Obesity is a global pandemic, affecting about 40% of adults in the United States. There is an enormous unmet need for an effective weight-loss solution. After a detailed review of available literature, the American Gastroenterological Association (AGA) has released new clinical guidelines recommending the use of intragastric balloons (IGB) for patients with obesity who have not been able to lose weight with traditional weight-loss strategies. This treatment is most successful with accompanying therapy, such as lifestyle modifications and pharmacological agents, and can be used in a sequential manner or along with bariatric surgery. These guidelines are published in Gastroenterology.
“Endoscopic bariatric therapies have evolved as an attractive tool for weight loss, however, less than 5% of patients with obesity seeking a weight loss therapy are aware of endoscopic weight loss options,” said lead author Thiruvengadam Muniraj, MD, MRCP, from Yale University School of Medicine, New Haven, Connecticut. “Our hope is that this new guideline can lead to shared decision making between patients and providers to determine if intragastric balloons are the best weight loss option for that individual patient.”
With the exception of acknowledgement that fluid-filled balloons may be associated with higher efficacy but lower tolerability than air-filled balloons, the guideline makes no recommendations on specific devices.
Key guideline recommendations:
1. Patients with obesity seeking a weight loss intervention should consider using intragastric balloon therapy to augment the effect of moderate to high intensity lifestyle modifications.
2. To minimize gastrointestinal bleeding risk, treat patients undergoing IGB therapy with proton pump inhibitors (PPIs).
3. To avoid nausea, sedate patients for the IGB placement with anesthetics associated with low incidence of nausea, and continue anti-nausea medication for two weeks.
4. While screening for nutritional deficiencies isn’t needed, providing 1-2 multivitamins after IGB placement is suggested.
5. To keep weight off after IGB removal, AGA recommends dietary interventions, pharmacotherapy, repeat IGB or bariatric surgery. The choice of this maintenance strategy should be determined based on a shared decision-making approach.
“Shared decision making is a critical component of obesity therapy—for everything from selecting the right IGB device to what concomitant lifestyle modifications, pharmacotherapy or sequential procedures a patient should pursue. This shared decision making should consider the patient’s values and preferences, balance benefits and harms within the patient’s clinical and behavioral context, and consider cost and availability,” added Dr. Muniraj.
Food insecurity may make losing weight more difficult, even with an intense intervention
Thiruvengadam Muniraj et al, AGA Clinical Practice Guidelines on Intragastric Balloons in the Management of Obesity, Gastroenterology (2021). DOI: 10.1053/j.gastro.2021.03.003
AGA recommends intragastric balloons as an additional weight loss strategy for obese patients (2021, April 6)
retrieved 6 April 2021
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.
- South African regulator rejects Russia’s COVID-19 vaccine - October 20, 2021
- Second wave of pandemic not receded yet, third wave feared post-Diwali: Maha health minister - October 20, 2021
- WHO chief discusses Covaxin, resumption of AstraZeneca vaccine supplies to COVAX facility with Health Minister Mandaviya - October 20, 2021
- Trivitron Healthcare in collaboration with Diagon- Vanguard Diagnostics launches Diagon’s Coagulation range in India - October 20, 2021
- Breast cancer early detection, screening, and management – what we need to know - October 20, 2021
- WHO’s technical advisory group to meet on Oct 26 to consider Covaxin - October 19, 2021
- 163 oxygen plants set up in MP after shortage during 2nd COVID-19 wave: CM Shivraj Singh Chouhan - October 19, 2021
- India’s R-value below 1 since September, researchers say - October 19, 2021
- Mumbai: Double vaccine jab not mandatory to enter theatres, colleges to reopen with 50% attendance - October 19, 2021
- Daily exercise routine, balanced diet, active lifestyle & quality sleep key to success in personal & professional lives: Experts - October 19, 2021