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Gastric balloons

Some people need to lose a lot of weight to be healthy, but for many, diets haven’t worked and bariatric surgery seems too big a step. This population is the target of a newly approved, nonsurgical therapy being performed by Washington University physicians at Barnes-Jewish West County Hospital. The therapy involves placing special balloons into the stomach and inflating them to give patients the feeling of being full after eating small meals. The balloons are inserted with an endoscope that is guided into the stomach through the patient’s mouth. The strategy is a substitute for gastric bypass and other surgical procedures.

ONE COMMON STRATEGY FOR ASSISTING WEIGHT LOSS IS TO FIND A WAY TO MAKE A PATIENT FEEL FULL. THAT COULD INVOLVE DRINKING LOTS OF WATER, OR IT COULD INVOLVE SURGERY TO MAKE THE STOMACH SMALLER SO THAT IT FILLS UP MORE QUICKLY. NOW WASHINGTON UNIVERSITY PHYSICIANS AT BARNES-JEWISH WEST COUNTY HOSPITAL IN ST. LOUIS HAVE BEGUN INSERTING BALLOONS INTO THE STOMACHS OF PEOPLE WITH EXCESS WEIGHT AND INFLATING THE BALLOONS WITH FLUID TO MAKE THEM FEEL FULL AND EAT LESS. JIM DRYDEN HAS THE STORY…

THE BALLOONS ARE LESS DRASTIC THAN SURGERY, BUT THE IDEA IS SOMEWHAT SIMILAR — MAKE IT HARDER TO EAT AS MUCH FOOD BY MAKING PEOPLE FEEL FULL AFTER EATING LESS. WASHINGTON UNIVERSITY GASTROENTEROLOGIST SHELBY SULLIVAN SAYS THERE ARE TWO TYPES OF BALLOON INTERVENTIONS: ONE IS CALLED ORBERA AND THE OTHER RESHAPE. SHE SAYS BOTH ARE LESS DRASTIC THAN SURGERY BECAUSE THEY ARE TEMPORARY, AND THAT’S MORE ATTRACTIVE THAN BARIATRIC SURGERY FOR MANY PATIENTS.

(act) :06 o/c still risk

Some people really don’t want that. And even though the risk

of surgery is small compared to other surgery, there’s still risk.

THE BALLOONS ARE INSERTED ENDOSCOPICALLY AND THEN FILLED WITH LIQUID AFTER THEY’RE IN THE STOMACH. SULLIVAN SAYS DURING CLINICAL TRIALS OF THE BALLOON SYSTEMS, MANY PATIENTS TOLD HER THAT THEY PREFERRED THIS TEMPORARY INTERVENTION TO THE MORE PERMANENT SURGICAL OPTION.

(act) :21 o/c helping them

We had patients that we treated with the intra-gastric balloons,

and those patients said, “You know what? If I get a balloon, that’s

just a tool.” They didn’t see it as a failure. They just saw it as an

additional tool that was helping them.

THE CHANGES CAUSED BY THE BALLOONS ARE ONLY TEMPORARY BECAUSE THE BALLOONS ARE DEFLATED AND REMOVED AFTER 6 MONTHS, BUT PATIENTS ARE ENROLLED IN CLASSES TO HELP THEM CHANGE THEIR LIFESTYLE AND EATING HABITS, AND SULLIVAN SAYS THOSE CLASSES CONTINUE AFTER THE BALLOONS COME OUT.

(act) :19 o/c behavior changes

What the balloons do is they just make you feel full earlier in

a meal, and we’re trying to capitalize on that to help you make

those lifestyle changes. But behavior change is difficult, and we

understand that. And we also understand that the more contact we

have with you, the more likely you are to be able to maintain

those behavior changes.

THERE ARE SOME SIDE EFFECTS. PATIENTS CAN GET NAUSEATED FOR A FEW DAYS AFTER THE BALLOONS ARE PLACED IN THE STOMACH. ALSO, SHE SAYS…

(act) :22 o/c healthier diet

There’s much less downtime. You do have symptoms that you have

to get over, so there is some nausea and vomiting that occurs, but

most patients get over that in the first couple of days — and then

you go back to work. And you can go back to do all of the activities

that you were doing before, with the exception of eating fewer

calories and a much healthier diet.

SULLIVAN SAYS THE THERAPY IS GEARED AT PEOPLE WHO NEED TO LOSE QUITE A BIT OF WEIGHT, SO IF YOU’VE BEEN CARRYING AROUND 10 EXTRA POUNDS, THIS MIGHT NOT BE FOR YOU. ON THE OTHER HAND, IT MIGHT NOT BE THE BEST OPTION FOR THOSE WHO NEED TO LOSE 100 POUNDS EITHER.

(act) :24 o/c versus surgery

They probably need to lose at least 30 pounds. The FDA indications

are a BMI of 30 to 40, and that’s because those were the studies

that were included. You know if somebody comes to us and has a BMI

that’s higher than 40 and says, “Look, I really don’t want surgery,”

would we be willing to do a balloon? We would, but they would have

to understand what the expectations of weight loss is with this

therapy versus surgery.

CLASSES AND INFORMATION SESSIONS ARE CONDUCTED REGULARLY AT BARNES-JEWISH WEST COUNTY HOSPITAL. AT PRESENT, INSURANCE DOES NOT COVER THE BALLOONS. I’M JIM DRYDEN…

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