Obesity is a big concern in the USA for dietitians, physicians and other healthcare professionals. There are many reasons why people are gaining weight while having minimal success with weight loss diets/programs. The majority of dietitians will agree that diet is a major factor in the obesity epidemic.
Surgical interventions for weight loss, such as gastric bypass, were developed in the 1960s. There are risks and complications that are associated with surgical weight loss procedures; however, the benefits outweigh the risks. Also, there are requirements for gastric bypass approval, such as: unsuccessful efforts to lose weight, BMI 40 or higher OR BMI 35 or more with a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. Unfortunately, many people who are considered obese (BMI 30-40) will not qualify for gastric bypass. With the invention of gastric balloons, we can now provide a weight loss procedure and program for those within the BMI 30-40 category.
The gastric balloon procedure is a year-long program that includes the gastric balloons and nutrition counseling as well as the tests needed to assure safety for each patient. There are 2 types of gastric balloons that our gastroenterology practice carries: ReShape and Obalon. The two primary differences between these gastric balloons are (1) number of balloons and (2) content inside balloons. The ReShape dual-balloon system is composed of 2 saline-filled gastric balloons tethered together. The Obalon gastric balloon program includes 3, 250 cc gas-filled balloons.
Both types of gastric balloons do the same thing: take up space in the stomach to create a fullness sensation. There should be 1/2 to 1 cup remaining in the stomach after all balloons are placed. The balloons remain in the stomach for 6 months and are then removed endoscopically under light sedation.
The Obalon gastric balloons seems to have less symptoms associated with it when compared to the ReShape dual-balloon system. The reason for this is that each Obalon balloon is placed 2-3 weeks apart allowing time for adjustment for each new balloon. The ReShape balloons are inserted under light sedation going from 0 to 100% in a matter of a few minutes. Patients feel more discomfort, nausea and vomiting for the first week. Obalon's placement is simple and does not require sedation. The patient swallows a pill which contains the balloon attached to a catheter. After the balloon passes the upper esophageal sphincter into the stomach, an x-ray image will be obtained to ensure the balloon is in the stomach. Each Obalon balloon has a marker that will be visible during the imaging. After assurance of location, the physician will inflate the gastric balloon using a canister of a natural, non-toxic gas. After pressurization, and one more imaging to ensure inflation, the catheter is removed. The whole procedure takes about 15 minutes and patients can usually go back to daily life. ReShape patients initially experience more weight loss, especially if they are feeling sick the first week. The average weight loss during the 6 months that the balloons are in is 20-40 lbs. Most patients are no longer considered obese and healthful diet habits are created and sustained.
Obalon (Gas-filled)
VS.
ReShape Dual Balloon System (Saline filled)
My Professional Experience
My patients have been very successful with this weight loss program. I begin with teaching patients general healthful eating habits, including mindfulness and positive body image. Depending on the patient, I recommend following intermittent fasting (time-restricted feeding), pseudo-keto diet (my version of high healthful fat, low processed carbohydrate diet), or both. My patients have found IF convenient and easy. All have been successful with weight loss thus far. Maintenance is something I have not yet experienced as I am rather new in this field of gastric ballooning. In January, a few of my patients will have their balloons removed and we will begin the maintenance process.
To Be Continued...
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