Monday, Feb. 26, 2018

OBALON

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The newest gastric balloon system for weight loss

Science and technology have come together to create a fascinating new, non-surgical weight-loss tool called the Obalon Balloon System. You may have heard about the fluid-filled gastric balloons in the past few years, but this new system uses three gas-filled balloons for a whole new approach.

What is Obalon? The Obalon Balloon System is the first FDA-approved, swallowable, intragastric balloon system to facilitate weight loss in adults with obesity (BMI of 30 – 40) who have failed to lose weight through diet and exercise. This novel, nonsurgical, fully reversible device for weight loss consists of a balloon folded inside a capsule that is swallowed by the patient, with no sedation or anesthesia required. Once the balloon reaches the stomach, it is remotely inflated with gas via a micro-catheter that is then removed, leaving a buoyant balloon in the stomach. Each actual placement process is less than 10 minutes on average. A fully inflated single balloon is about the size of a small orange and weighs approximately three grams (about what a penny weighs).

How does it work? Three balloons are placed gradually over six to 12 weeks to maximize patient tolerability and facilitate continual weight loss throughout the sixmonth treatment period. At the end of six months, all three balloons are removed via an outpatient endoscopy under light, conscious sedation. I’m excited to offer this new weight-loss tool to our area. I believe this new system, because of its design, will be well-tolerated by even the most sensitive patients. Also, with this system, the patient can resume their normal activity right after the placement of the balloon. They can come in for a 30-minute placement appointment, a 30-minute dietitian appointment and then go right back to work or their other commitments of the day.

Why does it work? The success of this system is built around three components: design, commitment and support. In terms of design, the Obalon Balloon System helps facilitate weight loss by taking up space in a patient’s stomach so the patient eats less and feels full longer. During treatment, patients receive professional nutrition and exercise support to help make the lifestyle changes that facilitate weight loss for the long term.

Are you a good candidate? In general, good candidates are adults 30 to 100 pounds overweight who have not had any previous bariatric or stomach surgery, are not pregnant or nursing, don’t have untreated H Pylori, are not on prescription blood thinners, aspirin or anti-inflammatory medication, and don’t have restricted swallowing. (You can find side-effects information and a complete list of contraindications, warnings and precautions at www.obalon.com/ safety-information.) A patient’s mindset is another very important factor to determine if he or she is a good candidate. As I tell my patients, making a choice to incorporate this weight-loss tool for six months is not a lifetime fix. Obalon can jumpstart your weight loss, but it must be seen as a start to addressing major changes in eating habits, exercise and even emotional issues related to food. If you are ready for this change, Obalon can help you.

Who is not a good candidate? If you have a BMI of more than 40 or 35 and higher with significant other health problems related to your weight, in my experience you would be better served exploring weightloss surgery options. Morbid obesity (BMI of 40+) is an extremely complex disease which requires a comprehensive, lifelong care plan.

What about results? As with all procedures, individual results will vary, but in my experience in the last few years with the various intragastric balloons, a successful patient can achieve a loss of 15-20 percent of their total body weight. For Obalon, in their large clinical study, the system was shown to help adults experience clinically meaningful weight loss. Patients lost twice as much weight as diet and exercise alone. Six months after the balloons were removed, an average of 89 percent of the weight lost was kept off, when combined with diet and exercise. In the clinical trial, the majority of adverse events were reported as mild and consisted of abdominal pain and nausea, which typically resolve within two weeks (serious side effects were less than 0.3 percent).

How about the cost? Unfortunately with many new procedures for weight loss, insurance does not cover their system. Prices around the country range from $6,000-$9,000 for the system. Our current price for this region is near the lower end and includes six appointments with our registered dietitian on staff.

What does the future hold? The good news is that the medical field has for the last 10 years steadily accepted and confirmed that obesity is, in fact, a complex disease. With this acknowledgement has come great research and development in this area. There are new devices being FDA-approved every few years as well as new weight-loss medications. There is no one-size-fits-all answer for any patient, but the options for treatment are better than ever before.

For more information, visit Obalon.com or locally visit FreedomFromObesity.com/ Balloon.

George R. Merriman II, MD, FACS, FASMBS, is a boardcertified laparoscopic and general surgeon specializing in bariatric surgery, hernia repairs, heartburn/reflux surgery and weight loss. He has been in practice since 1992 and has performed over 3,500 weight-loss surgeries in his career.

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