Treatment of morbid obesity with intragastric balloon in association with diet.
BACKGROUND
The BioEnterics Intragastric Balloon (BIB, BioEnterics, Santa Barbara, CA) in association with restricted diet has been used for the treatment of obesity and morbid obesity.


METHODS
Since March 1998, 322 BIB were placed in 281 obese and morbidly obese patients; 73 patients were male and 208 female; mean age was 41.6 years (21-70); mean weight was 117.4 kg (67-229); mean BMI was 41.8 kg/m2 (29-81); % excess weight was 62% (10-216). The balloon was inserted and removed endoscopically under general anesthesia. Patients were given a balanced diet of 1000 kcal/day. Also, for 18 months we compared 42 obese patients treated only with 1000 kcal/day diet (group A) with 31 obese patients subjected to BIB for 4 months + 1000 kcal/day diet (group B).


RESULTS
After 4 months of balloon treatment, the mean weight loss was 13.9 kg and the mean reduction in BMI was 4.8. Weight loss was greater in male patients. Weight loss was accompanied by an improvement of the diseases associated with obesity, in particular diabetes. In the diet vs BIB + diet study, BIB with diet produced a greater weight loss in a shorter time than diet alone.


CONCLUSIONS
The best indications for BIB were: morbidly obese opatients (BMI > 40) and super-obese patients (BMI > 50) in preparation for bariatric operations; obese patients with BMI 35-40 with co-morbilities in preparation for bariatric surgery; obese patients with BMI 30-35 with a chronic disease otherwise unresolved; patients with BMI < 30 only in a multidisciplinary approach.
Cattedra di Chirurgia Generale dell'Università degli Studi di Milano, Unità Operativa di Chirurgia Generale, Istituto Clinico Sant'Ambrogio di Milano, Italy. sbdoldi@tiscali.it
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Doldi
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Micheletto
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Perrini
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Librenti
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Rella
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy*; D011183:Postoperative Complications; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology