Intragastric Balloon Treatment Research Articles

Complications of the intragastric balloon treatment. Small bowel obstruction caused by migrated intragastric balloon - clinical case report and literature review.

An endoscopic intragastric balloon (IGB) placement is one of the minimally invasive methods of obesity treatment. One of the rare serious complications is mechanical bowel obstruction requiring operative management. We report a case of a male patient with small bowel obstruction due to IGB migration and the literature review of complications during IGB treatment. Detailed Case Description: A patient with a BMI of 28 kg/m2 was admitted to the hospital with spontaneous deflation of an IGB. Due to the suspected location of IGB in the ileum laparoscopy was performed. The enterotomy was performed and the IGB removed. The procedure and the postoperative period were uneventful. Spontaneous IGB ruptures are reported in the literature with a frequency ranging from 0.6 to 23%. The majority of deflated devices are spontaneously excreted with the stool with no abdominal symptoms. Only 0.38% of IGBs cause mechanical bowel obstruction of requiring surgical management. Based on our own experience and literature review, we propose the diagnostic and therapeutic algorithm. Complications after IGB placement can range from mild to severe, that is why it is so important to make an early diagnosis based on the emerging symptoms and to implement prompt management to reduce or avoid serious complications. Any patient reporting disturbing symptoms occurring over a pro- longed period of time requires hospitalization and careful observation for the occurrence of gastrointestinal obstruction. The ideal option is hospitalization in the center which implemented the IGB and start with the algorithm we proposed.

Intragastric Balloon as a Noninvasive Method for Obesity Treatment: A Single-Center Retrospective Study.

The incidence of obesity is increasing globally, with approximately 1 in 3 adults either overweight or obese. Surgery provides the most effective treatment for advanced obesity; however, endoscopic treatment, including intragastric balloon therapy, is commonly used in patients who do not meet the indications for surgery. Our study aimed to evaluate short- and mid-term weight changes of patients who had intragastric balloon therapy. In this single-center retrospective study, we enrolled 320 patients with body mass index (BMI) values between 30 and 40 kg/m2 and without comorbidities, who underwent intragastric balloon treatment. 284 patients successfully underwent the operation. All patients were followed-up at 6 months after treatment, balloons were removed, and BMIs were recorded. Further follow-up was performed 6 months after balloon removal, and patients' BMI and demographic data were recorded again. Overall, 320 patients were enrolled in this study. In this cohort, 82 returned to their preprocedural weight at 1 year postprocedure, whereas 260 had BMI lower than the preprocedural values, but higher than the values at 6 months postprocedure. None of the patients had lower BMI compared to their 6-month postprocedural values. Balloon therapy typically helps patients lose 10% of body weight. Intragastric balloons are effective when used as weight loss tools, but are ineffective at maintaining weight loss. An intragastric device placed for 6 months may also be expected to help the patients develop better eating habits; however, we did not encounter this lifestyle change in our series.

Effect of preoperative intragastric balloon treatment on perioperative and postoperative outcomes after laparoscopic sleeve gastrectomy: A retrospective cohort study

<b><br>Introduction:</b> Intragastric balloon (IGB) insertion is used as a bridging therapy in patients with body mass index (BMI) ≥ 50 kg/m2 . We arranged a retrospective study to evaluate whether pre-operative IGB treatment influences perioperative and postoperative weight loss outcomes after laparoscopic sleeve gastrectomy (SG), and especially to evaluate the impact of post - IGB percentage of excessive weight loss (%EWL) on postoperative %EWL.</br> <b><br>Materials and methods:</b> Patients who underwent IGB placement followed by laparoscopic SG were divided into the following groups considering %EWL after IGB: Group 1 <=10.38%; Group 2 >10.38% and <=17.27%; Group 3 >17.27% and <=24.86%; Group 4 >24.86%. 1 year after SG data were collected. The following parameters were compared between groups: operative time, total blood loss, length of stay and weight, BMI, percentage of total weight loss (%TWL), %EWL.</br> <b><br>Results:</b> There were no statistically significant differences between groups in perioperative results. Post-SG %EWL was the highest in intermediate groups: 2 and 3. Post-treatment results were observed: body weight and BMI were the lowest in Group 4 and the highest in Group 1. Post-treatment %EWL was the highest in Group 4, the lowest in Group 1 and grew gradually in subsequent groups.</br> <b><br>Discussion:</b> The study confirmed the impact of weight loss on IGB on postoperative results. The study showed that %EWL after the IGB treatment influences %EWL after SG and most of all affects definitive %EWL after two-stage treatment and it could be a foreshadowing factor of these outcomes.</br> <b><br>Importance:</b> The importance of research for the development of the field %EWL after IGB influences the final BMI and final weight, which means that patients with the greatest %EWL after IGB are more likely to have the greatest postoperative weight loss and overall weight loss.</br>

Factors Affecting Weight Reduction after Intragastric Balloon Insertion: A Retrospective Study

Intragastric balloon (IGB) is a safe option for obesity management. However, studies determining the factors influencing the procedure's outcomes are scarce. Therefore, our goal was to determine the factors affecting weight reduction after IGB insertion. This retrospective study included 126 obese patients who underwent IGB treatment using the ORBERA® Intragastric Balloon System. Patients' records were retrieved; and demographic data, initial body mass index (BMI), complications, compliance with both diet and exercise programs, and percentage of excess weight reduction were recorded. The study included 108 female (85.7%) and 18 male (14.3%) patients. The mean age was 31.7 ± 8.1 years. The percentage of excess weight loss (EWL) was 55.8 ± 35.7%. The mean weight loss was 13.01 ± 7.51 kg. A significant association was found between EWL and age, initial weight, initial body mass index, and the number of pregnancies. No major complications were observed. However, the balloon had to be removed early in two patients (1.59%) due to its rupture and in two other patients (1.59%) due to severe gastritis. IGB therapy is a safe and effective option for obesity management, associated with low rates of complications. The EWL after IGB insertion is significantly higher among older patients, those with a relatively low initial body mass index, those with a longer duration of IGB insertion, and female patients with less parity. Larger prospective studies are needed to support our results.

Results of intragastric balloon treatment and evaluation of patient satisfaction.

Endoscopic bariatric therapies are an alternative treatment method for patients who do not respond to diet, exercise and drug therapy or who are not yet candidates for surgery or who are suitable and hesitant to undergo surgery. In this study, we aimed to evaluate our intragastric balloon (IGB) treatment results and the satisfaction of the patients in the light of the literature. The study was conducted by retrospectively evaluating the patients who underwent IGB application in the gastroenterology and general surgery endoscopy units of our hospital. Sixty-eight patients who had IGB for 6 months were evaluated. The mean weight given was 10 (0-25) kg and the mean body mass index (BMI) decrease was 3.6 (0-9) kg/m2. A statistically significant decrease was obtained between the initial weight and BMI of our patients and the weight and BMI at the end of the 6th month (P ≤ 0.0001). Thirty-five (51.5%) patients reported that they were satisfied with the procedure, while 33 (48.5) reported that they were not satisfied. IGBs for the treatment of obesity are an attractive form of treatment because they provide minimally invasive, temporary and significant weight loss. Patients need to be repeatedly told that diet and lifestyle changes should be followed in the treatment of IGB. Thus, we believe that possible disappointments can be prevented.

Efficacy and safety of intragastric balloon for obesity in Korea.

Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea. We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed. In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain. IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

S3344 The Hunt for the Lost Intragastric Balloon and Its Complications

Introduction: Obesity is a global pandemic on the rise, affecting about 40% of adults in the United States. There is a need for minimally invasive methods to aid current standard of care practices. The intragastric balloon (IGB) is a temporary therapy for weight loss, with the FDA approving several devices including the ObalonⓇ in the recent years. In 2021, AGA published clinical practice guidelines on Intragastric Balloons in the management of obesity. Serious adverse events are relatively rare in patients receiving IGB treatment, and include injury to the gastrointestinal (GI) tract, such as perforation (0.3%), esophageal mucosal injury (0.8%), gastric ulcer/bleeding (0.76%), and gastric outlet/bowel obstruction (0.12%). Case Description/Methods: A 47-year-old female with a medical history including two intragastric balloon placements (ObalonⓇ) one year ago, presented with severe acute abdominal pain. Patient’s BMI was 28 kg/m2. Routine labs were unremarkable and vitals were stable. Initial CT Abdomen/pelvis with contrast showed gastric and duodenal thickening; however, imaging failed to comment on a foreign object and location. A gastroscopy was performed subsequently showing one Obalon balloon found in the gastric fundus. The balloon was cut with a needle knife, collapsed and withdrawn with rat tooth forceps. To locate the second balloon, repeat imaging showed dilated bowel loops with a deflated ObalonⓇ lodged in the distal ileum, 7 centimeters proximal to ileocecal valve, resulting in mechanical small bowel obstruction. A colonoscopy was deferred due to concern for risk of perforation given the small bowel obstruction. Subsequently, the patient underwent laparoscopic enterectomy with approximately 5 cm of bowel on either side of the enterotomy with creation of anastomosis and foreign object retrieval. (Figure) Discussion: Intragastric balloons are a minimally invasive therapy for weight loss in conjunction with lifestyle modifications in the war against obesity. We present a rare, yet crucial case report of IGB complication resulting in small bowel obstruction and subsequent need for surgical intervention. IGBs are meant to be a short term, temporary tool for weight loss in obese patients generally BMI ≥ 30. This case highlights the importance of a timely removal, risk of severe complications, and emphasis on the importance of assessing proper indication for placement.Figure 1.: (A) Coronal view of CT scan showing dislodged Intragastric Balloon in the distal ileum (red arrow); (B) XR Abdomen showing radiopaque density overlying the left hemisacrum (red arrow) and dilated small bowel loops; (C) XR Abdomen Complete w/ Decub/Erect showing radiopaque foreign body in the right mid abdomen and second foreign body in the stomach (red arrows).

Endoscopic intragastric balloon: A novel therapy for weight loss.

Endoscopic intra gastric balloon placement provides an alternative method for weight loss in patients who fail to respond to life style modification, diet restriction and pharmacological therapy. Intra gastric balloon (IGB), placement can be used as a temporary measure for weight loss in obesity with or without related complications or bridge therapy in morbid obesity prior to bariatric surgery. Weight loss achieved following IGB implantation depends on the type of balloon, medium, and filling volume used for IGB inflation. This brief review provides an overview of the indications, efficacy and safety of intragastric balloon treatment in patients with obesity.

Enchanced preoperative rehabilitation as part of the complex perioperative rehabilitation of patients with super-obesity and obstructive sleep apnea syndrome (clinical outlook)

Obesity is a global social and economic problem. The bariatric surgery is a most effective treatment for obesity. The presented clinical case demonstrates the usage of principles of enchanced perioperative rehabilitation for the preoperative preparation of a patient with super obesity and with severe obstructive sleep apnea and alveolar hypoventilation syndrome.A 54-year-old patient was hospitalized with complaints of obesity, impossibility of persistent weight loss conservatively, severe daytime sleepiness, frequent nocturnal awakenings (up to 8 times per night). The patient’s weight was 230 kg with a height of 157 cm (BMI 93.5 kg / m2). The examination revealed a syndrome of sleep apnea of mixed genesis of extremely severe degree, chronic night hypoxemia of an extremely severe degree. Preoperative preparation was performed in accordance with the program of enchanced perioperative rehabilitation. The duration of preoperative preparation was 19 days; weight loss — 40 kg (%WL -17,4), compensation of comorbidities was achieved as well. After that the patient underwent a laparoscopic sleeve gastrectomy. There were no complications in the postoperative period. Length of postoperative hospital stay was 6 days. At follow-up examination one year after surgery, body weight dropped from 230 to 153 kg (% WL-33.5), a significant improvement of the quality of life was achieved.The enchanced perioperative rehabilitation program can be successfully used as an effective method for preoperartive preparation of the patients with morbid obesity in combination with severe obstructive sleep apnea syndrome.and obesity hypoventilation. It can be a reasonable alternative to the standard program with preoperative intragastric balloon treatment. The use of this technique allows to increase the effectiveness of treatment of these high-risk patients, as well as to reduce the risk of perioperative complications.

Gray matter volume increases induced by intragastric balloon treatment and their associations with neuroinflammation: A magnetic resonance study

ObjectiveWe simultaneously performed structural MRI, 1H magnetic resonance spectroscopy, and whole-body hydration status assessment to evaluate brain changes in patients with morbid obesity treated with intra-gastric balloon (IGB) for six months. We asked, if changes in myo-inositol ratios (marker of neuroinflammation) are related to brain volume increases accompanying IGB-induced weight loss. MethodsTwenty five patients with morbid obesity (OB, 43.9 ± 11.8 years, BMI = 49.1 ± 7.2, 12 females, 9 without co-morbid conditions) were treated with IGB for six months. They underwent magnetic resonance imaging at 3T one month before IGB insertion, three months after insertion (N = 19), and one month after IGB removal (N = 14). ResultsInsertion of IGB lead to 8.9% and 12.3% weight reduction over the first three months and over the entire treatment, respectively. Over the entire treatment, total gray matter volume increased by 2.0% (p = 0.009). These changes were mostly pronounced in the left precuneus and in the right frontal pole (>1.9%, p < 0.009). The increases in cortical volume in the right hemisphere and the left posterior cingulate cortical thickness over the entire treatment were significantly related to decreases in myo-inositol ratios measured over the first three months of the treatment (r < −0.740, p < 0.006). ConclusionsIGB treatment lead to brain structural improvements consistent with earlier studies of bariatric patients without co-morbid conditions. Our results also pointed to improvements in brain regions, where atrophy in other studies was related to type 2 diabetes and hypertension. The correlations point to neuroinflammation as one of the potential processes behind brain volume reductions in patients with morbid obesity.

Benchmarking the Discriminatory Performance of Body Mass Index and Body Fat for Obesity Detection in Patients Treated by Intragastric Balloon.

The accuracy of body mass index (BMI) in detecting obesity in patients treated by intragastric balloon (IGB) remains still speculative. We aimed to determine the discriminatory performance of BMI as an estimate of excess body fat (%BF) in an IGB-treated population. Retrospective analysis of prospectively collected data of 476 patients who completed the 6-month IGB treatment period and were subjected to body composition analysis. We evaluated the relationship between BMI and %BF or lean mass and the diagnostic performance of BMI ≥ 30 kg/m2 for adipose tissue detection, stratified by age (< 40 and ≥ 40 years) and gender. Moreover, we identified anthropometric and body composition parameters serving as predictors of obesity according to %BF-based criteria (> 25% in men or > 35% in women). Gender emerged as an effect modifier in the quadratic polynomial relationship between BMI and %BF (R2 = 0.849 for men, R2 = 0.715 for women), while BMI was linearly associated with %BF in both age groups (R2 = 0.435 for men, R2 = 0.474 for women). BMI was strongly correlated with both %BF (r = 0.67) and lean mass (r = - 0.65). The overall area under the ROC curve for BMI ≥ 30 kg/m2 to detect %BF was 0.87 (95%CI 0.85-0.90). A regression model including lean mass, total body water, age, BMI, and female gender explained 0.970 of the variance in %BF. The discriminatory performance of BMI as an estimate of excess body fat is enhanced by the implementation of gender- and age-specific BMI thresholds for defining obesity, in IGB-treated patients.

The Effect of Stress Coping on Mood Variability in Morbidly Obese Patients Qualified for Intragastric Balloon Treatment: Preliminary Results

Introduction: Obesity, like any medical condition, is a stressful experience that detrimentally affects the quality of life and mood of the patient. Objectives: To evaluate the correlation between ...

A Randomized, Controlled Trial Comparing the Impact of a Low-Calorie Ketogenic vs a Standard Low-Calorie Diet on Fat-Free Mass in Patients Receiving an Elipse\u2122 Intragastric Balloon Treatment

BackgroundThe Elipse™ intragastric balloon (EIGB) is a new swallowable balloon for weight loss (WL). Preserving metabolically active fat-free mass (FFM) and resting metabolic rate (RMR) during WL are crucial to maximize fat mass (FM) loss. After EIGB placement, a standard low-calorie diet (LCD) is generally prescribed. A low-calorie ketogenic diet (LCKD) has proven to be safe and effective in reducing FM while preserving FFM and RMR.ObjectiveTo prospectively compare the effects on WL, FM, FFM, and RMR in two groups of patients who were randomized to two different diets: LCKD and a standard LCD after EIGB placement.MethodsWL, FM, FFM, and RMR were measured before EIGB and at 4 months in 48 patients who received either a LCKD (n = 24) or a standard LCD (n = 24). Compliance in following the prescribed diet was determined with food frequency questionnaires in all patients. The impact of LCKD and LCD on renal function was also evaluated.ResultsThe LCKD group showed a significantly lower decrease in FFM and RMR when compared with the LCD group (3.55 vs 14.3%, p < 0.001; 9.79 vs 11.4%, p < 0.001, respectively). FM decreased more significantly with LCKD compared to LCD (41.6 vs 33.1%, p = 0.0606). Compliance in following the prescribed diets, without negative impact on renal function, was found.ConclusionBased on our findings, despite the small sample size, we were able to support the hypothesis that LCKD is associated with an increased FM loss while reducing the FFM loss and the RMR, without interfering with renal function after EIGB.

Endoscopic intragastric balloon therapy for 15 years in Japan: Results of nationwide surveys.

Endoscopic intragastric balloon (IGB) placement has been performed in Japan since 2004. The nationwide surveys were repeatedly carried out to confirm the effectiveness and safety of IGB in Japan. We herein present the accumulated results. Twenty-six Japanese endoscopists personally imported products of the BioEnterics Intragastric Balloon (BIB)/Orbera system after completing the training courses in Japan. Mail surveys were posted to them every 2 years from 2010. This study included the accumulated data of the six surveys, and excluded data from non-Japanese patients and the Orbera365 data. Between 2004 and 2019, 399 obese Japanese patients underwent IGB treatment using the BIB/Orbera system. The incidence rates of early removal of IGB within 1week and complications due to IGB were 4.8% and 6.1%, respectively. The average percent excess weight loss (%EWL) and percent total weight loss (%TWL) at IGB removal were 46.6% and 11.5%, and successful weight loss, defined as %EWL ≥ 25% or %TWL ≥ 10%, was achieved in 65.6% or 54.5% of the patients, respectively. Multivariate analyses revealed that older age and larger saline filling volume were independent predictors of successful weight loss. At 1year after IGB removal, successful weight loss defined by the %EWL and %TWL was maintained in 44.7% and 34.1% of the patients, respectively. IGB therapy using the BIB/Orbera system has been safely and effectively performed in Japan. The successful weight loss may be associated with older age and larger saline filling volume.

Randomized Prospective Clinical Study of Spatz3® Adjustable Intragastric Balloon Treatment with a Control Group: a Large-Scale Brazilian Experiment.

To analyze the results regarding weight loss and complications related to the Spatz3® adjustable intragastric balloon (IGB) in Brazil. This randomized prospective study covered patients who had undergone treatment using a Spatz3® adjustable IGB between October 2016 and June 2018 at a private clinic in Rio de Janeiro, Brazil. The patients had a minimum body mass index (BMI) of 27kg/m2. The study examined complications of Spatz3® treatment and BMI reduction, percentage of total weight loss (%TWL), and % of excess weight loss (%EWL). One hundred eighty patients underwent a Spatz3® balloon implant in the period. The patients were randomly divided into one group in which the Spatz balloon was kept at the same volume (600mL) throughout treatment (Control Group), and another adjustment group with 250mL greater volume. The complication rate was 16.14%. No death or major complication occurred during the study. Mean BMI decreased from 39.51 to 32.84kg/m2 (p < 0.0001), bodyweight from 111.87 to 90.28kg (p< 0.0001), and excess weight from 41.55 to 22.99kg (p <0.0001). The adjustment resulted in greater mean weight loss of 4.35kg (- 8 to 17.6kg), and the average time of the procedure was 7.12 ± 1.63months. The upward adjustment group did not present greater %TWL, %EWL, or BMI reduction when compared with the control group (p = 0.4413, p = 0,9245, p = 0.2729, respectively). This study shows that Spatz3® IGB treatment is an effective procedure for weight reduction, with no mortality but higher morbidity compared with traditional IGBs. This procedure also enabled the balloon to stay in place for longer. The efficacy of upward adjustment still requires further confirmation.

Intragastric Balloon: a Retrospective Evaluation of 5874 Patients on Tolerance, Complications, and Efficacy in Different Degrees of Overweight.

Endoscopic methods, especially the intragastric balloon (IGB), have been shown to be effective for the treatment of excess weight. This study aimed to assess the tolerance, complications, and efficacy of excess weight treatment with a non-adjustable IGB during 6months. A total of 5874 patients treated with a liquid-filled IGB (600-700mL) and followed up by a multidisciplinary team were evaluated. Participants presented an initial body mass index (BMI) ≥ 25kg/m2 and were stratified according to sex and degree of overweight (overweight and obesity grades I, II, and III). The incidence of complications was 7.32% (n = 430): 6.10% (n = 357) early IGB removal, 0.20% (n = 12) gas production inside the balloon, 0.54% (n = 32) leakage, 0.32% (n = 19) pregnancy, 0.07% (n = 4) gastric perforation, 0.05% (n = 3) upper digestive bleeding, 0.01% (n = 1) Wernicke-Korsakoff syndrome due to excessive vomiting, and 0.02% each (n = 1) pancreatitis and esophagus perforation. The 5444 remaining patients (4081 women, 38 ± 38years) presented a weight loss of 19.13 ± 8.86kg and a BMI decreased significantly (p < 0.0001) (36.94 ± 5.67 vs. 30.08 ± 5.06kg/m2). The % total weight loss (%TWL) was 18.42 ± 7.25%, and the % excess weight loss (%EWL) was 65.66 ± 36.24%. The treatment success rate (%TWL ≥ 10%) was 85%. The %EWL was higher in the pre-obese group (122.19%), followed by obesity grades I (76.67%), II (56.01%), and III (45.45%), with p < 0.0001 for each group. %EWL was higher in women (69.71%) than in men (53.39), with p < 0.0001 for each group. There was also a statistical difference between the TWL and EWL groups, with p < 0.001 for all analyses. Endoscopic IGB treatment for excess weight is an excellent therapeutic option for patients with different degrees of overweight.

Changes in resting metabolic rate and body composition due to intragastric balloon therapy.

Intragastric balloon (IGB) insertion leads to dietary restriction; however, its neurohormonal actions were also described. Resting metabolic rate (RMR) adjusted for body mass (RMR/mass) seems to increase after bariatric interventions, whereas it generally decreases after caloric restriction-based therapies. However, no studies have evaluated the changes in body composition and RMR over IGB treatment. To evaluate the relationships between changes in body composition, RMR, RMR/mass, and RMR adjusted for fat-free mass (FFM) (RMR/FFM) over IGB treatment lasting 6 months. Single-center observational study. Twenty-one morbidly obese patients treated with IGB (143 ± 20 kg, body mass index [BMI] = 49.5 ± 7.3, 98% ± 29% percent excess weight, 43.6 ± 12.6 yr) were enrolled. Changes in body composition, RMR, RMR/mass, and RMR/FFM were evaluated between 1 month before IGB insertion (time point 1 [TP1]) and 3 months thereafter (TP2). Fourteen patients were also assessed 1 month after IGB removal (TP3). There was a 9.5% reduction in weight, a 9.4% reduction in BMI, and 19.1% decrease in percent excess weight at TP2 (n = 21; P < .001); a further 6.5% reduction in weight and BMI and a 13.1% drop in percent excess weight (n = 14, P < .001) at TP3. They were accompanied by a 5.4% reduction in FFM between TP1 and TP2 (n = 21, P < .001). Compared with pretreatment values, at TP2 RMR was 12.5% lower (P < .001) but did not change thereafter. RMR/mass increased 12.4% between TP2 and TP3 (n = 14, P = .02) but on average did not change between TP1 and TP3. The results in the smaller cohort (n = 14) between TP1 and TP2 were consistent with results obtained for the entire cohort. Similar findings were obtained for RMR/FFM. The larger increases in RMR/mass between TP1 and TP3 were associated with more weight loss, larger drop in BMI, and more loss of excess weight (r < -.55, P < .03). This is the first study to evaluate the relationship between changes in body composition and RMR over IGB treatment. IGB therapy leads to both fat and fat-free mass reductions and RMR decreases. More weight reduction is associated with larger increases in RMR/mass.

Tu1920 – Changes in Quality of Life, Body Adiposity and Dietary Intake of Obese Individuals During 6 Months of Intragastric Balloon Treatment

Tu1920 – Changes in Quality of Life, Body Adiposity and Dietary Intake of Obese Individuals During 6 Months of Intragastric Balloon Treatment

Tu1905 – Changes in Metabolic and Inflammatory Biomarkers in Obese Individuals Submitted to 6-Months Intragastric Balloon Treatment

Tu1905 – Changes in Metabolic and Inflammatory Biomarkers in Obese Individuals Submitted to 6-Months Intragastric Balloon Treatment

Impact of Intragastric Balloon Treatment on Adipokines, Cytokines, and Metabolic Profile in Obese Individuals.

Obesity is accompanied by adipose tissue remodeling characterized by increased production of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, leptin and resistin and reduced secretion of adiponectin, which favors inflammation, metabolic disorders, and cardiovascular diseases. Although intragastric balloon (IGB) can be considered safe and effective for weight loss, its effect on serum levels of these biomarkers has been evaluated only in a few studies, while no previous study evaluated its effect on circulating levels of resistin, TNF-α, and IL-6. The aim of this study was to evaluate the changes in serum levels of metabolic and inflammatory biomarkers in obese patients submitted to IGB treatment. A prospective observational study involving 42 patients with obesity using IGB for 6months. The patients were evaluated, on the day of insertion and withdrawal or adjustment of IGB, for the following: anthropometric measures and serum levels of adiponectin, leptin, resistin, TNF-α, IL-6, high-sensitivity C-reactive protein (hs-CRP), glucose, insulin, uric acid, triglycerides, and total cholesterol and fractions. The body mass index decreased from 35.15 ± 0.41 to 29.50 ± 0.54kg/m2. There was a reduction (p < 0.05) in leptin, hs-CRP, glucose, insulin, HOMA-IR, and triglycerides, while the adiponectin/leptin ratio increased (p < 0.05). Moreover, weight loss presented (1) a positive association with the decrease in leptin, hs-CRP, glucose, insulin, HOMA-IR, uric acid, and total cholesterol and (2) a negative association with the reduction in adiponectin/leptin ratio. The present study suggests that 6months of IGB treatment in obese individuals reduce serum leptin and hs-CRP and improves insulin resistance and lipid profile which may decrease cardiovascular risk.