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EDUCATION13 April 2026

Intragastric Balloon Placement

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Duration

30-60 minutes

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Downtime

1-3 days

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Cost

6000 -9000$

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Setting

Outpatient

Overview

An intragastric balloon is a weight loss procedure. It involves placing a soft balloon inside your stomach. It helps you feel full faster and eat less. This procedure is best if you seek subtle weight loss and are willing to adopt healthy eating and exercise.

Candidates


Ideal BMI range: 30–35 kg/m²  Crossan, K., & Sheer, A. J. (2025). Intragastric Balloon. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK578184/

If your BMI is higher (above 40 kg/m²): This procedure can serve as a bridge before major weight loss surgeries like sleeve gastrectomy or Roux-en-Y. Reducing weight first helps lower surgical risks such as blood clots or breathing complications. GÖttig, S., Weiner, R. A., & Daskalakis, M. (2009). Preoperative Weight Reduction Using the Intragastric Balloon. Obesity Facts, 2(1), 20–23. https://doi.org/10.1159/000198243 

If your BMI is lower (27–30 kg/m²): You may still be a candidate if you have an obesity-related condition, such as type 2 diabetes, high blood pressure, or sleep problems, or if supervised diet and exercise programs haven't worked for you. Martins Fernandes, F. A., Carvalho, G. L., Lima, D. L., Rao, P., Shadduck, P. P., Montandon, I. D., de Souza Barros, J., & Rodrigues, I. L. V. (2016). Intragastric Balloon for Overweight Patients. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 20(1), e2015.00107. https://doi.org/10.4293/JSLS.2015.00107

This procedure helps kick-start your weight loss journey, but it's not a standalone solution. Long-term success still requires committing to healthy eating and activity habits.

You should avoid this procedure if you have :

Benefits

6-15 kg weight loss. Edathodu, Z., Khan, S. A., & Peedikayil, M. C. (2025). Comparative Efficacy and Long-Term Outcomes of Intragastric Balloons for Obesity: A Systematic Review and Meta-Analysis. Cureus. https://doi.org/10.7759/cureus.88002 Muniraj, T., Day, L. W., Teigen, L. M., Ho, E. Y., Sultan, S., Davitkov, P., Shah, R., & Murad, M. H. (2021). AGA Clinical Practice Guidelines on Intragastric Balloons in the Management of Obesity. Gastroenterology, 160(5), 1799–1808. https://doi.org/10.1053/j.gastro.2021.03.003 Saber, A. A., Shoar, S., Almadani, M. W., Zundel, N., Alkuwari, M. J., Bashah, M. M., & Rosenthal, R. J. (2017). Efficacy of First-Time Intragastric Balloon in Weight Loss: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Obesity Surgery, 27(2), 277–287. https://doi.org/10.1007/s11695-016-2296-8 Xia, C., Wang, Y., Sun, G., Lei, W., & Liang, D. (2025). The Efficacy and Safety of Adjustable Intragastric Balloon for Weight Loss: A Systematic Review and Meta-Analysis. Obesity Facts, 18(4), 415. https://doi.org/10.1159/000542921

 6.7 Kg greater weight loss compared to lifestyle interventions alone. Amaral, G. de O., Schmitt, J. P., Delgado, L. M., & Meine, G. C. (2025). Intragastric balloon for obesity treatment: Systematic review and meta-analysis of randomized controlled trials. Endoscopy International Open, 13, a26812859. https://doi.org/10.1055/a-2681-2859 Imaz, I., Martínez-Cervell, C., García-Álvarez, E. E., Sendra-Gutiérrez, J. M., & González-Enríquez, J. (2008). Safety and Effectiveness of the Intragastric Balloon for Obesity. A Meta-Analysis. Obesity Surgery, 18(7), 841–846. https://doi.org/10.1007/s11695-007-9331-8

Common Misconceptions

The balloon in my stomach will cause obstruction and prevent food from passing into the intestines. 

The balloon won't cause obstruction if properly inflated. Its diameter is larger than the opening between the stomach and intestines, like a ball that can't fit through a doorway, so it stays safely in place. However, if the balloon deflates (such as when left more than 6-12 months), it may squeeze through the opening and cause an obstruction. 

This procedure will provide permanent weight loss.  

Intragastric balloons are temporary devices. Long-term success depends on patient commitment towards a healthier lifestyle.  

Balloon Types

Two types of intragastric balloons are currently approved by FDA. Both of them are inserted and removed endoscopically. Stavrou, G., Shrewsbury, A., & Kotzampassi, K. (2021). Six intragastric balloons: Which to choose? World Journal of Gastrointestinal Endoscopy, 13(8), 238–259. https://doi.org/10.4253/wjge.v13.i8.238

Orbera

  • clock icon6 months

Total body weight loss: 13.2% Kumar, N., Bazerbachi, F., Rustagi, T., McCarty, T. R., Thompson, C. C., Galvao Neto, M. P., Zundel, N., Wilson, E. B., Gostout, C. J., & Abu Dayyeh, B. K. (2017). The Influence of the Orbera Intragastric Balloon Filling Volumes on Weight Loss, Tolerability, and Adverse Events: A Systematic Review and Meta-Analysis. Obesity Surgery, 27(9), 2272–2278. https://doi.org/10.1007/s11695-017-2636-3

Excess weight loss: 25-38% Abu Dayyeh, B. K., Kumar, N., Edmundowicz, S. A., Jonnalagadda, S., Larsen, M., Sullivan, S., Thompson, C. C., & Banerjee, S. (2015). ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointestinal Endoscopy, 82(3), 425-438.e5. https://doi.org/10.1016/j.gie.2015.03.1964 Imaz, I., Martínez-Cervell, C., García-Álvarez, E. E., Sendra-Gutiérrez, J. M., & González-Enríquez, J. (2008). Safety and Effectiveness of the Intragastric Balloon for Obesity. A Meta-Analysis. Obesity Surgery, 18(7), 841–846. https://doi.org/10.1007/s11695-007-9331-8

This type can't be adjusted

Spatz3

  • clock icon8-12 months

Total body weight loss: 15-16.4% Xia, C., Wang, Y., Sun, G., Lei, W., & Liang, D. (2025). The Efficacy and Safety of Adjustable Intragastric Balloon for Weight Loss: A Systematic Review and Meta-Analysis. Obesity Facts, 18(4), 415. https://doi.org/10.1159/000542921

Excess weight loss: 43-67% Machytka, E., Klvana, P., Kornbluth, A., Peikin, S., Mathus-Vliegen, L. E. M., Gostout, C., Lopez-Nava, G., Shikora, S., & Brooks, J. (2011). Adjustable Intragastric Balloons: A 12-Month Pilot Trial in Endoscopic Weight Loss Management. Obesity Surgery, 21(10), 1499–1507. https://doi.org/10.1007/s11695-011-0424-z Schwaab, M. L., Usuy Jr, E. N., Albuquerque, M. M. de, Moreira, D. M., Derossi, V. O., & Usuy, R. T. (2020). ASSESSMENT OF WEIGHT LOSS AFTER NON-ADJUSTABLE AND ADJUSTABLE INTRAGASTRIC BALLOON USE. Arquivos de Gastroenterologia, 57, 13–18. https://doi.org/10.1590/S0004-2803.202000000-04

The volume can be adjusted by adding or removing saline.

There are other types of balloons that are available but are not approved or discontinued by FDA and we don’t recommend using them. These include:  

  • Approved but discontinued types: Obalon (gas-filled) - ReShape Duo  
  • Not FDA approved: Elipse/Allurion- Heliosphere. 

Risks

 Intragastric balloon is a low-risk procedure that has been used safely in thousands of patients worldwide. Saber, A. A., Shoar, S., Almadani, M. W., Zundel, N., Alkuwari, M. J., Bashah, M. M., & Rosenthal, R. J. (2017). Efficacy of First-Time Intragastric Balloon in Weight Loss: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Obesity Surgery, 27(2), 277–287. https://doi.org/10.1007/s11695-016-2296-8 Imaz, I., Martínez-Cervell, C., García-Álvarez, E. E., Sendra-Gutiérrez, J. M., & González-Enríquez, J. (2008). Safety and Effectiveness of the Intragastric Balloon for Obesity. A Meta-Analysis. Obesity Surgery, 18(7), 841–846. https://doi.org/10.1007/s11695-007-9331-8 Zheng, Y., Wang, M., He, S., & Ji, G. (2015). Short-term effects of intragastric balloon in association with conservative therapy on weight loss: A meta-analysis. Journal of Translational Medicine, 13, 246. https://doi.org/10.1186/s12967-015-0607-9 Most complications are mild and typically resolve within the first week. Serious complications, such as bowel obstruction or a hole in the stomach wall, remain rare. Trang, J., Lee, S. S., Miller, A., Cruz Pico, C. X., Postoev, A., Ibikunle, I., & Ibikunle, C. A. (2018). Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients – A systematic review and meta-analysis. International Journal of Surgery, 57, 22–29. https://doi.org/10.1016/j.ijsu.2018.06.038

Complication

Rate

Nausea 

63%  Trang, J., Lee, S. S., Miller, A., Cruz Pico, C. X., Postoev, A., Ibikunle, I., & Ibikunle, C. A. (2018). Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients – A systematic review and meta-analysis. International Journal of Surgery, 57, 22–29. https://doi.org/10.1016/j.ijsu.2018.06.038 Martins Fernandes, F. A., Carvalho, G. L., Lima, D. L., Rao, P., Shadduck, P. P., Montandon, I. D., de Souza Barros, J., & Rodrigues, I. L. V. (2016). Intragastric Balloon for Overweight Patients. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 20(1), e2015.00107. https://doi.org/10.4293/JSLS.2015.00107 Zheng, Y., Wang, M., He, S., & Ji, G. (2015). Short-term effects of intragastric balloon in association with conservative therapy on weight loss: A meta-analysis. Journal of Translational Medicine, 13, 246. https://doi.org/10.1186/s12967-015-0607-9 Yorke, E., Switzer, N. J., Reso, A., Shi, X., De Gara, C., Birch, D., Gill, R., & Karmali, S. (2016). Intragastric Balloon for Management of Severe Obesity: A Systematic Review. Obesity Surgery, 26(9), 2248–2254. https://doi.org/10.1007/s11695-016-2307-9

Abdominal pain 

58.5%   Trang, J., Lee, S. S., Miller, A., Cruz Pico, C. X., Postoev, A., Ibikunle, I., & Ibikunle, C. A. (2018). Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients – A systematic review and meta-analysis. International Journal of Surgery, 57, 22–29. https://doi.org/10.1016/j.ijsu.2018.06.038 Yorke, E., Switzer, N. J., Reso, A., Shi, X., De Gara, C., Birch, D., Gill, R., & Karmali, S. (2016). Intragastric Balloon for Management of Severe Obesity: A Systematic Review. Obesity Surgery, 26(9), 2248–2254. https://doi.org/10.1007/s11695-016-2307-9 Zheng, Y., Wang, M., He, S., & Ji, G. (2015). Short-term effects of intragastric balloon in association with conservative therapy on weight loss: A meta-analysis. Journal of Translational Medicine, 13, 246. https://doi.org/10.1186/s12967-015-0607-9

Vomiting  

55%  Trang, J., Lee, S. S., Miller, A., Cruz Pico, C. X., Postoev, A., Ibikunle, I., & Ibikunle, C. A. (2018). Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients – A systematic review and meta-analysis. International Journal of Surgery, 57, 22–29. https://doi.org/10.1016/j.ijsu.2018.06.038 Martins Fernandes, F. A., Carvalho, G. L., Lima, D. L., Rao, P., Shadduck, P. P., Montandon, I. D., de Souza Barros, J., & Rodrigues, I. L. V. (2016). Intragastric Balloon for Overweight Patients. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 20(1), e2015.00107. https://doi.org/10.4293/JSLS.2015.00107 Zheng, Y., Wang, M., He, S., & Ji, G. (2015). Short-term effects of intragastric balloon in association with conservative therapy on weight loss: A meta-analysis. Journal of Translational Medicine, 13, 246. https://doi.org/10.1186/s12967-015-0607-9

Heartburn 

50% Martins Fernandes, F. A., Carvalho, G. L., Lima, D. L., Rao, P., Shadduck, P. P., Montandon, I. D., de Souza Barros, J., & Rodrigues, I. L. V. (2016). Intragastric Balloon for Overweight Patients. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 20(1), e2015.00107. https://doi.org/10.4293/JSLS.2015.00107

Acid Reflux  

20.5%  Trang, J., Lee, S. S., Miller, A., Cruz Pico, C. X., Postoev, A., Ibikunle, I., & Ibikunle, C. A. (2018). Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients – A systematic review and meta-analysis. International Journal of Surgery, 57, 22–29. https://doi.org/10.1016/j.ijsu.2018.06.038 

Intolerance and early removal 

5.7%  Xia, C., Wang, Y., Sun, G., Lei, W., & Liang, D. (2025). The Efficacy and Safety of Adjustable Intragastric Balloon for Weight Loss: A Systematic Review and Meta-Analysis. Obesity Facts, 18(4), 415. https://doi.org/10.1159/000542921

Stomach ulcer 

1.1% Xia, C., Wang, Y., Sun, G., Lei, W., & Liang, D. (2025). The Efficacy and Safety of Adjustable Intragastric Balloon for Weight Loss: A Systematic Review and Meta-Analysis. Obesity Facts, 18(4), 415. https://doi.org/10.1159/000542921 

A hole in the stomach wall 

0.5% Yorke, E., Switzer, N. J., Reso, A., Shi, X., De Gara, C., Birch, D., Gill, R., & Karmali, S. (2016). Intragastric Balloon for Management of Severe Obesity: A Systematic Review. Obesity Surgery, 26(9), 2248–2254. https://doi.org/10.1007/s11695-016-2307-9  

Bowel obstruction  

0.8%  Yorke, E., Switzer, N. J., Reso, A., Shi, X., De Gara, C., Birch, D., Gill, R., & Karmali, S. (2016). Intragastric Balloon for Management of Severe Obesity: A Systematic Review. Obesity Surgery, 26(9), 2248–2254. https://doi.org/10.1007/s11695-016-2307-9

Patient can be at a higher risk if they have:

Anesthesia

This procedure uses 2 main types of anesthesia:

Conscious Sedation:

When is it used: This type is used when there is no severe anxiety or strong gag reflex.

How you will feel: You will be relaxed but still conscious, aware of what’s happening, and can respond to questions or instructions.

Deep Sedation

When is it used: Strong gag reflex or high anxiety/low tolerance for endoscopy.

How you will feel: You will be almost unconscious, usually breathe spontaneously, have little to no awareness of the procedure, and usually have no memory of what happened.

General anesthesia is only used in specific situations, like patients with BMI>40 and/or have issues like sleeping, lung or heart issues.

Chapter references

  1. 1
    Crossan, K., & Sheer, A. J. (2025). Intragastric Balloon. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK578184/
  2. 2
    GÖttig, S., Weiner, R. A., & Daskalakis, M. (2009). Preoperative Weight Reduction Using the Intragastric Balloon. Obesity Facts, 2(1), 20–23. https://doi.org/10.1159/000198243
  3. 3
    Martins Fernandes, F. A., Carvalho, G. L., Lima, D. L., Rao, P., Shadduck, P. P., Montandon, I. D., de Souza Barros, J., & Rodrigues, I. L. V. (2016). Intragastric Balloon for Overweight Patients. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 20(1), e2015.00107. https://doi.org/10.4293/JSLS.2015.00107
  4. 4
    Edathodu, Z., Khan, S. A., & Peedikayil, M. C. (2025). Comparative Efficacy and Long-Term Outcomes of Intragastric Balloons for Obesity: A Systematic Review and Meta-Analysis. Cureus. https://doi.org/10.7759/cureus.88002
  5. 5
    Muniraj, T., Day, L. W., Teigen, L. M., Ho, E. Y., Sultan, S., Davitkov, P., Shah, R., & Murad, M. H. (2021). AGA Clinical Practice Guidelines on Intragastric Balloons in the Management of Obesity. Gastroenterology, 160(5), 1799–1808. https://doi.org/10.1053/j.gastro.2021.03.003
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