Intragastric balloon treatment for obesity: what does it really offer?

Obesity is a chronic metabolic disorder with considerable health risks, which can be approved by a sustained modest weight loss. This can be achieved by medical treatment through behavioral therapy, diet, exercise and pharmacotherapy. Surgery is often needed for the severely obese. Intragastric balloon treatment stands in between, being more drastic than medical treatment but less invasive than surgery. In the light of the high premature deflation rate and the high incidence of gastric ulcers, a safer balloon had to be awaited, constructed according to predefined criteria. This new balloon (BioEnterics Intragastric Balloon) promoted a weight loss of 5-9 BMI units in 6 months with an impressive improvement of obesity-associated comorbidities. A weight regain of 25-40% has to be considered in a 1-year balloon-free follow-up period. A failure rate of 15% was observed in studies that defined a successful weight loss. With respect to safety, there was no mortality. Gastrointestinal complications, mainly consisting of esophagitis, were present in 5.5%. Intolerance of the balloon resulted in its removal in 7%. Balloons deflated in 8% with an uneventful outcome in all except 5 patients, who had to be operated. Balloon treatment is a valuable method, but nonresponse, intolerance and weight regain have to be taken into account.