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Obalon gastric balloon

Obalon gastric balloon

I’m always keen on new and innovative treatments that will help people to lose weight and maintain a healthy weight. The caveat is that whatever the treatment or device might be, it has to be safe and there must be good scientific evidence to support it.

Intra-gastric balloons have been around for decades and they have a part to play in patient care for those who are either not eligible for surgery or who would prefer a non-surgical option. We regularly implant gastric balloons, though we always make it clear to patients that the balloon is a temporary weight loss device and that – once the balloon is removed (usually after 6 months) - there will be a strong tendency to regain any lost weight. For some patients the balloon proves to be an effective “kick-start” and they do well, though for others it proves to be less effective.

The Obalon is a new type of balloon that differs in a number of ways from conventional balloons. The balloon itself is very small and is rolled up inside a capsule small enough to be swallowed. Once the capsule has been swallowed, the connecting tube is attached to a cylinder and the balloon is inflated with 200cc of nitrogen. An x-ray is then performed to ensure the balloon is in the correct position within the stomach. Depending on the weight loss, up to 3 balloons can be implanted over the next few weeks, though they all have to be removed at week 12-weeks and an x-ray has to be performed after each implant. The balloons are removed by means of an endoscopic procedure carried out by a surgeon or a gastroenterologist requiring sedation, though not a general anesthetic.

In clinical trials the average weight loss over 12-weeks was 1st 3lbs, ie around 1¼ lbs per week*.  A couple of observations are relevant here:

  • Note that unlike a conventional balloon where an endoscopy is first carried out to inspect the inside of the stomach, the Obalon balloon is a “blind” implant.  Whilst this may be attractive because it means avoiding an endoscopy, many doctors (including myself) would be very concerned about putting anything into the stomach without first having a look. There are common conditions such as gastric ulceration and a large hiatus hernia, which could be hazardous if a balloon is implanted.

  • Whilst the Obalon avoids the first endoscopy, an endoscopic procedure is still required to remove the balloons.


  • Unlike conventional balloon patients, Obalon patients are exposed to x-rays each time an implant is carried out.


  • Weight loss with the Obalon is less than with conventional balloons (see table) , because the Obalon balloons are only in place for 12-weeks whereas the conventional balloons stay in for 6-months.


  • Although most of the weight loss with a conventional balloon occurs in the first 4-months, the additional 2-months is desirable because it helps to maintain weight loss for another 2-months.  With Obalon the device is out at 12-weeks so there is much less time for the patient to habituate to a new lifestyle.


  • Note also that weight loss with the Obalon device is no greater than that which can be achieved with a standard low-calorie diet!


For all these reasons, we do not recommend the Obalon gastric balloon. We don’t feel it offers anything more over existing balloons (Orbera™) and there is a greater body of evidence to support the use of conventional balloons compared with Obalon.


The key differences between conventional balloons and the Obalon are shown below:


Conventional balloons

Endoscopy performed before implantation



Endoscopy required for removal



X-rays to check balloon



Length of implant


6 months

Average weight loss over implant



Average reduction in BMI kg/m2



Scientific evidence

 Very limited safety and efficacy data

Large body of evidence
and safety data

Dr David Ashton MD PhD
29th January 2014


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