total number of 876 patients (77% female). Intragastric balloons were the predominant endoscopic therapy (n = 14) [2,20,[33][34][35][36][37][38][39][40][41][42][43][44][45], followed by aspiration therapy (n = 2) [46,47], TOGA (n = 2) [12,48], ESG (n = 1) [13], and TPS (n = 1) [49] (Table S2). ...
... All studies in the meta-analysis were neutral quality except two studies [2,20]. Studies reporting the most significant changes in QoL and mental health were rated neutral [34,40]. All studies reported a significant decrease in weight as changes to total body weight, BMI, TBWL%, or EWL%. ...
... All studies reported a significant decrease in weight as changes to total body weight, BMI, TBWL%, or EWL%. The two studies (Guedes et al. [40] and Deliopoulo et al. [43]) with the largest improvements in mental health also had the greatest weight loss; however, associations with strength of weight loss and change in mental health were not consistent thereafter. The largest improvements in QoL did not coincide with the highest mean weight loss. ...
... This prospective observational study was conducted with patients suffering from obesity that were submitted to IGB treatment for 6 months at a private clinic, between March 2016 and October 2017. The design of this study has already been described in a previous publication [29], in which data about changes in body adiposity, dietary intake, physical activity, and quality of life during IGB treatment were evaluated. The data of our study were divided into two papers to allow a comprehensive discussion of the different results. ...
Background
Obesity is accompanied by adipose tissue remodeling characterized by increased production of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, leptin and resistin and reduced secretion of adiponectin, which favors inflammation, metabolic disorders, and cardiovascular diseases. Although intragastric balloon (IGB) can be considered safe and effective for weight loss, its effect on serum levels of these biomarkers has been evaluated only in a few studies, while no previous study evaluated its effect on circulating levels of resistin, TNF-α, and IL-6. The aim of this study was to evaluate the changes in serum levels of metabolic and inflammatory biomarkers in obese patients submitted to IGB treatment.
Methods
A prospective observational study involving 42 patients with obesity using IGB for 6 months. The patients were evaluated, on the day of insertion and withdrawal or adjustment of IGB, for the following: anthropometric measures and serum levels of adiponectin, leptin, resistin, TNF-α, IL-6, high-sensitivity C-reactive protein (hs-CRP), glucose, insulin, uric acid, triglycerides, and total cholesterol and fractions.
Results
The body mass index decreased from 35.15 ± 0.41 to 29.50 ± 0.54 kg/m². There was a reduction (p < 0.05) in leptin, hs-CRP, glucose, insulin, HOMA-IR, and triglycerides, while the adiponectin/leptin ratio increased (p < 0.05). Moreover, weight loss presented (1) a positive association with the decrease in leptin, hs-CRP, glucose, insulin, HOMA-IR, uric acid, and total cholesterol and (2) a negative association with the reduction in adiponectin/leptin ratio.
Conclusions
The present study suggests that 6 months of IGB treatment in obese individuals reduce serum leptin and hs-CRP and improves insulin resistance and lipid profile which may decrease cardiovascular risk.
Endoscopic bariatric procedures in the treatment of obesity have become widespread in recent years. In this systematic review, it was aimed to assess the role of intragastric balloons and transpyloric shuttle in the treatment of obesity. A comprehensive search was conducted using the search terms “Intragastric Balloon” and “TransPyloric Shuttle” in PubMed, Cochrane Library and Web of Science databases from 1st of December to 25th of December in 2020. Twenty-seven clinical studies (24 studies on intragastric balloons and 3 studies on transpyloric shuttle) were assessed. It is clear that both methods have significant positive effects on obesity-related comorbidities and weight loss. These techniques also have potential to reduce comedications in patients with type 2 diabetes mellitus and obesity. The most important differences between intragastric balloons and transpyloric shuttle are in the severity and frequency of the complications they cause. While the most common complications related to intragastric balloons are vomiting, nausea, bloating, and abdominal pain, the most common complications due to transpyloric shuttle are gastroduodenal ulcers, gastroesophageal reflux disease, and sore throat. In addition, one of the most important finding is that the type and structure of the balloon, as well as the application period and position of the balloon in the stomach, may cause changes in the adverse and practical effects of intragastric balloons. As a conclusion, intragastric balloon application is a relatively effective short term treatment and relatively safe endoscopic technique used in patients with obesity to improve comorbidities accompanying obesity, but with risks of adverse events. On the other hand, the safety profile of the transpyloric shuttle still needs to be improved.
Intragastric balloon (IGB) placement under endoscopy is a non-invasive method for weight loss.By placing a space-occupying balloon in the stomach, IGB treatment can achieve better effect of weight loss than medications.Herein we review the development of IGB, its effect on weight loss and the mechanism, and the eligible individuals for IGB treatment.We also examine the high-intensity postoperative management following IGB placement, which is important for maintaining long-term weight loss, and discuss the future development of IGB.The patients should understand that on the basis of ensuring a high safety, the weight-losing effect of IGB can be limited and relies heavily on postoperative management.Patients should make a decision on IGB placement after careful consideration of their own physical, economic, and psychological conditions, lifestyle and the line of work in addition to the indications of IGB.IGB placement combined with high-intensity postoperative management and active interventions of lifestyle and dietary habits help to achieve long-term effect of weight loss and improve obesity-related complications.
Background:
Intragastric balloon (IGB) placement can provide a mean percent total weight loss (%TWL) of 10.2% at 6-month follow-up.
Objectives:
We aimed to evaluate 30-day outcomes and safety of patients undergoing IGB placement.
Setting:
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.
Methods:
The 2016 to 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program was queried for adult patients who underwent primary IGB placement. Demographic characteristics and preoperative risk factors were collected. Postoperative outcomes included %TWL, percent excess weight loss, and complications rates and causes. Subset analysis was done for outcomes comparison between surgeons or gastroenterologists performing the procedure. Statistical analysis was performed using SPSS 25.0.
Results:
A total of 1221 patients were included. The majority was female (81.9%), Caucasian (81.2%), with a mean age of 48 ± 11.3 years and a mean preoperative body mass index of 34.9 ± 11.2 kg/m2. Of patients, 98.8% were discharged within 24 hours of the procedure. Two patients were admitted to the intensive care unit, and 7.2% received postoperative treatment for dehydration. Reoperation and readmission rates were 1.1% and 7.2%, respectively, mainly due to nausea, vomiting, and poor nutritional status (n = 22). The intervention rate was 6.2%. Patients in this cohort achieved a mean %TWL of 6.2% (standard deviation, 5.52%) and mean TWL of 6.8 kg within 30 days postoperatively (n = 147; 24-30 d).
Conclusions:
Our data show patients met approximately 50% of their target weight loss 30 days after IGB placement. Nausea, vomiting, and poor nutrition status were the most common complications within 30 days of the procedure. Long-term follow-up is necessary to determine if these patients are able to sustain their weight loss and for how long.
Intragastric balloons (IGBs) are the most widely available endoscopic bariatric therapy for class I and II obesity in the United States. Although simple in application and reversible by nature, these devices may help patients initiate the important first steps in weight loss maintenance, provided that parallel efforts are in motion to prevent weight recidivism. Too often, therapeutic nihilism stems from unrealistic expectations of a given therapy. In the case of IGBs, this sentiment may occur when these interventions are applied in a vacuum and not within the purview of a multidisciplinary program that actively involves dieticians, endocrinologists, gastroenterologists, and surgeons. There is a clear and present need to apply different tactics in the remissive strategy to control the obesity pandemic, more so in a struggling landscape of an ever-widening gap in bridging interventions. With such demand, the IGB is an available tool that could be helpful when correctly implemented. In this exposition, we summarize the current state of IGBs available worldwide, discuss their mechanism of action, relay evidence for their short- and long-term efficacy, address safety profile concerns, and suggest procedural considerations in the real-world quotidian application.
