Intragastric Balloon Treatment for Obesity

Obesity is a major health burden and its prevalence is rapidly increasing. Endoscopic treatments may help patients with obesity to interrupt or slow down the weight gain, thereby reducing complications associated with excess weight. In patients with morbid obesity, the weight loss obtained with endoscopic procedures represents a chance to reduce the bariatric surgical and anesthesiologic complications. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures are available, but many aspects lack standardization. Many intragastric balloon (IGB) devices are available with their own peculiarities; some are US Food and Drug Administration approved while others are currently being investigated. We discuss several aspects of IGB treatment and present the evidence regarding safety and efficacy of the most common IGBs. Overall, IGBs are reasonably safe devices and represent a practical tool to aid weight loss when managed in the context of multidisciplinary team. Patients should be thoroughly evaluated for the procedure and adequate medical and nutritional follow-up is needed. For some devices, the evidence is strong both in terms of safety and efficacy; for other newer devices, further prospective studies are necessary.