title: Intragastric balloon in association with lifestyle and/or pharmacotherapy in the long-term management of obesity.
abstract: BACKGROUND
  Intragastric balloon (BioEnterics Intragastric Balloon, BIB®) or pharmacotherapy are possible options for the treatment of obese patients when traditional approaches have failed. The aim of our study was to compare in obese patients the effect on weight loss and metabolic changes of lifestyle modifications associated with either BIB or pharmacotherapy or the two treatments in sequence as a maintenance strategy for weight loss.
  
  
  METHODS
  Fifty obese patients were recruited and randomly assigned to lifestyle modifications combined with either BIB for 6 months (n = 30) or sibutramine (pharmacotherapy group) for 1 year (n = 20). After BIB removal, patients were randomly assigned to either correct lifestyle (BIB/lifestyle) or lifestyle plus pharmacotherapy (BIB/pharmacotherapy).
  
  
  RESULTS
  At 6 months, patients treated with BIB lost significantly (P < 0.05) more weight (percent of initial weight lost, %IWL = 14.5 ± 1.2; percent of excess BMI lost, %EBL = 37.7 ± 3.2) than patients who received pharmacological treatment (%IWL = 9.1 ± 1.5, %EBL = 25.3 ± 4.1). At 1 year, the weight lost was significantly (P < 0.05) greater in patients treated with either BIB/pharmacotherapy (%IWL = 15.8 ± 2.3%, %EBL = 41.3 ± 6.7%) or BIB/lifestyle (%IWL = 14.3 ± 2.7, %EBL = 34.9 ± 6.5%) in respect to pharmacotherapy group (%IWL = 8.0 ± 1.4%, %EBL = 22.1 ± 3.9%). Moreover, patients treated sequentially with BIB/lifestyle or BIB/pharmacotherapy showed a significant (P < 0.05) improvement in insulin sensitivity and triglycerides levels.
  
  
  CONCLUSIONS
  BIB represents an efficacious long-term obesity treatment when supplemental strategies, as lifestyle modifications or pharmacotherapy, are established for weight maintenance after its removal.
authors: Endocrinology Unit, Department of Clinical and Molecular Biomedicine, University of Catania Medical School, Catania, Italy.
authors: Maria Grazia
authors: MG
authors: Farina
authors: Roberto
authors: R
authors: Baratta
authors: Angela
authors: A
authors: Nigro
authors: Federica
authors: F
authors: Vinciguerra
authors: Concetta
authors: C
authors: Puglisi
authors: Roberto
authors: R
authors: Schembri
authors: Clara
authors: C
authors: Virgilio
authors: Riccardo
authors: R
authors: Vigneri
authors: Lucia
authors: L
authors: Frittitta
mesh_terms: D000293:Adolescent; D000328:Adult; D001067:Appetite Depressants / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003503:Cyclobutanes / Q000627:therapeutic use*; D005260:Female; D015905:Gastric Balloon; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
chemical_list: D001067:Appetite Depressants; D003503:Cyclobutanes; C058254:sibutramine