title: Intragastric Balloon for Overweight Patients.
abstract: OBJECTIVE
  Current treatments for overweight adults include reduced-calorie diet, exercise, behavior modification, and selective use of medications. Many achieve suboptimal results with these measures and progress to obesity. Whether the intragastric balloon (IGB), a reversible device approved for treatment of obesity, is a safe and effective option in overweight adults is less well studied. We conducted a study to prospectively analyze the safety and effectiveness of IGB in overweight adults, to compare the results to a simultaneously studied cohort of obese patients, and to share procedural tips for safe IGB placement and removal.
  
  
  METHODS
  One hundred thirty-nine patients were evaluated in this prospective, nonrandomized study. Twenty-six overweight [body mass index (BMI), 26-30)] and 113 obese (BMI > 30) patients underwent outpatient, endoscopic IGB placement under intravenous sedation. The IGB was filled with a 550-900 mL (average, 640 mL) solution of saline, radiological contrast, and methylene blue, with an approximate final proportion of 65:2:1. The patients were followed up at 1-2 weeks and then monthly for 6 months. At 6 months, they underwent IGB removal via an esophageal overtube to optimize safety, and then they were observed for 6 more months.
  
  
  RESULTS
  IGB time was 190 ± 36 d in the overweight patients and 192 ± 43 d in the obese patients. Symptoms of IGB intolerance included nausea and pain, which were transiently present in 50-95% of patients for several days, and necessitated early IGB removal in 6% of patients. There were no procedure-related complications and no IGB-related esophagitis, erosion, perforation, or obstruction. The percentage of excess weight loss (EWL%) was 96 ± 54% in the overweight group and 41 ± 26% in the obese group (P < 0.001).
  
  
  CONCLUSIONS
  In overweight adults failing standard treatments, IGB placement for 6 months had an acceptable safety profile and excellent weight loss.
authors.affiliation: Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil.
authors.forename: Flavio Augusto
authors.initials: FA
authors.lastname: Martins Fernandes
authors.affiliation: Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil.
authors.forename: Gustavo L
authors.initials: GL
authors.lastname: Carvalho
authors.affiliation: Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil.
authors.forename: Diego L
authors.initials: DL
authors.lastname: Lima
authors.affiliation: Global Hospitals and Mamata Hospital, Mumbai, India.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Rao
authors.affiliation: TOA Surgical Specialists, Durham, North Carolina, USA.
authors.forename: Phillip P
authors.initials: PP
authors.lastname: Shadduck
authors.forename: Isabelle D
authors.initials: ID
authors.lastname: Montandon
authors.affiliation: Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil.
authors.forename: Juscielle
authors.initials: J
authors.lastname: de Souza Barros
authors.affiliation: Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil.
authors.forename: Ingrid Lais Vieira
authors.initials: IL
authors.lastname: Rodrigues
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000295:instrumentation*; D015992:Body Mass Index; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Endoscopic device; Intragastric balloon; Obesity; Overtube; Overweight