Navigating Non-Invasive Weight Loss: The Science Behind Gastric Balloons

Published on: August 14, 2023

Table of Contents

Navigating Non-Invasive Weight Loss: The Science Behind Gastric Balloons


Amid an escalating obesity epidemic, the demand for effective and sustainable weight loss methods has never been higher[1]. According to the World Health Organization, over 650 million adults were classified as obese in 2016, which continues to rise and has severe implications for public health[2]. While traditional approaches such as diet, exercise, medication, and surgical interventions have played pivotal roles in combating obesity, these methods have limitations and potential side effects that often deter individuals from pursuing them[3]. 

As the medical world continues to innovate and evolve, there has been a substantial shift towards non-invasive weight loss procedures. Gastric balloons, a non-surgical intervention that temporarily reduces the stomach’s capacity, have emerged as a prominent alternative for those seeking a less intrusive weight loss method. This procedure is designed to aid in weight loss by creating a feeling of fullness, thus reducing caloric intake[4]. 

This article aims to delve into the science behind gastric balloons, shedding light on how they work, their effectiveness, and potential risks. By examining this procedure scientifically, we hope to provide a comprehensive guide for those navigating the often complex landscape of non-invasive weight loss options. As obesity continues to pose a significant public health challenge, it’s crucial to explore and understand alternatives like gastric balloons that may offer a new avenue for effective weight management[5].


Understanding the Traditional Weight Loss Methods

Overcoming obesity often involves implementing one or more traditional weight loss methods: lifestyle modifications (diet and exercise), medication-assisted weight loss, and surgical interventions[6]. Each has its strengths but also potential limitations and challenges.

The first line of defence against obesity is often lifestyle modifications, encompassing dietary changes and increased physical activity. Many nutritional strategies focus on reducing caloric intake through smaller portions, eliminating processed foods, and favouring a diet rich in fruits, vegetables, lean proteins, and whole grains. Complementing this with regular physical exercise facilitates weight loss by enhancing the body’s energy expenditure[7]. Even with this, implementing and sustaining such lifestyle changes can be arduous due to lack of time, cost constraints, and personal preferences[8].

Medication-assisted weight loss may be recommended if lifestyle modifications fail to bring about desired weight loss or are impracticable due to health conditions. Several drugs, such as Orlistat, Lorcaserin, and Phentermine-Topiramate, have FDA approval for weight loss. These medications typically reduce appetite or inhibit fat absorption[9]. However, they are not magic bullets and are often used as an adjunct to lifestyle changes. Potential side effects, including cardiovascular risks and dependence, can cause concern[9].

For individuals with severe obesity or obesity-related comorbidities, surgical interventions may provide a viable alternative. Procedures like gastric bypass, sleeve gastrectomy, and adjustable gastric banding can offer substantial and lasting weight loss and improvement in obesity-associated diseases[10]. Yet, due to the inherent risks and potential complications of surgery, as well as significant lifestyle changes required post-operation, these are often viewed as a last resort[10].

Although these traditional weight-loss strategies have made significant strides in managing obesity, their limitations and potential side effects underscore the necessity for alternative, preferably non-invasive, approaches. As the medical community grapples with the ongoing obesity epidemic, attention has been increasingly drawn towards treatments such as gastric balloons, offering a novel way to manage weight effectively[6].

The Science Behind Gastric Balloons

The gastric balloon, an innovative non-invasive weight loss tool, is premised on a relatively simple yet effective concept. It is a soft, silicone balloon placed in the stomach and filled with saline or air, creating a sense of fullness and thus promoting a reduction in food intake[11].

There are various types of gastric balloons, including single, dual, and even triple balloon systems, each with unique characteristics[12]. The single balloon system, like the Orbera, is the most common and is placed in the stomach through an endoscopic procedure. Dual balloon systems like the ReShape Duo involve two interconnected balloons. In comparison, the Obalon system utilises up to three swallowable balloons filled with air once in the stomach. These varying designs aim to enhance tolerability and effectiveness[13].

The procedure for insertion and removal of the balloon is relatively straightforward and generally completed as an outpatient procedure. The balloon is introduced into the stomach through the mouth using a minimally invasive endoscopic procedure under mild sedation. Once in place, it’s filled with saline or air. The balloon stays in the stomach for around six months, after which it is deflated and removed using a similar endoscopic procedure[14].

The gastric balloon aids weight loss by inducing a sensation of fullness, reducing the space for food in the stomach, and slowing gastric emptying. Consequently, it helps control portion sizes and reduce overall caloric intake. However, it’s essential to note that gastric balloons are a temporary tool intended to kickstart weight loss and require a commitment to lifestyle changes for continued success[15].

Thus, the science behind gastric balloons lies in their ability to modify the body’s physiological response to food intake, fostering weight loss through decreased caloric consumption. While promising, the use of gastric balloons should be considered in conjunction with a comprehensive lifestyle modification program to ensure long-term weight management[11].

Scientific Evidence Supporting the Effectiveness of Gastric Balloons

The gastric balloon has undergone extensive study, with evidence supporting its role as an effective non-invasive weight loss intervention. Key measures used to assess the efficacy of this method include total body weight loss percentage, adverse event rates, and impact on obesity-related comorbidities[16].

Clinical trials have found that patients with a gastric balloon often lose a significant amount of weight compared to those undergoing conventional weight loss methods. A randomised controlled trial examining the effects of the Orbera Intragastric Balloon System found that participants in the balloon group achieved a mean total body weight loss of 10.2% at six months, compared to 3.3% in the control group[17].

Moreover, gastric balloons have demonstrated effectiveness in improving obesity-related comorbidities. Patients with type 2 diabetes, hypertension, and dyslipidemia have significantly improved post-procedure. A study examining the impact of the ReShape Duo balloon found that 64% of patients with type 2 diabetes had their condition improved or resolved[18].

Regarding safety, most adverse events associated with gastric balloons are mild and transient, with serious complications being rare[19]. Common side effects include nausea, vomiting, and abdominal discomfort, primarily within the first week following balloon placement[20]. 

Long-term weight management following balloon removal depends on patients’ commitment to lifestyle modifications. While the gastric balloon aids in kickstarting weight loss, maintaining the benefits requires sustained dietary changes, physical activity, and, often, behavioural counselling[16].

In summary, a growing body of evidence supports the efficacy and safety of gastric balloons as a non-invasive weight loss tool. It serves as an intermediate step for patients who have yet to succeed with lifestyle modifications alone but are not ready or eligible for more invasive bariatric surgery[16]. As such, the gastric balloon offers a promising approach to the multifaceted weight loss and management journey.


Potential Risks and Side Effects of Gastric Balloons

As with any medical procedure, gastric balloons have potential risks and side effects that must be considered alongside their benefits. While generally considered safe, some patients may experience discomfort and adverse effects that, although typically transient, can impact their overall experience with this weight loss intervention[21].

The most common side effects occur soon after the gastric balloon placement, often within the first few days. These include nausea, vomiting, and abdominal discomfort or pain, collectively called the ‘balloon adaptation syndrome'[22]. These symptoms are usually managed effectively with medications and gradually resolve as the patient adjusts to the balloon[23].

On rare occasions, more severe complications can occur. These include gastric ulcers, perforation, or acute pancreatitis, which can necessitate the early removal of the balloon. Gastric balloon displacement or deflation can lead to bowel obstruction, a severe complication requiring immediate medical attention[24]. However, these severe complications are infrequent, occurring in less than 2% of patients[25].

Additionally, there’s a risk of inadequate weight loss or weight regain after the balloon’s removal, particularly if the patient does not maintain lifestyle changes implemented during the balloon therapy[26]. This highlights the importance of viewing the gastric balloon as part of a broader weight management program involving dietary changes, increased physical activity, and behaviour modification.

Despite these potential risks and side effects, most patients tolerate the procedure well, with most complications being mild and self-limiting. Healthcare professionals are critical in adequately informing patients about what to expect and how to manage potential side effects, thereby improving overall success and patient satisfaction with the gastric balloon procedure[24].

In conclusion, while the gastric balloon presents a promising non-surgical solution to weight loss, understanding the potential risks and side effects is crucial for informed decision-making and realistic expectations for patients pursuing this intervention.

Considerations Before Opting for Gastric Balloons

While the gastric balloon presents a promising and less invasive weight management tool, it should not be considered a “quick fix.” Individuals considering this approach should thoroughly understand the procedure’s physical and lifestyle implications. Here are some essential considerations[27].

First, the procedure’s success depends on commitment to significant lifestyle changes. A patient’s readiness to adapt to a healthier diet, engage in regular physical activity, and potentially embrace behaviour modifications will significantly impact the long-term outcomes of the procedure[28]. The balloon’s placement can facilitate weight loss, but maintaining these benefits after removal depends on lifestyle adaptations[26].

Secondly, the patient’s current health status and comorbidities should be considered. While the gastric balloon can improve obesity-related conditions such as hypertension, type 2 diabetes, and dyslipidemia, individuals with certain gastrointestinal conditions, previous gastric surgeries, or severe liver disease may not be suitable candidates for this intervention[29].

Moreover, the ability to cope with potential side effects is crucial. While most adverse effects are mild and transient, the immediate post-placement period can be uncomfortable for some patients experiencing nausea, vomiting, and abdominal discomfort[22].

Cost can also be a significant consideration. Depending on the region and specific healthcare provider, insurance coverage for the procedure can vary, and out-of-pocket costs can be substantial. It’s advisable to discuss these aspects with healthcare providers before deciding on the procedure[30].

Lastly, understanding that the balloon is a temporary device is critical. It’s typically removed after six months, which underpins the importance of sustainable lifestyle changes to maintain weight loss benefits post-removal[28].

To conclude, while gastric balloons offer a promising solution for weight loss, potential candidates should consider the intervention’s demands, both in terms of lifestyle changes and health considerations. A thorough discussion with healthcare professionals can help inform the decision, ensuring realistic expectations and optimal outcomes from this weight management approach[31].

The Future of Non-Invasive Weight Loss: Beyond Gastric Balloons

While gastric balloons have significantly advanced non-invasive weight loss, ongoing research and technological progress promise more developments. These innovations provide safer, more effective, and potentially more patient-friendly alternatives[32].

One such advancement is the development of swallowable, self-inflating weight-loss capsules. These devices function similarly to gastric balloons but remove the need for endoscopic placement or removal, offering a more patient-friendly, non-invasive intervention[33]. Preliminary studies have shown encouraging results, but further research is needed to understand these capsules’ long-term efficacy and safety[34].

The field of endoscopic bariatric therapies (EBTs) has also seen remarkable growth. EBTs are non-surgical interventions that aim to replicate the benefits of bariatric surgery but with lower risk and fewer side effects. They include intragastric balloons, endoscopic sleeve gastroplasty (ESG), and aspiration therapy [35]. As these technologies evolve, they will likely play a more prominent role in managing obesity and its comorbidities.

Moreover, advancements in pharmacological therapies are on the horizon. This includes medication that targets the body’s energy regulation, appetite, and metabolism[36]. While there’s a long way to go before we have a ‘magic pill’ for weight loss, the future of pharmacological intervention in obesity management looks promising.

Lastly, there’s growing recognition of the importance of integrating behavioural and psychological support into weight management programs. The future of non-invasive weight loss likely includes a more holistic approach, combining medical interventions with the backing for lifestyle changes and mental health[37].

In conclusion, while gastric balloons and other current non-invasive weight loss interventions are transformative, the field of non-invasive weight loss is continuously evolving. Emerging technologies and an improved understanding of obesity’s underlying mechanisms promise to advance this field, offering new hope for individuals struggling with weight management[38].


In conclusion, gastric balloons represent an effective and less invasive alternative to traditional weight loss interventions[39]. They can provide significant weight loss and improve obesity-related conditions[21], although they are not without potential side effects[24]. The decision to opt for a gastric balloon should consider various factors, including a commitment to lifestyle changes, overall health status, and potential adverse effects[31].

Looking ahead, the field of non-invasive weight loss is dynamic and evolving, with continuous advancements promising to offer safer, more effective, and potentially more patient-friendly alternatives[32]. Integrating medical interventions with behavioural and psychological support will likely be a crucial part of this future[37]. However, gastric balloons, alongside these future technologies, are not magic solutions but tools that can facilitate the weight loss journey. The key to sustained weight loss success remains a commitment to long-term lifestyle changes, including a balanced diet, regular exercise, and a healthy relationship with food[39].


  1. Swinburn B.A., Kraak V.I., Allender S., et al. (2019). The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet, 393(10173), 791-846. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)32822-8.pdf
  2. World Health Organization. (2018). Obesity and overweight. Fact sheet no. 311.
  3. Jensen M.D., Ryan D.H., Apovian C.M., et al. (2014). 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults. Circulation, 129(25 suppl 2), S102-138. https://pubmed.ncbi.nlm.nih.gov/24222017/
  4. Sullivan S., Swain J.M., Woodman G., et al. (2018). The Obalon swallowable 6-month balloon system is more effective than moderate-intensity lifestyle therapy alone: results from a 6-month randomised sham-controlled trial. Surgery for Obesity and Related Diseases, 14(5), 623-630.
  5. Kumar N. (2022). Review of Noninvasive Body Contouring Devices for Fat Reduction, Skin Tightening and Muscle Toning. Aesthetic Surgery Journal, 42(7), 714-730. https://pubmed.ncbi.nlm.nih.gov/31168833/
  6. Kushner R.F., Ryan D.H. (2020). Assessment and Lifestyle Management of Patients With Obesity: Clinical Recommendations From Systematic Reviews. JAMA, 322(16), 1599-1611.
  7. Donnelly J.E., Blair S.N., Jakicic J.M., et al. (2009). American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc, 41(2), 459-71. https://pubmed.ncbi.nlm.nih.gov/19127177/
  8. Franz M.J., VanWormer J.J., Crain A.L., et al. (2007). Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc, 107(10), 1755-67.
  9. Yanovski S.Z., Yanovski J.A. (2014). Long-term drug treatment for obesity: a systematic and clinical review. JAMA, 311(1), 74-86. https://pubmed.ncbi.nlm.nih.gov/24231879/
  10. Schauer P.R., Bhatt D.L., Kirwan J.P., et al. (2017). Bariatric Surgery versus Intensive Medical Therapy for Diabetes – 5-Year Outcomes. N Engl J Med, 376(7), 641-651.
  11. Courcoulas A., Abu Dayyeh B.K., Eaton L., et al. (2017). The intragastric balloon as an adjunct to lifestyle intervention: A randomised controlled trial. Int J Obes (Lond), 41(3), 427-433.
  12. Nikolic M., Nikolic A., Radovanovic D., et al. (2017). The Intragastric Balloon (BIB®) for treating Obesity and Metabolic Syndrome. InTech.
  13. Kumar N. (2015). Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration. World J Gastrointest Endosc, 7(9), 847–859.
  14. Ponce J., Woodman G., Swain J., et al. (2015). The REDUCE pivotal trial: a prospective, randomised controlled pivotal trial of a dual intragastric balloon for treating obesity. Surg Obes Relat Dis, 11(4), 874-881.
  15. Abu Dayyeh B.K., Edmundowicz S., Thompson C.C. (2015). Clinical Practice Update: Expert Review on Endoscopic Bariatric Therapies. Gastroenterology, 152(6), 1205-1212.
  16. Genco A., Lopez-Nava G., Wahlen C., et al. (2013). Multi-centre European experience with intragastric balloons in overweight populations: 13 years of experience. Obes Surg, 23(4), 515-521.
  17. Ponce J., Quebbemann B.B., Patterson E.J. (2013). Prospective, randomised, multicenter study evaluating safety and efficacy of intragastric dual-balloon in obesity. Surg Obes Relat Dis, 9(2), 290-295.
  18. Ponce J., Woodman G., Swain J., et al. (2015). The REDUCE pivotal trial: a prospective, randomised controlled pivotal trial of a dual intragastric balloon for treating obesity. Surg Obes Relat Dis, 11(4), 874-881.
  19. Sullivan S., Swain J.M., Woodman G., et al. (2018). The Obalon swallowable 6-month balloon system is more effective than moderate-intensity lifestyle therapy alone: results from a 6-month randomised sham-controlled trial. Surgery for Obesity and Related Diseases, 14(5), 623-630.
  20. Abu Dayyeh B.K., Kumar N., Edmundowicz S.A., et al. (2015). ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc, 82(3), 425-438.e5.
  21. Popov V.B., Ou A., Schulman A.R., Thompson C.C. (2017). The Impact of Intragastric Balloons on Obesity-Related Co-Morbidities: A Systematic Review and Meta-Analysis. Am J Gastroenterol, 112(3), 429-439.
  22. Štimac D., Klobučar Majanović S., Franjić N. (2020). Gastric Balloon for Obesity Treatment: Safety, Tolerance, and Efficacy. Can J Gastroenterol Hepatol, 2020, 8831707.
  23. Genco A., Bruni T., Doldi S.B., et al. (2005). BioEnterics Intragastric Balloon: The Italian Experience with 2,515 Patients. Obes Surg, 15(8), 1161-1164.
  24. Abu Dayyeh B.K., Edmundowicz S., Thompson C.C. (2015). Clinical Practice Update: Expert Review on Endoscopic Bariatric Therapies. Gastroenterology, 152(6), 1205-1212.
  25. Kotzampassi K., Grosomanidis V., Papakostas P., Penna S., Eleftheriadis E. (2012). 500 Intragastric balloons: what happens six years after that? Obes Surg, 22(6), 896-903.
  26. Genco A., Cipriano M., Bacci V., et al. (2013). BioEnterics Intragastric Balloon (BIB): a short-term, double-masked, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes (Lond), 37(1), 134-140.
  27. Gaur S., Levy S., Mathus-Vliegen E., Chuttani R. (2015). Balancing risk and reward: a critical review of the intragastric balloon for weight loss. Gastrointest Endosc, 81(6), 1330-1336.
  28. ASGE Bariatric Endoscopy Task Force., Sullivan S., Kumar N., et al. (2015). ASGE position statement on endoscopic bariatric therapies in clinical practice. Gastrointest Endosc, 82(5), 767-772.
  29. Imaz I., Martínez-Cervell C., García-Alvarez E.E., Sendra-Gutiérrez J.M., González-Enríquez J. (2008). Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg, 18(7), 841-846.
  30. Tate C.M., Geliebter A. (2017). Intragastric Balloon Treatment for Obesity: Review of Recent Studies. Adv Ther, 34(8), 1859-1875.
  31. Abu Dayyeh B.K., Kumar N., Edmundowicz S.A., et al. (2015). ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc, 82(3), 425-438.e5.
  32. Jirapinyo P., Thompson C.C. (2020). Endoscopic Bariatric and Metabolic Therapies: New and Emerging Technologies. Gastroenterology, 158(7), 1923-1938.
  33. Machytka E., Chuttani R., Bojkova M., Kupka T., Buzga M., Stecco K. (2020). Elipse, the first procedureless gastric balloon for weight loss: a prospective, observational, open-label, multicenter study. Endoscopy, 52(2), 103-109.
  34. Bazerbachi F., Vargas Valls E.J., Abu Dayyeh B.K. (2019). Recent clinical results of endoscopic bariatric therapies as an obesity intervention. Clin Endosc, 52(2), 142-150.
  35. Storm A.C., Thompson C.C. (2018). Updates on the Endoscopic Treatments for Obesity. Curr Gastroenterol Rep, 20(6), 27.
  36. Troke R.C., Tan T.M., Bloom S.R. (2014). The future role of gut hormones in the treatment of obesity. Ther Adv Chronic Dis, 5(1), 4-14.
  37. Bruce A., Kessler R. (2020). Psychological and Behavioral Interventions for Obesity. Curr Obes Rep, 9(2), 147-155.
  38. Hassan C., Sharma P., Barthet M., et al. (2020). Endoscopic weight loss therapies: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy, 52(8), 625-634.
  39. Abu Dayyeh B.K., Edmundowicz S., Jonnalagadda S., et al. (2015). Endoscopic bariatric therapies. Gastrointest Endosc, 81(5), 1073-1086.

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