Sequence treatment with Intragastric Balloon BIB (R)

Background: Since 1998, we adopted the BioEnterics Intragastric Balloon (BIB®) in our clinical practice for treatment of obesity and morbid obesity. Aim of this work is to evaluate the efficacy of a second balloon to continue weight loss or to produce better weight loss. Methods: Since March 1998, 522 BIB® were inserted in 480 obese and morbidly obese patients (124 male and 356 female). 38 patients (15 male and 23 female) had two balloons and four (1 male and 3 female) underwent three balloon insertions. At first insertion mean age was 40 years (21-65); mean weight was 126 kg (82-229), mean BMI was 43.2 kg/m2 (29-81.1), and mean initial % excess weight was 76% (13.3-216.3). The patients were given a balanced diet of 1000 kcal/day with temporary addition of omeprazole, vitamins and oligoelements. Results: When the first BIB was removed, the mean weight loss was 19.9 kg (8-50), the mean reduction in BMI was 6.6 kg/m2 (2.7- 15.9) and the mean %EWL was 25.7%. At the second balloon removal, the mean weight loss was 7 kg (from +11 kg to -33 kg), the mean reduction in BMI was 2.6 kg/m2 (from +3.9 to -8.6) and the mean %EWL was 10.1%. Only with second balloon we observed six cases of intolerance with removal before the due date. Conclusion: Our experience shows that second balloon insertion is less effective in terms of weight loss and %EWL than the first balloon and that the incidence of complications is greater