Prof. Dr. Toygar Toydemir
He received the title of Professor of General Surgery in 2020. Dr. Toydemir, who has extensive experience in reflux and obesity surgery, continues his work in these fields. You can read the rest of our article about 6 Month Gastric Balloon prices, treatment process, and post-treatment precautions.
Read More Make an AppointmentIntragastric balloon (IGB) stands out as a non-surgical, effective method in the treatment of obesity. This silicone balloon, placed endoscopically into the stomach and filled with saline for six months, reduces food intake and induces a feeling of fullness. Clinical studies show that it provides an average weight loss of 16.3 kg in women and 19.3 kg in men. In addition, IGB therapy has been associated with improvements in body composition and reductions in anxiety and depressive symptoms. Common side effects include nausea and abdominal discomfort, while serious complications are rare. However, success increases significantly when supported by a healthy diet and regular physical activity. IGB offers an important opportunity for a sustainable solution.
The concept of 6-month gastric balloons emerged from the work of DeBakey and Ochsner in the 1930s, who observed that bezoars led to weight loss by reducing food intake. These observations laid the groundwork for developing gastric balloons as a non-surgical method for obesity treatment. The first specially designed gastric balloon was introduced by Nieben and Harboe in 1982. This device aimed to create a feeling of fullness within the stomach to reduce caloric intake. In 1984, Percival introduced the idea of “balloon dieting” by using inflated breast implants as balloons.
The first major commercial breakthrough for gastric balloons took place in 1985 with the FDA-approved Garren-Edwards Gastric Bubble (GEGB). However, because of stomach erosions and other complications caused by this balloon, GEGB was withdrawn from the market in 1992. These early challenges prompted the medical community to establish safer design and material standards. An international conference held in 1987 recommended improvements in the materials, shapes, and fill methods for balloons.
In the 1990s and early 2000s, new IGB models were developed in Europe and South America. Innovations of this period included fill materials such as methylene blue and designs better suited to stomach anatomy. However, due to a lack of FDA approval, these devices were used outside of the United States.
In 2015, the FDA’s approval of the ReShape Dual Balloon and Orbera IGB systems marked a turning point. With its dual-balloon design, ReShape offered enhanced safety, while Orbera featured a single silicone balloon for a six-month treatment period. These systems achieved significant weight loss when combined with lifestyle changes.
The evolution of gastric balloons continued in 2015 with the Allurion Elipse Balloon, which received the CE mark in Europe. This balloon does not require endoscopy, comes in capsule form, deflates naturally, and passes through the digestive system. Modern balloons have become more effective in obesity treatment when combined with diet and behavioral support. obezite tedavisinde
The 6-month gastric balloon (intragastric balloon, IGB) is an effective treatment option for individuals aiming for weight loss and seeking to manage obesity-related health problems. This method is especially suitable for patients who meet certain criteria.
Body Mass Index (BMI) Criteria:
Patients with a BMI range of 37–35 kg/m² who have not achieved sufficient weight loss through conservative methods such as diet and exercise may be candidates for IGB therapy. The goal is to prevent or treat medical conditions associated with obesity. For patients with a BMI ≥35 kg/m², a gastric balloon can be used as a bridge therapy before bariatric surgery to reduce surgical risks.
Failure of Conservative Methods:
Individuals who have not succeeded in achieving weight loss with dietary changes, physical activity, and medication therapy can benefit from IGB. This treatment provides an additional tool alongside traditional methods.
Although the 6-month gastric balloon (IGB) can be effective in weight management, this treatment method may not be suitable in some circumstances. Specifically, individuals who have undergone previous esophageal or stomach surgery are not advised to use IGB, as it increases the risk of complications. Active gastrointestinal diseases, such as Crohn’s disease, esophagitis, or gastric ulcers, can also make balloon therapy risky. Patients with a hiatal hernia larger than 5 cm are also unsuitable because the balloon may shift its position.
Severe coagulation disorders, liver failure, or conditions such as cirrhosis can lead to serious complications with balloon application. Additionally, the safety of IGB during pregnancy and breastfeeding has not been established, so it should not be used in these situations. In individuals with severe psychiatric disorders or substance addiction, the risk of non-adherence to follow-ups makes treatment less advisable.
Relative contraindications include a hiatal hernia of 3–5 cm, a history of esophagitis, and prolonged NSAID use. In such cases, a careful evaluation is required. Furthermore, the age limits for IGB are set at 18 to 65 years; the safety of treatment outside this age range is unclear.
Finally, IGB is not a suitable option for patients who are unable to attend regular follow-ups or implement the recommended lifestyle changes.
The 6-month gastric balloon application is a non-surgical method requiring careful preparation beforehand. Patients are generally advised to follow a liquid diet for 24 to 48 hours to empty the stomach and facilitate the placement procedure. All food and drink intake should be discontinued at least 12 hours before the procedure. These preparatory steps aim to minimize complications during balloon placement.
The procedure is usually performed under conscious sedation, allowing the patient to relax and respond if necessary. In some cases, general anesthesia may be chosen. During the procedure, a flexible endoscope is advanced through the mouth into the stomach to examine the gastric cavity in detail before the balloon is placed. At this stage, any anatomical abnormalities or potential issues are checked.
An uninflated silicone balloon is guided into the stomach using a catheter. After confirming the correct position, the balloon is filled with sterile saline. Usually inflated between 400 and 700 milliliters, the balloon creates a feeling of fullness in the stomach, thereby increasing satiety. The balloon’s valve closes automatically, eliminating the risk of leakage. At the end of the procedure, the endoscope is used again to verify the balloon’s correct placement.
After the placement procedure, patients are monitored for several hours. Side effects such as nausea, vomiting, and abdominal discomfort are common but generally subside quickly. Patients receive medications to manage these symptoms and detailed care instructions that include lifestyle changes. Most patients can be discharged on the same day and return to their daily routines.
Although the 6-month gastric balloon (intragastric balloon, IGB) provides effective results as a non-surgical approach in obesity treatment, it can cause some side effects and complications. These side effects are generally temporary and can be managed with proper care, but it should be noted that serious complications, albeit rare, can occur.
Common Side Effects:
After balloon placement, many patients experience gastrointestinal symptoms during the stomach’s adaptation period. These may include nausea, vomiting, and abdominal discomfort, which usually subside within a week. Such discomfort can be controlled with medications used to alleviate symptoms.
Because the balloon reduces the stomach’s volume, it can exacerbate symptoms of gastroesophageal reflux disease (GERD). This condition can result in heartburn and indigestion. Acid-suppressing medications are generally effective in alleviating these symptoms. Additionally, patients may experience abdominal bloating and cramping as the digestive system adapts to the balloon. These symptoms usually diminish over time.
Potential Complications:
In rare instances, more serious complications may occur. Among the most common is spontaneous balloon deflation and migration. If deflation is not noticed, the balloon may cause an intestinal blockage, necessitating surgery. To mitigate this risk, some balloons are filled with colored solutions, helping with early detection.
Gastric ulceration and erosion can result from the balloon’s pressure on the stomach lining. Endoscopic evaluation may be required if patients report upper abdominal pain or bloody vomit. Other rare complications include gastric perforation, acute pancreatitis, infections, and balloon hyperinflation. These typically require immediate medical intervention.
The 6-month intragastric balloon (IGB) treatment stands out as an effective method in the fight against obesity. According to systematic reviews and meta-analyses, patients treated with IGB achieve a 4.40% greater total body weight loss (%TBWL) than control groups. In terms of percentage of excess weight loss (%EWL), there is a 17.98% advantage. Patients receiving IGB therapy also experienced, on average, 6.12 kg more absolute weight loss (AWL) and a Body Mass Index loss (BMIL) of 2.13 kg/m².
Compared to lifestyle changes alone, this treatment provides more lasting and remarkable weight loss outcomes. For example, one meta-analysis showed that IGB offered a 6.89% advantage in %TBWL over standard care in a three-month period. However, the continuation of IGB’s effect over the long term depends on lifestyle changes following treatment. After the balloon is removed, weight loss tends to decline, underscoring the importance of diet and exercise habits.
Treatment success can vary depending on the patient’s adherence, initial body weight, and the type of balloon used. IGB is generally considered safe, with common side effects such as nausea and vomiting being temporary complaints. Although serious complications are rare, medical guidance regarding potential risks is essential.
Preparing for 6-month intragastric balloon (IGB) therapy requires a meticulously planned process to increase the procedure’s safety and maximize its success rate. First, a comprehensive medical evaluation must be conducted. During this stage, the patient’s medical history is examined, a physical examination is performed, and necessary blood tests and imaging studies are carried out. This process helps identify possible contraindications, thereby minimizing the risk of complications.
Dietary changes before the procedure are critical for reducing liver size and preventing complications. A high-protein, low-carbohydrate diet is typically recommended. Additionally, it is advised to avoid solid foods at least 12 hours prior to the procedure and maintain sufficient fluid intake.
Medication management is another key preparatory step in preparing the stomach. Patients are usually prescribed proton pump inhibitors (PPIs) about a week before the procedure. These medications reduce stomach acid and lower the risk of irritation and ulceration. Furthermore, a thorough review of existing medications is conducted to evaluate any potential interaction with the procedure.
The psychological preparation of the patient should also be evaluated for treatment adherence and long-term success. This determines whether the patient is ready to adopt lifestyle changes and includes providing any necessary psychological support.
Finally, informed consent is obtained. Patients should be fully informed about the risks, benefits, and alternatives of the procedure so they can make an educated decision.
A multidisciplinary approach is essential for sustaining the success of 6-month intragastric balloon (IGB) therapy in the long term. The first step involves adopting a balanced diet rich in nutrients and establishing healthy eating habits. Small, frequent meals, thorough chewing, and increased water intake are recommended. Lean proteins, whole grains, fruits, and vegetables should be the focus, while sugary, high-calorie, and fatty foods should be limited. Individual supplements may be necessary to address vitamin and mineral deficiencies.
Regular physical activity is also indispensable in post-treatment care. At least 150 minutes of moderate-intensity aerobic exercise should be performed weekly, complemented by strength training. These activities support metabolism and help preserve muscle mass. Patients are encouraged to choose physical activities they enjoy to maintain a sustainable routine.
Behavioral support is a strong pillar in weight control. Methods such as self-monitoring, setting realistic goals, and stress management techniques may be employed. Regular follow-ups with healthcare professionals are crucial for guidance and motivation.
In some cases, pharmacotherapy may support the weight maintenance process. However, it should be done under the supervision of healthcare professionals, following an individualized plan.
Finally, psychological well-being should not be overlooked. Therapy or counseling is advised if emotional eating behaviors or mental health issues arise. This holistic approach will enable a sustainable healthy lifestyle after IGB placement.
How is the 6-month gastric balloon applied?
The 6-month gastric balloon is a silicone balloon placed in the stomach via endoscopy and filled with fluid. By occupying a large portion of the stomach, it creates a feeling of fullness. The procedure typically takes about 30 minutes, and patients are discharged the same day. On average, patients lose 10–15% of their body weight after six months, which translates to a weight loss of approximately 10–15 kg. After balloon placement, side effects such as nausea and abdominal pain may appear in the first few days. At the end of six months, the balloon is removed using an endoscopic procedure. Generally, it is recommended for individuals with a Body Mass Index (BMI) between 25 and 40 who have not achieved sufficient weight loss through diet and exercise.
How does the gastric balloon support the weight loss process?
The 6-month gastric balloon fills the stomach to create an early feeling of satiety, leading to reduced food intake. Patients typically lose 10–15% of their body weight during this process, equivalent to about 10–15 kg. According to various studies, patients lose an average of 20–30 pounds (about 9–14 kg) after 6–8 months with the balloon in place. When combined with diet and lifestyle changes, the gastric balloon offers more effective results than relying solely on lifestyle modifications (which typically result in 1–5% weight loss). Common side effects such as nausea, vomiting, and stomach pain usually subside within a few days after balloon placement.
Will weight regain occur after the balloon is removed?
Yes, weight regain may occur after the 6-month gastric balloon is removed. Research shows that patients can lose up to 17.7 kg during the balloon’s placement, but some of the lost weight can be regained once the balloon is taken out. For instance, at the 18th and 24th months following gastric balloon therapy, significant reductions in both percentage of total weight loss (%TWL) and excess weight loss (%EWL) have been observed, indicating weight regain. Some studies report that while weight loss of around 18% can be achieved in the first 18 months of therapy, this figure drops to 9% by the end of 5 years. This indicates that the gastric balloon aids initial weight loss, but maintaining that loss in the long term requires lifestyle changes.
Which patients are suitable for this method?
The 6-month gastric balloon is suitable for individuals aged 18 and over, with a Body Mass Index (BMI) of 25 or higher, who have not undergone previous esophageal or gastric surgery and who are neither pregnant nor breastfeeding. Additionally, the gastric balloon can be beneficial for those seeking a non-surgical weight loss solution and who can adhere to nutrition and behavior modification programs. However, it is not recommended for individuals with a large hiatal hernia, inflammatory bowel diseases, or those using blood thinners. A thorough medical evaluation before the procedure is crucial for safety and efficacy.
What are the side effects of the gastric balloon?
Common side effects of the 6-month gastric balloon include nausea and vomiting, occurring in about 95% of patients and usually subsiding within 2–3 days. Gastric cramps often appear in the first 48 hours. About 5% of patients cannot tolerate the balloon and may require early removal. Severe complications are rare; however, deflation of the balloon occurs in about 1.5% of patients and can lead to intestinal obstruction. Other potential risks include gastric perforation and infection, although these are quite rare. Most side effects can be temporarily managed with medication and dietary adjustments.
References
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