Medically reviewed by Dr. John Rosdeutscher – Written by Sine Thieme
How a Gastric Ballon Works
A gastric balloon serves to help reduce a person’s weight. It is placed inside the stomach in a non-surgical procedure, meaning without the need for invasive surgery, and is left there for a period of time ranging from 4-6 months. During this time the balloon takes up space in the patient’s stomach and thus suppresses their feeling of hunger. This helps the patient reduce portion sizes and meal frequency which in turn leads to weight loss. By the time the balloon is removed again, the patient will have adopted these new, healthier eating habits, meaning the weight loss will remain permanent.
This process is also referred to as endoscopic bariatric therapy. It has become very popular in recent years, as it provides greater efficacy with lower risks than conventional surgical procedures.
Non-Surgical Gastric Balloon vs Surgery
There are different types of gastric balloons which will be compared in this article. Gastric balloons should not, however, be grouped together with other bariatric procedures such as a gastric bypass. A gastric bypass is a fully surgical procedure that essentially creates a smaller stomach for the patient. The end effect is the same – the reduced space in the stomach leading to weight loss via a reduction in portion sizes – but gastric bypasses are more invasive and therefore higher risk than non-surgical weight loss balloon placements.
Types of Gastric Balloons
The ORBERA Weight-Loss Balloon
Orbera is an FDA-approved weight loss system that helps patients to lose an average of 3x the weight of diet and exercise alone, yet does not require surgery. Of the various intra-gastric balloons, Orbera is the most widely sold, with over 300,000 placements worldwide.
The balloon is placed into the stomach endoscopically by a surgeon. This means he or she inserts the deflated balloon through the mouth all the way into the stomach. Once there, it is filled with approximately 550 cc of a sterilized saline solution (the size of a grapefruit) and stays in place over the course of 6 months. While free-floating in the stomach, it creates a sense of fullness which slows the digestion. The patient learns to eat smaller portions during meals and to curb impulsive eating. In this way the balloon becomes a learning tool for the patient to take control of their body without the need for weight loss surgery.
After the six months have passed, the balloon is drained and removed from the stomach the same way it was inserted – endoscopically. Both placement and removal are typically completed in 20 minutes or less.
The Obalon Balloon System
The Obalon balloon system for weight loss is similar to the Orbera balloon in that it takes up space in your stomach over the course of 6 months. However, instead of the surgeon threading the balloon into the stomach endoscopically, the patient simply swallows a capsule attached to a thin tube. Once it’s in the stomach, the surgeon fills the balloon with a gas. You then return 2 weeks later for the placement of a second balloon, and as necessary another 2 weeks later for a third and last one. Each balloon is the size of a small orange.
The rest of the procedure is the same as for Orbera. You retain the balloons in your stomach for 6 months and learn to adjust your portion sizes during this training period. After 6 months, the balloons are removed by a gastric surgeon in minimally-invasive fashion.
On average, Obalon costs about $2,000 more than Orbera. This makes sense as it requires more surgeon time, and more balloons. You’ll also need to budget more time to schedule the repeat placements.
Elipse Intragastric Balloon
The Elipse Balloon is touted as the “only gastric balloon in the world without endoscopy.” Just like the Obalon balloons it is placed in the stomach during a 20-minute consultation with your doctor. You swallow a tube that contains the deflated balloon, and once in the stomach the balloon is filled with saline. This can be achieved without anesthesia since you have control over the entire process. A quick x-ray determines if the balloon is in the right place.
Unlike Obalon or Orbera, the removal of an Elipse balloon does not require endoscopy. Rather, after about 4 months, a time-activated release valve drains the balloon, and it passes through your digestive system. The benefits are clear: The downtime of the procedure is cut in half, and the cost is lower as well because no doctor is required on the back end.
It should be noted that the Elipse system does not yet have FDA-approval for use in the United States. At the time of this writing it is undergoing FDA trials.
Spatz3 Adjustable Gastric Balloon System
The Spatz gastric balloon works much like the above solutions, with one major difference: it is adjustable to accommodate saline fill volumes of 400 cc to 800 cc. This allows the surgeon to increase and decrease the fill size along the way to make sure that it works to its full potential. Especially at the 4-month mark when a gastric balloon may lose some effectiveness, it is an advantage to be able to increase its size. Conversely, if the patient struggles to tolerate the initial balloon placement, it can help to be able to temporarily reduce its size.
The Spatz balloon system is currently under review by the FDA for use in the United States. Outside of the US, it is approved for placement lasting up to 12 months in select locations.
Reshape Intragastric Balloon
The Reshape balloon is no longer available as a weight-loss system. It was bought by Apollo Endosurgery, to maker of the Orbera balloon, in 2018 and has since been discontinued. It was very similar to the Orbera balloon, except that it consisted of two balloons filled to a total of 900 cc for a somewhat snugger fit. You may find information online for providers offering the Reshape Intragastric balloon, but you should know that it is no longer an option.
Which Type of Gastric Balloon is Best?
Given that the Reshape balloon is no longer available, and the Elipse and Spatz systems are still pending FDA approval, choosing a gastric balloon for your weight loss comes down to Orbera vs Obalon.
Both are reputable procedures with good efficacy and promising results. The main difference is that the Obalon balloon is self-swallowed, which avoids anesthesia at the front end. Placing up to 3 balloons can be accomplished in the office with an x-ray in about 15 minutes at every visit. The Orbera balloon requires endoscopic placement by a surgeon, but you are done in a single 20-minute procedure in an outpatient setting. Both balloons stay in for 6 months and are removed under sedation.
Which system you choose for your weight loss therapy will most likely depend on your gastric surgeon. It is important that you first have a consultation with an experienced bariatric surgeon who routinely performs endoscopic procedures and is trained in the latest technology.
Getting Started with your Gastric Balloon
Gastric balloon placement and removal including monthly dietician follow-ups are available at NuBody Concepts at our fully-equipped cosmetic surgery center in Nashville. If you are visiting from out of town, ask about a virtual consultation with our gastric surgeon as well as our travel package to cover hotel expenses. If you are ready to get started, call us at 615-229-5975 weekdays between 8:00 am and 4:30 pm to schedule your consultation!