Effects of Intragastric Balloon on Weight Loss, Physical Activity, Plasma Leptin and Ghrelin in Obese Patients, with Long-Term Follow-Up

Abstract

AIM: Intra-gastric balloon (IGB) represents, in the short-term, an alternative for obese patients non responding to diet and reluctant to surgery. Long-term effects of IGB have been rarely described. METHODS: BioEnterics IGB were placed in consecutive patients with Body Mass Index (BMI) higher than 30 kg/m2 with at least one co-morbidity, or BMI higher than 35 kg/m2. Body weight and physical activity (actimetry) were assessed before IGB insertion and just after removal. Efficacy was assessed at balloon removal (6 months), at 12 months and later on. Patients with excess weight loss (EWL) of more than 30 % were considered as responders. RESULTS: Sixty-seven patients (59 women, 88%) had a balloon inserted then removed at 6 months. Mean age±SD was 38.9±9.7 years, mean BMI 36.6±3.3 kg/m2. At balloon removal, BMI dropped to 32.2±4.0 kg/m2 (p=0.0001); 35/67 patients (52%) had EWL >30%. Energy expenditure (METS) did not change. Plasma C-peptide and leptin decreased at 6 months (p=0.001). The ghrelin/leptin ratio increased (p=0.007). Twenty-nine patients (43%) had a median follow-up of 53 months. Nine of these patients (31%) were still EWL responders at last visit. These long-term responders (possible selection bias) had a smaller baseline waist circumference (<110 cm) and lower plasma C-peptide levels. CONCLUSION: The short-term efficacy of IGBs persisted in one third of patients after long-term follow-up, especially in those with smaller baseline waist circumference and lower plasma C-peptide levels.