Intragastric balloon treatment for obesity is a temporary, non-surgical weight loss intervention involving the placement of a soft silicone balloon into the stomach to promote satiety and reduce food intake. In the UK, the procedure is predominantly offered privately, though some NHS Tier 3 specialist weight management services may consider it as a bridge to bariatric surgery. NICE guidance (IPG432) permits its use with special arrangements for clinical governance and audit. The balloon typically remains in place for 16 weeks to 12 months and must be combined with comprehensive dietary, behavioural, and lifestyle support to achieve sustainable results.
Summary: Intragastric balloon treatment for obesity is a temporary, non-surgical procedure that places a saline-filled silicone balloon in the stomach to reduce appetite and support weight loss over 16 weeks to 12 months.
- The balloon is inserted endoscopically under sedation or swallowed as a capsule, creating a feeling of fullness to limit food intake.
- Eligibility typically includes adults with a BMI from approximately 27 kg/m² with comorbidities to around 40 kg/m², who have not succeeded with diet and exercise alone.
- NICE guidance (IPG432) permits use with special arrangements for clinical governance, consent, and audit, reflecting limited long-term efficacy evidence.
- Common side effects include nausea, vomiting, abdominal discomfort, and reflux, usually resolving within 3–7 days; serious complications such as gastric perforation or balloon migration are uncommon.
- The procedure is not routinely NHS-funded and is mainly offered privately; referral is typically via Tier 3 specialist weight management services.
- Long-term success depends on sustained lifestyle modification, dietary changes, and behavioural support after balloon removal to prevent weight regain.
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What Is Intragastric Balloon Treatment for Obesity?
Intragastric balloon treatment is a temporary, non-surgical weight loss intervention designed for adults with obesity who have not achieved adequate results through diet and lifestyle modifications alone. The procedure involves placing a soft, silicone balloon into the stomach, where it is then filled with sterile saline solution. This creates a feeling of fullness, thereby reducing appetite and limiting food intake.
In the UK, several types of intragastric balloons are available, including endoscopically placed balloons (inserted during a gastroscopy procedure) and swallowable balloons (taken orally in capsule form and inflated remotely). Depending on the device, the balloon typically remains in place for 16 weeks to 12 months. Some systems are removed endoscopically, whilst swallowable balloons pass naturally through the digestive system. Unlike bariatric surgery, intragastric balloon treatment is reversible and does not alter the anatomy of the digestive system.
During the treatment period, patients work closely with a multidisciplinary team including dietitians, psychologists, and physicians to establish sustainable eating habits and lifestyle changes. NICE (National Institute for Health and Care Excellence) has issued guidance (IPG432) stating that intragastric balloon insertion may be used with special arrangements for clinical governance, consent, and audit, reflecting that long-term efficacy evidence remains limited. The treatment is intended as a tool to facilitate weight loss and support behavioural change, not as a permanent solution.
Intragastric balloon treatment is not routinely commissioned by the NHS. It is predominantly offered through private healthcare providers, though some local NHS services may consider it in selected cases, often as a bridge to bariatric surgery for patients awaiting or preparing for surgical intervention. Referral is typically via Tier 3 specialist weight management services. Success depends heavily on commitment to dietary modification and physical activity throughout and beyond the treatment period.
Who Is Eligible for Intragastric Balloon Treatment?
Eligibility for intragastric balloon treatment is carefully assessed to ensure patient safety and optimise outcomes. Selection criteria vary by device and local commissioning policy. In private practice, balloons are commonly considered for adults with a body mass index (BMI) from approximately 27 kg/m² with obesity-related comorbidities, up to around 40 kg/m², who have been unable to achieve or maintain clinically significant weight loss through supervised diet and exercise programmes. Patients with a BMI above 40 kg/m² who are unsuitable for or decline bariatric surgery may also be considered, particularly as a bridge to surgery.
Candidates must demonstrate commitment to lifestyle modification and be willing to participate in a comprehensive support programme involving dietary counselling, behavioural therapy, and regular follow-up appointments. Psychological assessment is often undertaken to identify any eating disorders or mental health conditions that might compromise treatment success or safety. In the UK, patients are usually referred to Tier 3 specialist weight management services for assessment and multidisciplinary input.
Contraindications to intragastric balloon placement include:
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Previous major gastric or oesophageal surgery (e.g., gastric resection)
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Large hiatus hernia (typically >5 cm)
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Oesophageal strictures or varices
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Significant dysphagia
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Active peptic ulcer disease or gastrointestinal bleeding
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Inflammatory bowel disease
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Severe liver disease or portal hypertension
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Severe coagulopathy or uncontrolled bleeding disorder
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High anaesthetic or sedation risk due to cardiorespiratory disease
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Pregnancy or planned pregnancy within the treatment period
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Uncontrolled psychiatric disease, alcohol or substance misuse
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Inability to comply with follow-up requirements
Patients taking anticoagulant or antiplatelet medications require careful evaluation according to British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidance on managing antithrombotic therapy around endoscopy. Pre-procedure assessment often includes testing and eradication of Helicobacter pylori to reduce the risk of gastric ulceration. A thorough medical history, physical examination, blood tests, and upper gastrointestinal endoscopy are essential. The multidisciplinary team will discuss realistic expectations, potential complications, and the importance of adherence to post-procedure dietary guidelines and proton pump inhibitor (PPI) prophylaxis during the balloon dwell period before proceeding with treatment.
How Does the Intragastric Balloon Procedure Work?
For endoscopically placed balloons, the procedure is performed as a day-case intervention under conscious sedation or light general anaesthesia, typically taking 20–30 minutes. Patients are advised to follow standard UK endoscopy fasting guidance: no solid food for at least 6 hours and clear fluids up to 2 hours before the procedure (unless advised otherwise by the endoscopy unit). The procedure begins with an upper gastrointestinal endoscopy to examine the stomach and oesophagus, ensuring there are no contraindications such as ulcers or anatomical abnormalities.
Once the stomach is confirmed suitable, the deflated balloon—attached to a thin catheter—is passed through the mouth and oesophagus into the stomach under direct endoscopic visualisation. The balloon is then filled with approximately 400–700 ml of sterile saline solution (the volume varies depending on the device used and individual patient factors). Some systems incorporate a blue dye within the saline; if the balloon ruptures, the dye is absorbed and excreted in urine, providing an early warning sign.
After inflation, the catheter is gently detached and withdrawn, leaving the balloon free-floating in the stomach. The balloon's size creates a sensation of satiety, encouraging smaller portion sizes and reduced calorie intake. Most patients are monitored for 1–2 hours post-procedure before being discharged home with anti-emetic and acid-suppression medications (typically proton pump inhibitors) to manage common early side effects.
Swallowable balloon systems do not require endoscopy for insertion. The deflated balloon is contained within a capsule attached to a thin catheter, which the patient swallows. Once confirmed in the stomach by X-ray, the balloon is filled remotely via the catheter, which is then detached and removed. These balloons typically remain in place for around 16 weeks and pass naturally after automatic deflation.
The first few days following insertion are often challenging, with nausea, vomiting, abdominal discomfort, and reflux being common. These symptoms usually improve within 3–7 days as the body adapts. Patients are advised to follow a liquid diet initially, progressing gradually to soft foods and then a normal healthy diet under dietetic supervision. After sedation, patients must be escorted home and should not drive, operate machinery, or sign legal documents for 24 hours. Clear contact details and urgent care advice should be provided, particularly if the patient is unable to keep fluids down.
Balloon removal for endoscopic systems occurs after the designated dwell period (typically 6–12 months depending on device) via a similar endoscopic procedure under sedation. The balloon is deflated and extracted through the mouth. Swallowable balloons deflate automatically and pass naturally. Some patients may be offered a second balloon if further weight loss is required, though this is assessed individually.
Benefits and Risks of Intragastric Balloon Treatment
The primary benefit of intragastric balloon treatment is clinically significant weight loss in appropriately selected patients. Evidence summarised by NICE suggests that patients typically lose a proportion of their excess weight during the treatment period, though individual results vary considerably depending on the device, programme intensity, and patient adherence. This weight reduction can lead to improvements in obesity-related comorbidities including type 2 diabetes, hypertension, obstructive sleep apnoea, and dyslipidaemia. The procedure offers a less invasive alternative to bariatric surgery, with no permanent anatomical changes and a shorter recovery period.
Additionally, the structured support programme accompanying balloon treatment helps patients develop healthier eating patterns and lifestyle habits that may be sustained long-term. For some individuals, successful weight loss with the balloon provides motivation and confidence to maintain these changes after removal.
However, intragastric balloon treatment carries several risks and potential complications. Common side effects during the adaptation period include:
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Nausea and vomiting (affecting the majority of patients initially)
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Abdominal pain and cramping
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Gastro-oesophageal reflux
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Constipation or diarrhoea
Serious complications, though uncommon, include:
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Balloon deflation and migration (potentially causing bowel obstruction)
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Gastric perforation or ulceration
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Oesophageal injury during insertion or removal
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Severe dehydration requiring hospitalisation
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Acute pancreatitis
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Balloon hyperinflation
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Aspiration pneumonia
Very rarely, deaths have been reported internationally in association with intragastric balloon treatment, often related to gastric perforation or aspiration. Patients should seek immediate medical attention by calling 999 or attending A&E if they experience severe abdominal pain, persistent vomiting preventing fluid intake, signs of dehydration, black or bloody stools, blue-tinged urine (suggesting balloon rupture), fainting, or difficulty breathing.
Weight regain after balloon removal is common if lifestyle modifications are not maintained. NICE emphasises that the balloon should be used as part of a comprehensive weight management programme rather than as a standalone intervention. Long-term success depends on continued adherence to dietary changes, regular physical activity, and ongoing behavioural support. Patients considering this treatment should have realistic expectations and understand their active role in achieving and maintaining weight loss.
If you suspect you have experienced a side effect or problem related to your intragastric balloon, you can report it via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or through the Yellow Card app. This helps improve the safety monitoring of medical devices in the UK.
Frequently Asked Questions
How does an intragastric balloon help with weight loss?
The intragastric balloon is filled with saline and sits in your stomach, creating a feeling of fullness that reduces your appetite and limits how much you can eat. This helps you consume fewer calories whilst working with a dietitian and support team to develop healthier, sustainable eating habits over the treatment period.
Can I get an intragastric balloon on the NHS?
Intragastric balloon treatment is not routinely commissioned by the NHS and is predominantly offered through private healthcare providers. Some local NHS Tier 3 specialist weight management services may consider it in selected cases, often as a bridge to bariatric surgery for patients preparing for or awaiting surgical intervention.
What are the side effects of having an intragastric balloon?
Common side effects include nausea, vomiting, abdominal pain, reflux, and changes in bowel habit, particularly during the first 3–7 days as your body adapts. Serious but uncommon complications include balloon deflation and migration, gastric perforation or ulceration, severe dehydration, and oesophageal injury during insertion or removal.
How long does the intragastric balloon stay in your stomach?
The balloon typically remains in place for 16 weeks to 12 months, depending on the device used. Endoscopically placed balloons are removed via a gastroscopy procedure under sedation, whilst swallowable balloons deflate automatically and pass naturally through the digestive system after the designated period.
What is the difference between an intragastric balloon and gastric band surgery?
An intragastric balloon is a temporary, non-surgical device that sits inside the stomach for up to 12 months and does not alter your digestive anatomy, whereas a gastric band is a permanent surgical implant placed around the upper stomach to restrict food intake. The balloon is reversible and less invasive, but gastric band surgery offers a longer-term structural intervention for weight management.
Will I regain weight after the intragastric balloon is removed?
Weight regain after balloon removal is common if you do not maintain the lifestyle and dietary changes developed during treatment. Long-term success depends on continued adherence to healthy eating patterns, regular physical activity, and ongoing behavioural support from your multidisciplinary team.
The health-related content published on this site is based on credible scientific sources and is periodically reviewed to ensure accuracy and relevance. Although we aim to reflect the most current medical knowledge, the material is meant for general education and awareness only.
The information on this site is not a substitute for professional medical advice. For any health concerns, please speak with a qualified medical professional. By using this information, you acknowledge responsibility for any decisions made and understand we are not liable for any consequences that may result.
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