The gastric balloon

People in Germany are getting fatter and fatter. According to a report by the DGE (Deutsche Gesellschaft fur Ernahrung e. V.), 59 percent of men and 37 percent of women are already overweight. [1] People who are overweight (obesity) often suffer from concomitant diseases such as high blood pressure, diabetes or cardiovascular problems and an increased risk of heart attack or stroke. In addition, there may be social discrimination, isolation or depression. In addition to genetic factors or metabolic diseases, poor diet and lack of exercise are the main causes of excess adipose tissue formation. In such cases, a gastric balloon can help to reduce weight permanently.

What is the aim of a gastric balloon treatment??

The main goal of all treatment methods for obesity is to reduce overweight and thus the risk factors for serious diseases. For patients with a BMI over 27, gastric balloon therapy can contribute to effective weight loss success, allowing them to participate more actively and confidently in social life again. In most cases, people suffering from obesity do not manage to reduce their weight permanently on their own. The intragastric balloon offers – without surgical intervention – a simple and effective way to achieve a significant and lasting weight loss. A gastric balloon is used to reduce the volume of the stomach, allowing patients to eat significantly less food. A healthy diet and plenty of exercise should always be an integral part of this therapeutic measure.

Am I overweight?

By definition of the World Health Organization (WHO), adults with a body mass index (BMI) above 25 are considered overweight. With a BMI over 30 people are classified as severely overweight, i.e. obese (adipose). To determine one’s personal BMI and thus get an indication of whether one’s weight is in the green zone, perform the following calculation: Weight in kilograms divided by height in meters squared. Note: While BMI is a common formula for classifying body weight into underweight, normal, and overweight, it does not take into account relevant factors such as age, gender, and body mass composition. Therefore, even trained, slim people who have a lot of muscle mass can be falsely considered overweight according to calculations of BMI.

Consequences of obesity

The increased fat storage in the body does not remain without health consequences. It has been shown that the risks increase from a BMI of between 25 and 30. Thus, even in this BMI range, the risk of heart attack is twice as high as in the normal population with a BMI below 25.

BMI and type II diabetes are also closely associated with each other. A BMI over 30 means a 30-fold increased risk of sugar disease

Other important secondary diseases

Cardiovascular disease
– High blood pressure
– Coronary heart disease
– Heart attack
– Heart failure
– StrokeMetabolic and hormonal disorders
– Diabetes mellitus
– Hyperuricemia (“gout”)
– Fat metabolism disorders
– Impotence in men
– Infertility in womenSkin diseases
– Fungal skin diseasesPsychological diseases
– Low self-esteem
– DepressionDiseases of the respiratory system
– Obstructive sleep apnea
Diseases of the digestive tract
– Gallstones
– Reflux disease (“heartburn”)
– Fatty liver*Mechanical problems
– Premature arthrosis
– Deformities of the spineIncreased risk of carcinoma
– Cervical cancer
– Ovarian cancer
– Breast cancer
– kidney cancer
– Prostate cancer
– Colon cancer
– Pancreatic cancer
– Liver cancerSocial problems
– Limited activity in everyday life
– Decreased quality of life

This is only an excerpt of the most common secondary diseases of overweight/obesity. It is worth noting that many of these risks are completely reversible if weight reduction is achieved. After weight reduction, many patients are able to stop taking their sugar pills or blood pressure tablets, not to mention the consequences for their social and psychological problems.

Finally, it should not go unmentioned that mortality also increases with increasing BMI. The motto “fat people live shorter lives” is scientifically well proven.

*The issue of “fatty liver” as a consequence of weight problems is a particular problem in our practice. As a hepatology practice, we naturally care for many patients with elevated liver values. Often these values and the fatty liver visible on ultrasound can only be explained by the overweight of the patient. Also for these patients the only sensible therapy is a weight reduction, in order not to have to live with an increased risk for a connective tissue remodeling of the liver (cirrhosis).

Is the Obera™ gastric balloon right for me??

Requirements for treatment with the intragastric balloon are:

  • Minimum age 18 years.
  • BMI 27-35 without and with secondary conditions.
  • BMI 35-40 who do not wish to undergo bariatric (=obesity) surgery.
  • Very obese patients prior to bariatric surgery to reduce surgical risks.
  • Willingness to reliably participate in a professional, medically supervised program.
  • Willingness to make long-term lifestyle and dietary changes.

A gastric balloon should not be placed in the following constellations:

  • Previous gastrointestinal surgery, peritonitis, large diaphragmatic hernia.
  • Severe kidney, liver or lung disease.
  • Long-term cortisone therapy.
  • Lack of willingness to make long-term lifestyle and dietary changes.
  • Drug and alcohol addiction.
  • Pregnancy and lactation.

Risks of the gastric balloon

As with all medical procedures and interventions, potential risks and side effects must be explained. These are rare and will be discussed during the informed consent interview:

  • Leakage of the balloon (green coloration of the urine). The balloon is usually excreted with the stool without any problems.
  • Risks of gastroscopy with injury to the stomach, unforeseen reactions to the administered medication, slight swallowing disorders following the examination.
  • Nausea and vomiting are common in the first few days after the balloon is placed and can be treated well with appropriate medications.
  • Rarely, liver elevations occur in the case of very severe weight loss.
  • There is no guarantee of satisfactory weight loss. However, if the previously discussed recommendations are adhered to, impressive success on the scale can be expected.

What is an Orbera™ gastric balloon?

The Orbera™ gastric balloon we use is a soft, sutureless silicone balloon. It is filled in the stomach with sterile saline solution, which is mixed with a blue dye. In the very rare case of balloon leakage, this would cause the patient’s urine to turn green.

The balloon can be filled with 400-700 ml of saline solution, depending on the patient’s needs. It is designed to remain in the stomach for 12 months.

What does the gastric balloon do?

The intragastric balloon has many advantages over conventional diets. Its principle of action is based primarily on the fact that it leads to an early, strong feeling of satiety, which significantly simplifies and accelerates weight loss. Other advantages are:

  • Studies have proven higher weight reduction than with pure diets.
  • Holistic therapy with the support of medical experts.
  • Learning the basics for long-term success.
  • No medication with side effects for weight loss.
  • No surgical procedures for weight loss.
  • Low side-effect application and removal of the balloon within 20 minutes.

Since the risk of various secondary diseases increases above a BMI of 25, weight-reducing measures are recommended above this value. At the latest from a BMI of over 30, additional supportive options should be considered. Here a gastric balloon could be the ideal solution for you.

What are the requirements for the use of a gastric balloon?

The basic condition for the implantation of a gastric balloon is the health of the stomach. In this respect, a gastroscopy is usually common practice in order to rule out stomach ulcers or malformations of the stomach, for example. Each patient must be asked about his or her individual history, personal goals and a medical history must be taken. Only then can the doctor weigh up the treatment options and decide whether the intragastric balloon is a suitable therapy option.

When should a gastric balloon not be used?

Gastric balloon therapy is also contraindicated in cases of eating disorders such as bulimia, severe mental disorders, alcohol and drug addiction, existing pregnancy or taking blood thinning medications (does not apply to aspirin). Other medical reasons that may speak against a treatment with the intragastric balloon are previous surgical interventions on the digestive tract as well as severe lung, liver or kidney diseases.

How much can you lose in total with the intragastric balloon?

After implantation of the intragastric balloon, a significant weight loss can be expected in the first 6 months. How much weight you ultimately lose during the intragastric balloon procedure and how long you keep it off depends on how consistently you change your eating and exercise habits.

A weight loss of 30 kg is quite possible during this period, 15-20 kg is the rule. The prerequisite for this is, however, close and reliable cooperation with the team looking after you, including participation in dietary consultations and regular success checks.

After 6 months with a gastric balloon, your body will have become accustomed to smaller meals and you will be able to more easily maintain or even further reduce the weight you have reached.

Does a gastric balloon guarantee weight loss?

No, there are definitely cases that have hardly lost weight despite a balloon in the stomach, because they have done nothing in addition for it. Therefore, the appeal to patients is: change your diet to healthy foods, change your eating habits, or change the way you eat. your pathological eating behavior and get enough exercise. Because only those who use a gastric balloon do not automatically lose weight. The intragastric balloon is a weight loss aid for the most difficult first steps to a healthier lifestyle

With a pure gastric balloon treatment one must expect costs of approx. 2.900 Euro calculate up to 5.000 euros [2] for package offers with additional services regarding nutrition, sports and motivation. The total cost of intragastric balloon treatment always includes the medical consultation and the preliminary medical examinations by a specialist and, as a rule, advice on dietary and behavioral changes; the insertion and removal of the intragastric balloon; the intragastric balloon itself; the cost of anesthesia and follow-up treatment; and the cost of the intragastric balloon itself. The control appointments. Depending on the service package, the cost of the gastric balloon may also include nutrition, fitness and health support from a health coach.

How to use the balloon?

The empty intragastric balloon is attached to a soft and flexible filling tube and inserted endoscopically into the stomach via the mouth and esophagus. You will be put into a twilight state, as you may already know from gastroscopy or colonoscopy, so that you will not notice anything of the whole procedure.

Under endoscopic view, the balloon is then filled in the stomach with the intended amount of saline solution. The procedure takes a total of 15-20 minutes. Afterwards, you will be monitored in our recovery room for a few hours and can then leave the practice with an accompanying person.

The day of the gastric balloon insertion

As already described, the procedure takes approx. 15 – 20 minutes, but you will sleep through them. Promised, you will not notice anything from the procedure.

The following preparations are important

  • A person you trust should accompany you, who will then also take you home again and also stay with you there if possible.
  • Do not eat anything for 12 hours before the operation, do not drink anything for 4 hours before the operation.
  • Plan the next 3 days, better the next week, “vacation”, d.h. If possible, do not have any professional or strenuous private obligations.
  • Specifically, no physical activity for the first 24 hours

Getting used to the intragastric balloon

The first few days after the balloon is in place are unpleasant. Nausea, vomiting, abdominal pain, diarrhea may occur and you should be prepared for them. Therefore, especially during the first few days, it is very important that you call our office at least once a day. Some patients also require an infusion, which they then receive in the practice.
On the first day you will probably only be able to drink a few sips of water, then in the days that follow it is very important that you drink a lot and do not eat solid food.

Recommended during the first days


  • Coffee
  • Carbonated drinks
  • Fatty foods
  • Chocolate
  • Ice cream
  • Alcohol

Transition to solid food

After a few days of eating only liquids, you are ready to transition to solid foods. This transition should be slow and include semi-solid food at first. Porridge, thicker soups are the “classics” in this phase. Our dietician is available to assist you with this.

Since, in our experience, most patients suffer from severe heartburn and sometimes develop severe inflammation of the esophagus, you will be prescribed a so-called acid blocker, which you will need to take once (or twice) a day, at least for the first few weeks.

Now the regular appointments with our team begin. They are guided individually through the next few months and prepared for later life without a balloon.

The next 6 months with your intragastric balloon

After a few days to 2 weeks, your body will have become accustomed to the intragastric balloon to the extent that you can resume your daily activities. Your diet plan, which you will discuss with our dietician, will become increasingly varied and you will be pleased with the rapid progress of your weight reduction during the regular meetings in our practice.

These 6 months are of crucial importance, because during this time you should be able to change your lifestyle so that you can reach and maintain your ideal weight.

The intragastric balloon is an aid that makes this change easier for you. But without your motivation, commitment and discipline, even the balloon will not be able to achieve lasting success.

The following tips increase the chances of success:

  • Be sure to attend the arranged doctor and diet counseling appointments. These meetings will help you maintain motivation. Patients who regularly check in with the caring team have the best short- and long-term results.
  • Carry if necessary. A diary in which you record all the food you eat and your daily exercise.
  • Make permanent changes in your lifestyle and diet. Be open with your surroundings about the topic.

Of course, it is very important that you report any changes in your condition to your doctor during this time. Persistent nausea, abdominal pain, heartburn, urine discoloration are circumstances that your doctor must know about in order to be able to react appropriately if necessary.

The day of the intragastric balloon removal

The intragastric balloon will be removed after 6 months at the latest. You will not notice anything from this procedure either. As with the balloon placement, you sleep through the procedure.

The saline solution is pumped out of the balloon and the balloon is then removed from the stomach via the esophagus when empty.

Please note:

  • No solid food 24 hours before the procedure.
  • No liquids for 6 hours before the procedure.
  • You will need a companion who will pick you up from the practice and take you home, and who will continue to look after you there for a few hours if possible.

Even after the removal of the balloon, our team will be at your side with help and advice. Take advantage of this opportunity. It increases the chances of a sustainable weight loss.

Your desire, after successful weight reduction, to maintain this achieved weight or to reduce it even further and to keep your so gained new attitude towards life, is a strong motivation to continue on this path. Nevertheless, do not be afraid to let us continue to help and guide you on this path.

Frequently asked questions about gastric balloon surgery

The success of the weight reduction depends decisively on your cooperation. The more intensively you change your eating habits, the greater the expected weight loss will be. 15 – 30 kg can be achieved in the 6 months mostly well.

Many studies show that you can expect a significantly higher weight loss than with diet alone. The fast feeling of satiety, which is created by the gastric balloon, helps here.

At the moment, cost absorption by the health insurance companies is the absolute exception. In individual cases, it is worth asking the health insurance company, but you should not plan for reimbursement.

Especially the first days are unpleasant. Nausea and nausea are common, but these can usually be treated well with medication. Also heartburn up to esophagitis often occurs. Therefore, you will be prescribed an “acid blocker” as a prophylactic measure.

You should not plan any physical activities during the first week. Afterwards, sporting activities are even desired and you should be able to fully cope with your everyday activities again. The control appointments with our team will be arranged in such a way that they can be integrated into your everyday life.

Thanks to the balloon you will not feel like eating as much as before. And very fatty and sweet food is often not tolerated so well. Overeating while the intragastric balloon is in place can be dangerous and should be avoided at all costs. Alcohol does not harm the balloon, but because of the additional calorie intake, it is not conducive to weight reduction and should be the exception.

Of course, many other questions will arise before and during the time with the intragastric balloon. Do not be afraid to write down any questions and discuss them with us at our next meeting.

No, the classic intragastric balloon treatment takes place in a kind of short anesthesia, in a twilight sleep. Immediately after the procedure, the patient is fully conscious again. a feeling of drowsiness may occur, but it is quite normal.

No, since the intragastric balloon treatment takes place under light sedation, the patient sleeps through the procedure and is not aware of the procedure. Even swallowing the capsule with the swallowing balloon method is not associated with pain. Possibly during the adjustment phase, d.h. in the first days after the implantation, stomach cramps occur, which are associated with corresponding pain.

The procedure lasts approx. 20 to 30 minutes and is performed on an outpatient basis. D.h. it is not necessary to stay in the hospital or. to stay in the clinic. Patients are usually observed for 1 to 2 hours after the gastric balloon treatment and can then go home.

The intragastric balloon is usually removed in the same way as it was placed: via an endoscope, i.e. a thin tube that is inserted into the stomach through the esophagus. The intact balloon is professionally punctured and deflated by the doctor before it is retrieved. Swallowing balloons are a special case. These dissolve after a certain wearing time respectively. Empty themselves independently and then get out via natural digestion.

It is possible for patients to feel and also palpate the intragastric balloon when lying flat on their backs. Some report preferring to lie on their side or stomach for this reason.

It is advisable for patients to receive special dietary instructions from their physician prior to treatment or. Be familiarized with the necessary dietary changes. This way they can prepare themselves optimally for the time with the intragastric balloon and internalize the new habits. For the first few days after the insertion of the intragastric balloon, it is recommended to get various liquid foods such as soup, broth and juices. Since you are not allowed to drive after the procedure, a driver should be arranged. It is also important not to be alone for 24 hours after the treatment.

Patients should not eat for at least 12 hours before the procedure and should not drink for at least 2 hours before the procedure. The doctor will measure the body circumference and take the most important body measurements, as well as measure the starting weight to document the success in weight loss.

After the intragastric balloon treatment, the patient should rest and drink only small amounts of liquids. In order to accustom the body to its new companion, patients should generally eat only liquid food during the first week. And only in small quantities, a maximum of 100 milliliters at a time, otherwise there is a risk of nausea and vomiting.

Relevant in the aftercare following gastric balloon treatment is regular weight monitoring, nutritional and dietary counseling, motivation to exercise, and the timely detection of any complications.

After the gastric balloon treatment, the first thing to do is to drink at least two liters a day. And even this poses a challenge for many patients, as the stomach is very sensitive during the acclimation phase and nausea and vomiting can easily occur. Generally, a build-up diet is recommended, d.h. Liquid food only for the first week, then pureed, mushy food and, if necessary, soft, easily mashed food for another week before being able to eat normally again.

No surgical intervention is necessary for gastric balloon therapy: The balloon is inserted into the stomach through the mouth and esophagus. For this reason, the treatment is extremely low-risk. Patients only report slight scratching of the throat shortly after insertion. In rare cases, a damaged gastric balloon can migrate to the intestine, where it is usually eliminated naturally.

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