Intragastric balloons are a safe and effective way to achieve weight loss in obese patients who have been unable to lose weight by other means, researchers reported here at the 16th European Congress on Obesity (ECO).The water-filled balloons are installed using endoscopy to achieve restriction of gastric intake in obese patients.
Sharon Marks, MD, Coordinator, Obesity Clinic, Consultant Physician in Clinical Nutrition, Monash Medical Centre, Melbourne, Victoria, Australia, and Frankston Private Hospital, Frankston, Victoria, Australia, and colleagues inserted 92 water-filled intragastric balloons into 73 obese patients over 6 years.
The 63 women and 10 men had been unable to lose weight using other means, including reduced-fat diets, exercise, very low-calorie diets, and the anti-obesity drugs sibutramine and orlistat.
Spontaneous deflations occurred in 13 balloons 2 to 4 months after surgery. "This was thought to be because of a leaky valve in one batch of balloons used between June 2002 and June 2003," the researchers explained in their poster presentation May 17.
Eight of the deflated balloons remained in the stomach and were removed endoscopically; 5 of them transited the bowel without causing bowel obstructions.
No spontaneous deflations occurred during the second 3 years.
The researchers reported that 79 fully-inflated balloons were removed from 73 patients. Twelve of the balloons were removed prematurely -- 8 of them because of intractable vomiting and nausea; 2 because of belching; 1 prior to emergency hernia surgery; 1 at the patient's request.
In the overall patient group, including patients whose balloons deflated, the mean weight loss was 10.5 kg (P < .0001). In the patients with intact balloons, mean weight loss was 11.0 kg (P < .0001).
"All the patients had attended the same physician for an average of 34 months and had previously trialed medications such as orlistat, sibutramine, and sertraline, in addition to using a very-low-calorie diet to achieve weight loss," the researchers reported. "Many required weight loss prior to joint replacement surgery."
They admitted that while this is not the ideal study cohort, they analysed the data in an attempt to evaluate the treatment's efficacy, tolerability, patient selection criteria, and safety.
Univariate analysis showed significantly greater weight loss in patients with a body-mass index of 50 kg/m2 or greater. Other variables, such as length of time of balloon insertion and number of review consultations, had a negative correlation with weight loss.
"These findings matched clinical experience and suggest that the intragastric balloon is a physical deterrent to large food portion sizes and achieves significant weight loss," the researchers reported.
Source: Doctor's Guide
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