Gastric balloons can help patients lose weight – Greenville Daily Reflector

Q I am morbidly obese and have tried diet and exercise, but I need more help to lose weight. I am afraid to have the gastric bypass surgery. I heard there is a newly approved balloon procedure. Can you tell us about it? — M.S., Greenville

A It sounds like you know that any procedure to treat obesity is truly just an aid to help you with the lifestyle changes needed to lose weight and keep it off. I do not personally have any experience yet working with a patient who has had the newly approved Orbera gastric balloon. Nicholas Koutlas, a third-year Brody student, has done some research about it, and this is what he learned.

There are a variety of forms of weight-loss surgery used to treat morbid obesity. However, due to high cost and complication rates, this type of procedure may not be an option for everyone who needs to lose a great deal of weight. Surgery has been shown to be more effective than lifestyle modification to achieve large amounts of weight loss, but as already noted, it is just an aid to lifestyle change.

Scientists and physicians continue in the search for other procedures that will produce greater weight loss than lifestyle modifications alone but are less invasive than traditional weight-loss surgery. Gastric balloons were invented to fit in between surgery and lifestyle modifications. You may know there are only a few medications that have been approved to treat obesity, and they have side effects as well.

The balloon can be used to make a person feel full faster and lead him/her to eat less. There is evidence that the balloon might also affect gut hormones that control hunger. The balloon insertions are done using an endoscope, a long tube with a light that can be used to look inside the body. The endoscope is passed through the mouth and the upper GI tract until it reaches the stomach. The balloon is then passed through the tube, fixed into place, and then inflated with a saline solution. The procedure is done outpatient and typically requires only mild sedation. There are videos on the web that demonstrate the procedure.

The FDA approved the silicon-based Orbera gastric balloon in August 2015, and there are physicians in our region who are doing this procedure. The balloon is not permanent but typically left in place for six months and then removed to decrease the risk of complications. The gastric balloon is used for patients who have BMIs greater than 35 kg/m2 (severely obese) or greater than 30 kg/m2 (moderately obese) with certain risk factors such as hyperlipidemia, Type 2 diabetes and hypertension. It has been used in patients with BMI greater than 40 kg/m2 (very severely obese) to allow them to lose enough weight to make it possible to have a safer weight-loss surgery.

A recent study showed that patients who have the gastric balloon procedure and complete a behavior-modification program lose about 10 percent of their total body weight. So a person weighing 300 pounds might lose 30 pounds in six months. In that study the behavior modification program was key because the patients who only had the balloon without education lost less than 5 percent of their weight or about 15 pounds. More importantly, six months after balloon removal, the patients who completed an education program maintained their weight loss. The weight loss did help these patients have a lower incidence of obesity-related diseases like Type 2 diabetes and high blood cholesterol after the balloon is removed.

While the short-term data supports the use of the gastric balloon to lose weight, there is only limited long-term data and it’s not strong. In another study I reviewed, only one in three of the patients who had the balloon maintained their weight loss around four years later.

There are some potential complications and side effects that can arise from using gastric balloons. Rarely, they can block the intestines. Additionally, some individuals experience nausea, vomiting and heartburn after the balloon is inserted. However, the overall complication rate is low as long as the balloon is removed no later than six months after insertion.

After the procedure, the diet must be adjusted to achieve maximum results. After day 10 of the gastric balloon, patients can eat a normal texture diet. However, it is recommended that patients avoid drinking carbonated beverages, alcohol and strong coffee with the balloon in place. In addition, patients are instructed to chew their food much more slowly and completely. They are also advised to avoid eating and drinking at the same time. Most of these behaviors should continue, including eating smaller portion sizes, after the gastric balloon is removed to be effective. Getting help from your doctor and a registered dietitian nutritionist both before and after the procedure is a key to success.

Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an Affiliate Professor in the Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu.

from myhealtyze http://www.myhealtyze.tk/gastric-balloons-can-help-patients-lose-weight-greenville-daily-reflector/