Abstract

Obesity has become a severe health problem in the Western world, and is rapidly becoming the most common disease of the 21st century. Morbid obesity is resistant to treatment and is accompanied by considerable morbidity. Some morbidly obese patients do not manage to reduce their weight by diet alone, yet are unsuitable or unwilling to undergo bariatric surgery. Lately, a new intragastric bioenteric balloonR (BIB) was developed to treat these patients. This article summarizes the current knowledge and experience with this balloon, and its advantages and disadvantages. There are very few placebo controlled studies regarding the BIB, and the results are controversial. One study shows the advantage of using the balloon compared with diet alone while another study showed no advantage of the balloon compared with a strict diet regimen. Uncontrolled studies show that balloon treatment combined with diet and physical activity had favorable results achieving both weight reduction and reduction in obesity associated morbidity. Those results were maintained a year after the balloon was removed. Mild and common side effects included vomiting and heartburn, but the balloon also caused severe complications including bowel obstruction, perforation and even death. The total rate of severe complications is estimated to be about 3%. We conclude that the intragastric balloon may be an appropriate addition to the treatment of morbid obesity, but only if combined with a proper diet, physical activity and psychological support. Patients should be carefully selected and monitored to avoid complications.