For many patients with a BMI (body mass index) of 27 - 35 surgical intervention is not always available or recommended according to the NICE (National Insitute of Clinical Excellence) guidelines, as patients with a lower BMI do not qualify.

For many the outlook does not look positive. Following years of yo-yo dieting and failed attempts at maintaining weight loss, patients return to old eating habits and unhealthy lifestyles.

Balloon placement constitutes a therapeutic attempt for the treatment of obesity. It was primarily used to reduce patients weight prior to having surgery for morbid obesity.

We have looked at the specific treatment of obesity and why some patients fail on supervised weight control programmes.

We have found that along with the insertion of the intra-gastric balloon and a professionally supervised “behavioural modification” program, successful weight loss can be achieved and maintained.

The balloon is a silicone sphere that holds 500cc volume of saline or air. The balloon stays in place for approximately six months and is radiopaque (can be seen easily under X-ray) and complications are extremely rare.

The feeling of satiety and fullness is achieved by the Baroceptor and the brain passing messages to each other that the patient is full; there is a delay in gastric emptying resulting in reducing the amount the patient can eat and a constant feeling of satiety.

Pre-insertion
All patients will follow our pre-screening assessment and complete a patient information profile, have a dietary evaluation and psychiatric consultation if clinically indicated.

An X-ray of the oesophagus, stomach and duodenum may be required if clinically indicated.

Routine blood tests, chest X-ray and ECG may also be required if clinically indicated.

All patients will commence a liquid diet 24 hours prior to midnight pre admission, then nil-by-mouth until insertion.

Insertion of the balloon
Most patients have the balloon inserted under sedation, unless there is a specific clinical reason. The balloon is inserted endoscopically and placed in the stomach, then inflated with saline or air (depending on the type used).

The balloon can easily be deflated and removed, if required, at any time. All patients will be required to stay one night in hospital.

Removal technique
The balloon will be removed endoscopically, under sedation, following six months treatment and behaviour program.

All patients will commence a liquid diet three days prior to removal. Patients may be discharged following removal within a few hours.

Risks and complications
With any surgical or medical intervention there are always going to be risks and some complications and although many are very rare and every effort is made to reduce or prevent them, you need to be fully aware of their existence, to make an informed decision.

• Nausea and vomiting
• Bloating
• Peptic ulcer
• Diarrhoea
• Reactions to sedation
• Aspiration Pneumonia
• Oesophageal/gastric perforation
• Gastro-Oesophageal reflux
• Deflation of the balloon and intestinal obstruction

Post Insertion

For the first 3 - 5 days following positioning, you may feel uncomfortable and nauseated, this will pass and every effort will be made to reduce these side effects. You may be offered some medication to settle your stomach and relieve the nausea.

All patients will commence a liquid only diet for one week and slowly progress to a semi-solid diet, resuming normal textured foods within two weeks.

All patients will be informed about the behaviour modification program and will be aware of the compliance, attendance and content that is paramount to weight loss success – this runs for 12 months (six months whilst the balloon is in place and six months after removal)

All patients will have access to our helpline and expert advice.

After the first 12 months all patients enter a maintenance follow up programme for a further 12 months (24 months aftercare in total) which during this time telephone contact will be made to help 'protect' the weight you have lost.