The gastric balloon, for weight loss without surgery
The gastric balloon is a non-surgical method of facilitating weight loss.
It consists of inserting a balloon into the stomach, to induce satiety and enable people who find it difficult to lose weight to receive support in their slimming process.
It is said that the gastric balloon can help you lose the same weight in 6 months as after 2 years of effort…
So we’re curious to discover the advantages and disadvantages of this slimming aid.
What is the gastric balloon?
The gastric balloon is a small balloon made of a soft, malleable silicone elastomer material. Once in the stomach, it is filled with saline or air, and floats freely. By occupying a certain volume in the space where food is ingested, the gastric balloon slows down digestion, providing a sensation of gastric fullness and satiety.
There are different types of gastric balloon. Some are ingestible, while others are connected to a tube which, with the aid of a fibroscope, enables them to be inserted empty into the stomach and then inflated. A gastric balloon can be fitted for between 3 months and 1 year, depending on the patient’s needs and the weight to be lost.
The different types of gastric balloon
Here’s an overview of the different types of gastric balloon.
- The ingestible gastric balloon – fitting time: 3 months – recommended for a BMI between 27 and 32
This gastric balloon is ingested under X-ray control, without anesthesia or fibroscopy. If the sensation of satiety proves insufficient, a second balloon can be inserted after 1 month, or even a third balloon if necessary. Removal is by fibroscopy after 3 months.
- The 6-month gastric balloon – recommended for a BMI between 30 and 35
This type of balloon comes in different models. Some have a silicone envelope filled with sterile saline solution; others have a polymer pouch inflated with air; finally, some gastric balloons have a polyurethane envelope, also filled with saline solution.
- The 1-year gastric balloon – recommended for BMI over 33
This type of balloon is adjustable by means of tubing. In this way, the balloon volume can be reduced at the outset, particularly in cases of poor tolerance, or increased after 6 months if weight loss stagnates. It is either filled with sterile saline or air.
Who is the gastric balloon for?
The gastric balloon is considered by professionals to be an effective aid when it is impossible to follow a diet for more than 2 months, or when the weight lost is regained as soon as the diet is stopped. Thanks to the feeling of satiety it provides, it helps to get rid of the yo-yo effect and facilitates regular follow-up of an overall slimming program. It’s important to stress that the gastric balloon is not a miracle solution for shedding unwanted pounds, but an accompanying tool that must be combined with a balanced diet and regular physical activity if it is to bear fruit. What’s more, every gastric balloon insertion is accompanied by an assessment and follow-up by a multidisciplinary team to ensure that the patient is motivated, able to follow a balanced diet and modify his or her lifestyle.
The gastric balloon is considered a good indication for people who have between 10 and 25 kg to lose.
However, there are a number of contraindications:
- Pregnancy or lack of contraception;
- Hiatal hernia greater than 3 cm in height;
- Coagulation disorders or anticoagulant treatment;
- Long-term use of anti-inflammatory drugs or aspirin;
- Psychiatric disorders or addictions (drug addiction, alcoholism);
- oesogastric surgery.
Gastric ballooning: a multidisciplinary approach
Although gastric ballooning does not require surgery, it is not a trivial procedure. For the gastric balloon to be an effective tool in the success of an overall weight loss program, a multidisciplinary approach is required.
The gastroenterologist
The gastroenterologist is the specialist who will fit the balloon. It is also with him or her that the possibility of fitting a gastric balloon, its indications and contraindications, is discussed beforehand. The gastroenterologist can also confirm whether, from a physiological point of view, you can benefit from a gastric balloon. Your gastroenterologist will monitor you closely in the days following balloon insertion, and every 2 months for as long as the balloon remains in your stomach. This follow-up is designed to ensure that the balloon is working properly, that there are no undesirable side effects, and to make any necessary size adjustments to maintain the feeling of satiety and the chances of success of the program. The nutritionist will also remove the balloon at the end of the program.
The nutritionist
A professional in the field of nutrition and weight loss, the nutritionist will help you understand the basics of a balanced diet, and apply them to your daily life. He or she will help you make the right food choices, while preserving the pleasure of eating. After gastric balloon insertion, follow-up with a nutritionist takes place at the rate of 1 appointment per month, more if necessary. Cooking classes can be offered to help you prepare healthy meals and manage your diet in your daily life. Follow-up continues for 1 year after balloon removal.
Psychiatrist or psychologist
This is a professional who deals with the psychological and behavioral aspects of the slimming process. He or she is there to listen and work on the underlying causes of excess weight. He or she can also help to modify eating disorders, and offer discussion groups to boost your chances of long-term success.
Gastric balloon insertion
Before the gastric balloon is inserted, the patient is cared for by a multidisciplinary team (discussed in our previous paragraph).
- The gastroenterologist will check that gastric ballooning is indicated in your case, and will explain the program to you. This is also the time to ask any questions you may have.
- The nutritionist will make an initial assessment of your diet, and give you initial advice on how to rebalance your diet.
- The psychologist will assess the coherence of your choice, and your ability to follow the program. He or she can begin to discuss with you any eating disorders or other needs requiring specific treatment.
- The anaesthetist will plan the procedure with you, taking into account your state of health and any allergies you may have… This visit is compulsory for safety reasons.
During – Gastric balloon insertion – approximate duration: 20 minutes
- A fibroscopy under anesthesia is performed to visualize the inside of the stomach.
- If no contraindications are detected, the balloon placement phase begins.
- The balloon is introduced through the mouth, deflated and lowered into the esophagus. It is coated with a local anesthetic to facilitate its passage down the throat.
- Once the balloon is in the stomach, it is filled with a sterile saline solution dyed blue, or with air through a catheter attached to the balloon.
- When the balloon is full, the gastroenterologist gently pulls on the end of the catheter to remove it. A self-sealing valve closes the balloon and prevents leakage. The balloon floats freely in the stomach.
- The patient remains under medical supervision in the clinic for a few hours.
After
- The gastroenterologist is especially present and available in the days following the operation, to ensure that the balloon is well tolerated and that there are no adverse effects.
- For the first 2-3 days, a diet based on stewed fruit and yoghurt is recommended. Good hydration is recommended.
- Nutritional follow-up begins 1 week after balloon insertion.
- Psychological follow-up is initiated according to the patient’s needs.
The following video clearly explains the gastric balloon insertion technique:
Removing the gastric balloon
At the end of the allotted time, the balloon is removed because the stomach has adapted, rendering it ineffective. Performed under general anaesthetic, the removal of the balloon is done under intubation and endoscopic control, and lasts around 15 minutes. No surgical intervention is required.
- The gastroenterologist places the fiberscope in the stomach.
- The balloon is punctured and the liquid aspirated.
- The deflated balloon is grasped and extracted through the esophagus, then through the mouth.
Does the gastric balloon cause side effects?
The gastric balloon is usually very well tolerated. In fact, the stomach adapts to its presence in just a few days. This leads to an increase in acid secretion, as well as contractions of the stomach against the balloon, which is perfectly normal.
However, in the 3 days following the procedure, the following side effects are common:
- Abdominal cramps
- Nausea
- Vomiting;
- Burning of the stomach or esophagus.
Medication is usually prescribed to alleviate the discomfort, which is only temporary.
Figures show that only 1-3% of people suffer from intolerance to the balloon, which is then removed. Other complications, though rare, are possible. These include esophagitis, gastritis, ulcer, pancreatitis or perforation (the latter 2 are extremely rare).
Finally, in some patients, the feeling of satiety disappears after just a few weeks, necessitating adjustments to the balloon.
Finally, what can I expect from a gastric balloon?
In combination with a balanced diet, regular physical activity and a profound change in lifestyle, the gastric balloon enables weight loss to be achieved in the vast majority of cases.
However, weight loss depends on a number of factors, including program follow-up and motivation. Whether you lose weight and keep it off depends on how you adopt the changes over the long term.
With a gastric balloon in the stomach for 6 months, weight loss can range from 10 to 25kg. This will depend on the number of kilos you need to lose, your metabolism, and how hard you work!
