What is the benefit of the gastric balloon and how does it work?

What is the benefit of the gastric balloon and how does it work?

You need to think of the gastric balloon as a reversible mechanical tool that reduces the functional size of your stomach. When the balloon is inside the stomach, the functional size of the stomach (i.e., the part of the stomach that receives food) is significantly smaller than it would have been without the balloon in place.

When I say mechanical tool, this is in contrast to some other bariatric procedures in which the main mechanism of action is hormonal.

The balloon results in weight loss that is significantly higher than the weight loss associated with dieting, physical activity, and medications but is less than the weight loss that can be achieved with sleeve gastrectomy or gastric bypass. The average weight loss with the balloon is 10-15%.

Patients need to work hard with the balloon to get the best out of it and to achieve better weight loss. Patients will benefit from following some rules to get good outcomes out of the balloon. The following are my seven golden rules for the balloon:

Golden rules for gastric balloon success.

  1. Eat a portion size that is equal to or smaller than the new size of the stomach (otherwise you will experience sickness). So, for the balloon to work, patients need to learn the new size of their stomach and eat up to that size. To ascertain the new size of your stomach, find out which portion size makes you sick or have reflux. That is the new size of your stomach.
  2. Eat solid food: You must eat food that is solid. You will not feel restricted if you ate liquid or pureed food (like ice cream or shakes) as such a diet will bypass the balloon.
  3. Change the type of food you eat and the order you eat them: Ensure that you eat protein-rich food (like meat, eggs, dairy products, beans) at the beginning of each meal. If you still had a space after eating the protein, eat vegetables to fill up your stomach. Finally, reduce the carbohydrate content in your food and limit carbohydrate-rich food to the end of your meal.
  4. Avoid foods and drinks that are rich in sugar and/or calories! For example alcohol, chocolates, sweets. These must be limited to special occasions.
  5. Don’t drink for 30 minutes after eating. This helps to give you a full feeling after eating.
  6. Increase your physical activity! I advise patients with balloons to do physical activity that makes them sweaty or breathless or preferably both for an average of half an hour every day.
  7. Do the above every day! You need to transform the above changes into habits that you keep for life (even after the balloon is removed). That can only happen if you intentionally did everything, I mentioned every day for at least two months. After two months, it is likely that the changes will become habits. When they became habits, keep them for life!

What are your gastric balloon options?

There is the traditional option of a gastric balloon that is inserted using endoscopy (I currently use the Orbera 365 for this purpose). The Orbera 365 is a tried and tested gastric balloon that I introduced a few years ago to the North East of England. The Orbera balloon is a slightly improved design from the older BIB 6 months balloon that is produced by the same company. The benefit of the Orbera 365 balloon is that it stays inside the stomach for 12 months which may help you by giving you more time to stick to the changes in dietary and physical activity habits. However, this balloon requires two endoscopy procedures: one for insertion and one for removal. It also might require sedation.

This takes us nicely to the second type of balloon that I am introducing in September to the Northeast of England. The new balloon is called Allurion. This balloon does not require endoscopy for insertion or removal and you only need to swallow a tablet that has a size that is almost equal to about two-thirds of the little finger of an average size person. After the balloon is swallowed, you do not need to do anything (the rest is done by me as I take x rays and fill in the balloon with a special type of fluid). If you cannot swallow the gastric balloon tablet, I will be able to help by stiffening the tube that is connected to the gastric balloon tablet and by guiding it to go through the back of your throat.

The Allurion balloon is designed in a way so that it bursts and deflates and after about four months of the insertion of the balloon. This balloon works in a similar way to the traditional balloons but does not have some of the downsides of the traditional balloon requiring endoscopies and sedation.

The Allurion balloon only stays inside the stomach for about four months. It is possible to argue that this gives patients less chance of turning the changes they introduced to their diet and lifestyle Toumi Rules above) into established habits. It might also give them less time to lose weight while the balloon is inside.

However, in my experience patients normally require to adhere to changes for 2 months to make them into established habits. Therefore, four months can be a reasonable length of time to establish these habits. In regard to the weight loss, the majority of the weight loss with the balloon happens early on after the balloon insertion. However, there might be some difference between the two balloons in regards to weight loss and other outcomes but at present, we don’t have a head-to-head comparison between these two balloons.
The Allurion balloon comes with intensive dietetic input from my dietitian. It also comes with a fitness tracker, an app, and electronic scales. All of this will support you in your weight loss journey and will hopefully result in more weight loss.

I think the Allurion swallowable balloon will generate great interest in many patients who are affected by being overweight or obesity and who tried many other methods of weight loss. The Allurion is perfect for those who want to try to kick start their weight loss journey with an extra tool, but they do not want to go as far as bariatric surgery and who do not want to have an endoscopy (for whatever reason).

If you are affected by obesity and would like to discuss your suitability for the gastric balloon options (Allurion or Orbera 365) or if you wish to discuss treatment for obesity in general, please get in touch or book an appointment.

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