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Gastric Balloon (Intragastric Balloon)

Gastric Balloon (Intragastric Balloon)

  • February 5, 2022

The battle with weight loss can be long and hard. Though the remedy that is often prescribed is diet and exercise, sometimes, that does not work for everyone. In these cases, outside help might be just the answer – this is why certain weight loss procedures exist, namely the temporary insertion of a gastric balloon in the stomach. This procedure, alongside a healthy diet and regular exercise, can help you lose weight and feel better in your own skin.

What is a gastric balloon?

A gastric balloon (also called an intragastric balloon) is a non-surgical weight loss procedure. It is an inflatable silicone bag that is filled with either saline or gas, depending on the type of balloon. This balloon is then inserted into the stomach orally by swallowing a pill or through endoscopy. The balloon then limits the amount of food that you can eat by making you feel full faster. There are two main types of gastric balloons:

Orbera Managed Weight Loss System

This type of gastric balloon has been around the longest and has a high success rate among patients. It is a single balloon device, meaning that only one balloon is used throughout the whole time period for the procedure and recovery.  The insertion procedure for the Obera gastric balloon is through endoscopy – this means that a small tube with a camera attached, which is called an endoscope, is inserted into your esophagus. Through that, a small deflated balloon is inserted into your stomach, which is then filled with saline.


This is a new type of gastric balloon. Though the function is the same, there are a few main differences with the Orbera system. The first is that the Obalon system consists of a total of three balloons. The first balloon is added initially, and then a month after the first insertion, a second balloon is added. A month after that (the second month overall), a third and final balloon is added.

The next difference is the insertion technique. This type of gastric balloon is inserted via a pill that is swallowed by the patient. So, unlike the Orbera system, there is no need to have an endoscopy to put the balloon in place. A final difference is the fact that while the Orbera system fills the balloon with saline, the Obalon system fills it with gas. This could be beneficial because it can reduce the risk of acute pancreatitis that comes with balloons filled with saline.

What does a gastric balloon do to aid weight loss?

In a nutshell, a gastric balloon does two things: it restricts the amount of food you can eat, and it slows the passage of food through your stomach. Intragastric balloons typically take up about half of the space in your stomach. So, the amount of room that is left for the food you consume is almost cut in half. This makes it physically impossible to eat as much food as before.

Another function of the balloon is that it makes you feel full faster, as well as makes you keep that full feeling for longer. This is done because the balloon does not let the food in your stomach pass through as quickly as before. It stays there for a longer period of time, so you will not feel the need to eat so soon after a meal.

Who qualifies to get a gastric balloon?

The main qualification for someone who wants to get a gastric balloon inserted is their BMI. Your BMI (body mass index) should be between 30 and 40, therefore falling under the classification of “obese”. Another important factor is the fact that you should not have had any previous stomach or esophageal surgeries. This is because if you have, your risk of stomach injury or perforation (a hole in your stomach) increases.

The final qualification is both the easiest and the hardest to meet: a willingness to change your lifestyle. A gastric balloon is only a temporary weight loss aid. After six months, the balloon will be removed, and if you go back to the eating habits that you had before, the weight will come back. So, the commitment to living a healthier lifestyle is important.

However, the gastric balloon is not the right choice for every patient. Because of this, a special screening process is usually done prior to surgery, to ensure that the balloon is the right path for you.

The Procedure: Before, During, And After

The full procedure involving the insertion of the gastric balloon is a multi-step process. It not only includes the insertion itself, but also the preparation before it, the 6-month period that the balloon is in your stomach, the removal, and then finally the period after the balloon. Below is a detailed walkthrough of each step in the procedure, from start to finish:

*Note: This walkthrough is for an endoscopic intragastric balloon procedure, which is usually done with the Orbera system. The Obalon system is inserted via pill, not endoscopy.

Preparing for the gastric balloon procedure

In order to prepare in the days leading up to the procedure, there are a few things that you might have to do. First, there is a possibility that your doctor will ask you to take some lab tests before the balloon is inserted. You might also be required to start an exercise program. Your doctor may also ask you to restrict the things that you eat or drink or the medications that you take in the time leading up to the procedure.

On the day of the procedure, you will be instructed to not drink anything for the six hours leading up to the insertion. In regards to food, you will be told not to eat anything for the last twelve hours leading up to the procedure, as well. Following these instructions is important because, after the insertion of the balloon, a nauseous feeling might be felt. Food or drink in your system may worsen those symptoms.

During the gastric balloon procedure  

This procedure is done in the endoscopy unit of a hospital and usually takes anywhere from twenty minutes to an hour. It is done as an outpatient procedure, meaning that you will not be required to stay overnight at the hospital after the procedure is over.

Before the procedure begins, your doctor might give you a mild sedative or light anesthetic in order to relax. An endoscope (a small, flexible telescope) will be placed into your mouth. At this time, the doctor may ask you to swallow while the endoscope is at the back of your throat. This lets the endoscope pass into your stomach more easily. Using this, the doctor can check for any preexisting problems with your stomach, like an ulcer or inflammation.

If there are none, then the deflated gastric balloon will be placed into your stomach using the endoscope. The balloon is attached to a small tube. This tube will then inflate the balloon with 650 to 750 milliliters of air or 400 to 700 milliliters of saline.

After the gastric balloon procedure

The procedure above should take about twenty minutes to an hour to complete. You should be able to go home about twenty or thirty minutes after this, or the next day at most. You may also be prescribed some medication to help alleviate any symptoms of nausea or acid reflux. These should be taken regularly.

What will my life be like with the gastric balloon?

The gastric balloon will remain in your stomach for six months before it is removed through endoscopy. During this time period, you might notice some changes in your appetite, particularly in the first few weeks. This is completely natural. The six months that you will live with the gastric balloon will look like this:

Immediately after the procedure

You may feel some discomfort after the inflation of the balloon, and this discomfort might not go away completely for a few days to even a couple of weeks. This discomfort is common and completely normal. However, if you feel any pain or discomfort that feels abnormal, be sure to contact your surgeon.

Week 1

You probably will not feel hungry for the first week after the procedure. This loss of appetite, as well as experiencing nausea (which might feel worse after eating something) is common. In addition, usually, patients lose a large amount of weight in the first week. Men usually lose between 8 and 15 pounds (between 3.5 kilograms and 7 kilograms), while women lose between 4 and 8 pounds (between 2 kilograms and 3.5 kilograms).

Week 2

You will slowly start to gain your appetite back in week two. In this week, you will probably feel full after a small amount of food.

Weeks 3 – 6

In these weeks, your appetite will increase, as well as your ability to tolerate a larger amount of food. You should still try to eat slowly and continue paying attention to the foods that you eat. You should also be on the lookout for signs of discomfort after eating which can show that you ate too much or too quickly. These signs include hiccups, acid reflux, and nausea.

Weeks 7 – 12

You will continue to see weight loss, but at a slower rate than it was during the first six weeks. This is the time to focus on changing your lifestyle: eating healthy foods and incorporating a regular exercise routine into your daily schedule.

Weeks 12 – 26

This is a time where your focus should shift from only weight loss to maintaining your weight loss. This is when you strengthen the habits that you have formed in the last few weeks and head into a sustainable healthy lifestyle.

Removing the gastric balloon

Gastric balloons stay in the stomach for up to 6 months. Then, regardless of the type of insertion technique (via pill or endoscopy), the balloon is removed using an endoscope.

The endoscopy process is a rather straightforward one: first, the balloon in your stomach is deflated. Then, an endoscope (a tube) with a grasper attached to it is inserted orally. This grasper then takes hold of the balloon and removed it from your stomach. The process will also probably require you to take a mild sedative or receive an anesthetic.

Life after the gastric balloon

After the procedure, it is crucial that you do not fall back into old habits. As previously stated, the main factor in weight loss is the formation of new habits. So, your main concern after having the balloon removed would be to maintain your routine of a healthy diet and frequent exercise. Below are some helpful tips in order to keep the momentum that you have built up while having the balloon:

  1. Eat slowly – eating slowly can help you digest your food better and slowly increases the hormones in your stomach responsible for making you feel full.
  2. Schedule your meals – some experts say three meals per day with one healthy snack in between is the best, while others say that five or six small meals throughout the day is. However, whichever you choose, stick to it.
  3. Choose foods with more nutrients – these foods include fruits, vegetables, meats, and fish.
  4. Do not eat fast food and do not drink soda.
  5. Continue and stick to a regular exercise routine.

Risks and complications of the gastric balloon

As with any procedure or surgery, there are a number of risks and complications that should be taken into consideration. First, there are a number of common and benign symptoms that you may see for a few days after the insertion. These include:

  • Acid reflux
  • Nausea and vomiting during the first few days
  • Vomiting after eating for the first few weeks
  • Stomach cramps (but not intense abdominal pain)
  • Difficulty sleeping

In addition, some more serious risks come with this procedure. One important risk is the possibility of the balloon deflating. If deflation occurs, the balloon could then move into your digestive system causing a blockage. In this case, surgery may be needed to remove the device. Other risks include:

  • Hyperinflation (when the balloon fills with extra air or liquid while inside a patient’s stomach)
  • Ulcers
  • Perforation (a hole in the stomach)

Alternatives to the gastric balloon

If you’ve found that the gastric balloon is not the best for you, then there are a number of alternatives that you can try instead. The first option is something that does not require surgery or medication: trying to have a better diet and keeping to a regular exercise routine. If this does not work, another simple alternative can be one of a number of medications that your general practitioner may prescribe you.

Surgeries also exist that can help you with weight loss. These include:

  • Gastric banding
  • Gastric bypass
  • Shortening your digestive tract
  • Sleeve gastrectomy

Frequently Asked Questions (FAQS)

  1. How much weight can I expect to lose after the procedure?

Usually, patients lose anywhere from 20 to 50 pounds or about 10% to 20% of their initial weight. However, two important factors in keeping the weight off after the removal of the balloon are diet and exercise. Alongside the procedure, a lifestyle change is what determines the amount of weight you lose.

  1. How much does the procedure usually cost?

In the United States, the cost tends to be in the range of $6,000 to $9,000.

  1. Is the procedure covered by insurance?

No. Intragastric balloons are not typically covered by insurance companies in the US. Even though this is the case, you should still contact your insurance company if you are looking to undergo a weight loss procedure.

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