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Millions of patients struggle with their weight every day in the US and all over the world. Weight loss can be very difficult and frustrating. Weight loss goals can be very elusive despite serious ongoing efforts, restrictive diets, and exercise. The issue is not a lack of willpower. Obesity is a chronic disease with multiple metabolic, hormonal, and other components that make it very difficult for patients to lose weight. So many patients go on diets, and they either cannot lose any weight, or they lose a few pounds, only to see the weight come back.

At Digestive Care Specialists and The Silhouette Clinic, we offer our patients in the Virginia, Maryland, and DC area, the most advanced minimally invasive endoscopic weight loss procedures to help them in their weight loss journey and to make sure that their efforts pay off with great results. We offer various options such as Endoscopic Sleeve Gastroplasty (ESG) and intragastric balloons (Orbera balloon and Spatz3 balloon).


Gastric balloons for obesity treatment.

When we think about the treatment of obesity, we have a range of options that go from the least invasive interventions such as diet, exercise, and medications; to the most invasive bariatric surgery such as sleeve gastrectomy, gastric bypass, and duodenal switch. Most patients have already tried diet and exercise, but they kept losing and gaining the same few pounds for a long time. Bariatric surgery is a very effective option for weight loss, however, most patients prefer not to undergo such invasive interventions and they prefer not to “go under the knife”. In fact, only around 1% of patients suffering from obesity in the US undergo bariatric surgery. There are many other patients who actually do not qualify for bariatric surgery based on their insurance plan, or they simply do not have bariatric coverage through their insurance. This can represent a major barrier, as bariatric surgery can be very expensive and cost-prohibitive if patients are to pay out of pocket.

This is where endoscopic weight loss procedures come to fill this huge gap in obesity treatment. Gastric weight loss balloons can be an ideal option based on several benefits they offer. Let’s dive deeper into the world of intragastric balloons.


What is the intragastric balloon procedure?

The gastric balloon procedure is a very simple endoscopic procedure that involves inserting a deflated balloon from the mouth into the stomach. The balloon is then inflated with a saline solution. The balloon becomes the size of a grapefruit, and it fills you up, so you feel full after eating a small portion of food. This results in weight loss. The gastric balloon is a temporary intervention. The balloon is removed, also endoscopically, after 6 or 8 months depending on the type of weight loss balloon used.


How is the gastric balloon placed?

Gastric balloon placement is an endoscopic procedure. This is an outpatient procedure performed at an outpatient surgery center. The procedure is performed under sedation, which means that you are asleep but breathing on your own. You are not connected to a breathing machine. The endoscopist inserts a scope (a flexible tube with a camera and a light on its tip) through the mouth and into the stomach. After inspecting the stomach to make sure there are no contraindications, such as an ulcer, the deflated balloon (which is wrapped as a thin tube) is inserted into the stomach then it is inflated with a saline solution. This is done under direct visualization as the scope is in the stomach and the doctor can see the balloon being inflated. When the desired balloon volume is reached, the balloon is dropped in the stomach and the scope is withdrawn from the patient.


How is the gastric balloon removed?

The removal of the gastric balloon is a simple procedure. It is done the same way the balloon placement is performed. It requires an outpatient endoscopy performed under sedation.


How long is the gastric balloon procedure?

The gastric balloon procedure is a quick 15-minute procedure. The patient is usually asked to present to the surgery center an hour before the procedure and they are usually monitored in the recovery area for an hour post-procedure. This is mostly needed to give the patient IV fluids, so they are very well hydrated. The patient is discharged home after that. Since driving is not safe after undergoing sedation, an adult person is needed to accompany the patient home after the procedure.


Which are the best FDA-approved gastric balloons?

When undergoing any medical procedure, safety is always first. You want to make sure the procedure is a safe and well-studied intervention. The best way to ensure that is to verify it was reviewed and approved by the Food and Drug Administration (FDA). The most effective, safe, and FDA-approved weight loss balloons available in the US are the Orbera balloon and the Spatz3 balloon.


Orbera balloon

Orbera balloon held in hand

Orbera gastric balloon is the number one gastric balloon in the world. Almost 400,000 Orbera balloons were placed around the world. The Orbera program is very well tested as it has been around for 20 years now. Orbera is a smooth silicone gastric balloon that is very “gentle” on the stomach lining. Because the Orbera balloon is smooth, it is less likely to irritate the stomach. This means that the risk of developing ulcers and erosions is extremely low. This makes the Orbera balloon very well tolerated. The Orbera intragastric balloon is kept in the stomach for a total of 6 months before it is removed endoscopically. However, the Orbera weight loss program is a 12-month program. We continue to work with you and provide you with the support you need after removing the balloon, to make sure you continue with the diet and lifestyle changes you adopted while the balloon was in. This way, we make sure that the weight loss is maintained long-term.


Spatz3 balloon

Spatz3 balloon

Spatz3 gastric balloon is the first and only adjustable weight loss balloon in the world. The Spatz3 gastric balloon has been placed in the rest of the world for a while and it is usually kept in the stomach for up to 12 months. However, in the US, the Spatz3 gastric balloon is approved by the FDA for 8 months. The Spatz3 balloon has a catheter connected to it. This allows the endoscopist to adjust the balloon size if needed. If the patient is having symptoms of nausea and vomiting that do not resolve with medications, we can perform an endoscopy and aspirate fluid from the balloon to make it smaller and well-tolerated. This avoids unnecessary removal of the balloon. On the other hand, when a patient hits a plateau around 3 months post Spatz3 balloon placement, we can perform an endoscopy and add more fluid to the balloon to make it larger and restore the restriction which allows the weight loss to resume and makes it more likely for the patient to achieve their weight loss goal. The Spatz3 weight loss program also includes continued support and dietitian follow-up televisits to make sure the weight loss success is maintained long-term.


Do I qualify for a gastric balloon?

The ideal patient for a gastric weight loss balloon is someone with a BMI between 30 and 40 who is ready to make the necessary diet and lifestyle changes and who is willing to adhere to the weight loss program. The BMI requirements are not strict and may vary on an individual basis. A gastric balloon can certainly be placed in a patient with a BMI higher than 40 depending on their specific weight loss goals and medical condition. The gastric balloon may sometimes be used as a bridge to another weight loss intervention. The weight loss balloon can be used in combination with prescription weight loss medications such as the GLP-1 agonists. The gastric balloon is also an ideal low-risk procedure to achieve the required weight loss before orthopedic surgery, particularly knee and hip replacement surgeries.

Gastric balloons can also be placed in patients whose BMI falls under the “overweight” category (between 25 and 30) if they have not been able to reach their weight loss goals with diet and exercise. A gastric balloon may provide the necessary decrease in the weight to help improve certain weight-related medical problems like diabetes, high blood pressure, sleep apnea, and fatty liver. It can help prevent such conditions in patients at risk due to a family history of obesity-related medical problems.

Intragastric balloons are contraindicated in any patient with a previous history of bariatric surgery or stomach surgery of any kind. Gastric weight loss balloons are also contraindicated in patients with eating disorders such as bulimia or binge eating disorder.


What are the benefits of the gastric balloon procedure?

Gastric balloons can provide very significant weight loss results, which in turn translate into significant health benefits as we discussed above. But there are also several advantages to the gastric balloon procedure that may be appealing to many patients.

  • Gastric balloon placement is an outpatient procedure that does not require hospital admission. You go home the same day.
  • Placing a gastric balloon in the stomach is not surgery. It does not involve any incisions and does not leave any scars.
  • The gastric weight loss balloon is a very low-risk procedure with an extremely low complication rate.
  • Gastric balloons are fully reversible. They can be removed at any time. The gastric balloon is only kept in the stomach temporarily.
  • The gastric balloon does not involve changing your anatomy in any way.
  • The balloon placement does not require general anesthesia. It is done under sedation.
  • Recovery after intragastric balloon placement is very fast. You take 2-3 days off only.
  • The gastric balloon cost is significantly lower than the cost of bariatric surgery.
  • The gastric balloon procedure can result in rapid weight loss.
  • With the gastric balloon, you can lose 3 times more weight than with diet and exercise alone. Most patients lose at least 10%-15% of their total body weight.



Digestive Care Specialists, with The Silhouette Clinic, bring endoscopic weight loss procedure options including the Orbera balloon and Spatz3 balloon to our patients in Virginia, Maryland, and Washington, DC. We also offer these procedures to patients who come to us from all over the US. The initial evaluation and the follow-up visits can be done as virtual visits. Patients need to come for their procedure, and they stay locally so they are seen in the office in person the next day, and after the visit, they can fly home.


If you are struggling with your weight and you need help starting a successful weight loss journey, reach out to us now as our team is ready to give you all the support you need to achieve the best weight loss results with no surgery. Call us now at: (301) 288-1319, or schedule a virtual consult online.