Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2040-2046
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2040
Weight regain after intragastric balloon for pre-surgical weight loss
Danielle Abbitt, Kevin Choy, Alexandra Kovar, Teresa S Jones, Krzysztof J Wikiel, Edward L Jones
Danielle Abbitt, Kevin Choy, Alexandra Kovar, Teresa S Jones, Krzysztof J Wikiel, Edward L Jones, Department of Surgery, University of Colorado, Aurora, CO 80045, United States
Teresa S Jones, Krzysztof J Wikiel, Edward L Jones, Department of Surgery, Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO 80045, United States
Author contributions: Abbitt D designed and conducted the study and wrote the manuscript; Choy K and Kovar A contributed to study design and data collection; Jones TS and Wikiel KJ provided clinical advice and reviewed the paper; Jones EL supervised the study and reviewed the manuscript.
Institutional review board statement: The study was reviewed and approved by the Colorado Multi-institutional Review Board (Approval No. 221659).
Informed consent statement: Study granted waiver of HIPAA Authorization and waiver of signed informed consent due to retrospective review and minimal risk. This study was approved by Colorado Institutional Review Board.
Conflict-of-interest statement: Dr. Edward Jones is a consultant for Boston Scientific; the other authors have no disclosures.
Data sharing statement: Dataset available from the corresponding author at edward.jones@cuanschutz.edu.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Edward L Jones, MD, Associate Professor, Department of Surgery, Rocky Mountain Regional Veteran Affairs Medical Center, 1700 N Wheeling Street, MS 122, Aurora, CO 80045, United States. edward.jones@cuanschutz.edu
Received: February 1, 2024
Revised: June 11, 2024
Accepted: June 24, 2024
Published online: July 27, 2024
Processing time: 172 Days and 10 Hours
Abstract
BACKGROUND

Over one-third of Americans carry the diagnosis of obesity, many also with obesity-related comorbidities. This can place patients at increased risk of operative and postoperative complications. The intragastric balloon has been shown to aid in minor weight loss, however its weight recidivism in patients requiring short interval weight loss has not been well studied.

AIM

To evaluate weight loss, ability to undergo successful elective surgery after intragastric balloon placement, and weight management after balloon removal.

METHODS

This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective surgery. Clinical outcomes including weight loss, duration of balloon placement, successful elective surgery, weight regain post-balloon and post-procedure complications were assessed. Exclusion criteria included those with balloon in place at time of study.

RESULTS

Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective surgery. All patients were required to participate in a 12-month weight management program to be eligible for balloon therapy. Elective surgeries included incisional hernia repair, umbilical hernia repair, inguinal hernia repair, and knee and hip replacements. The average age at placement was 53 years ± 11 years, majority (91%) were male. The average duration of intragastric balloon therapy was 186 days ± 41 days. The average weight loss was 14.0 kg ± 7.4 kg and with an average percent excess body weight loss of 30.0% (7.9%-73.6%). Over half of the patients (52.0%) achieved the goal of 30-50 lbs (14-22 kg) weight loss. Twenty-one patients (64%) underwent their intended elective surgery, 2 patients (6%) deferred surgery due to symptom relief with weight loss alone. Twenty-one of the patients (64%) have documented weights in 3 months after balloon removal, in these patients the majority (76%) gained weight after balloon removed. In patients with weight regain at 3 months, they averaged 5.8 kg after balloon removal in the first 3 months, this averaged 58.4% weight regain of the initial weight lost.

CONCLUSION

Intragastric balloon placement is an option for short-term weight management, as a bridge to elective surgery in patients with body mass index (BMI) > 35. Patients lost an average of 14 kg with the balloon, allowing two-thirds of patients to undergo elective surgery at a healthy BMI. However, most patients regained an average of 58% of the original weight lost after balloon removal. The intragastric balloon successfully serves as a tool for rapid weight loss, though patients must be educated on the risks including weight regain.

Keywords: Intragastric balloon; Weight loss; Obesity; Bariatric; Body mass index

Core Tip: Obesity places patients at increased risk of postoperative complications. The intragastric balloon is an endoscopic tool which is lower risk and temporary and offers good initial weight loss in the preoperative setting for patient’s undergoing elective surgery in order to reduced perioperative risk, however the majority of patient will experience some degree of weight regain following removal of the balloon.