Obesity Surgery

, Volume 23, Issue 4, pp 515–521 | Cite as

Multi-Centre European Experience with Intragastric Balloon in Overweight Populations: 13 Years of Experience

  • Alfredo Genco
  • Gontrand López-Nava
  • Christian Wahlen
  • Roberta Maselli
  • Massimiliano Cipriano
  • Maria Mara Arenas Sanchez
  • Chantal Jacobs
  • Michele LorenzoEmail author
Original Contributions



The request to lose weight is expanding not only in obese and morbidly obese patients but also in overweight patients affected by co-morbidities as diabetes and hypertension and who do not tolerate diet regimen or lifestyle changes. The aim of this study is a multicenter evaluation of outcomes of intragastric balloon in overweight patients.


Patients (BMI 27–30 kg/m2) treated with a BioEnterics Intragastric Balloon (BIB) between 1996 and 2010 were extracted from the database of the participating centres in Rome (Italy), Liège (Belgium) and Madrid (Spain). Primary endpoints were the efficacy and safety at 6 and 42 months from balloon positioning. Secondary endpoints included resolution of co-morbidities.


A total of 261 patients were included in this study. The most common indication for balloon placement was a psychological disorder (54 %). Mean body mass index (BMI) fell from 28.6 ± 0.4 at baseline to 25.4 ± 2.6 kg/m2 at 6 months and to 27.0 ± 3.1 kg/m2 at 3 years from BIB removal. The mean %EWL was 55.6 % at 6 months and 29.1 % at 3 years. Forty-seven patients (18 %) had complications associated with placement of the intragastric balloon (leak = 28, intolerance = 14, duodenal ulcer = 2, gastritis = 1, oesophagitis = 1, duodenal polyps = 1). The rate of patients with hypertension decreased from 29 % at baseline to 16 % at 3 years. Diabetes decreased from 15 to 10 %, dyslipidaemia decreased from 20 to 18 %, hypercholesterolaemia decreased from 32 to 21 % and osteoarthropathy decreased from 25 to 13 %.


The intragastric balloon is safe and effective in overweight patients, helping to reduce progression to obesity and decreasing the prevalence of a number of important co-morbidities.


Intragastric balloon Obesity Overweight BMI %EWL Co-morbidities 


  1. 1.
    World Health Organization. Factsheet: obesity and overweight.
  2. 2.
    Seidell JC. The impact of obesity on health status: some implications for health care costs. Int J Obesity. 1996;19 Suppl 6:S13–6.Google Scholar
  3. 3.
    Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355:763–78.PubMedCrossRefGoogle Scholar
  4. 4.
    Manson JE, Willett WC, Stampfer MJ, et al. Body weight and mortality among women. N Engl J Med. 1995;333:677–85.PubMedCrossRefGoogle Scholar
  5. 5.
    Jung RT. Obesity as a disease. Br Med Bull. 1997;53:307–21.PubMedCrossRefGoogle Scholar
  6. 6.
    Colditz GA, Willett WC, Rotnitsky A, et al. Weight gain as a risk factor for clinical diabetes in women. Arch Intern Med. 1995;122:481–6.Google Scholar
  7. 7.
    Chan JM, Rimm EB, Colditz GA, et al. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994;17:961–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67:968–77.PubMedCrossRefGoogle Scholar
  9. 9.
    Willet WC, Manson JE, Stampfer MJ, et al. Weight, weight change, and coronary heart disease in women. JAMA. 1995;273:461–5.CrossRefGoogle Scholar
  10. 10.
    NIH Conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991;115:956–61.Google Scholar
  11. 11.
    Messina T, Genco A, Favaro R, et al. Intragastric balloon positioning and removal: sedation or general anesthesia? Surg Endosc. 2011;25:3811–4.PubMedCrossRefGoogle Scholar
  12. 12.
    Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of the intragastric balloon. Obes Surg. 2004;14:991–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Genco A, Bruni T, Doldi SB, et al. BioEnterics Intragastric Balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15:1161–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Lopez-Nava G, Rubio MA, Prados S, et al. BioEnterics® Intragastric Balloon (BIB®): single ambulatory center Spanish experience with 714 consecutive patients treated with one or two consecutive balloons. Obes Surg. 2011;21:5–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Angrisani L, Lorenzo M, Borrelli V, et al. Is bariatric surgery necessary after intragastric balloon treatment? Obes Surg. 2006;16:1135–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Genco A, Cipriano M, Bacci V, et al. BioEnterics Intragastric Balloon (BIB): a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes. 2006;30:129–33.CrossRefGoogle Scholar
  17. 17.
    Genco A, Balducci S, Bacci V, et al. Intragastric balloon or diet alone? A retrospective evaluation. Obes Surg. 2008;18:989–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Genco A, Cipriano M, Bacci V, et al. Intragastric balloon followed by diet vs intragastric balloon followed by another balloon: a prospective study on 100 patients. Obes Surg. 2010;20:1496–500.PubMedCrossRefGoogle Scholar
  19. 19.
    Wadden TA, Sternberg JA, Letizia KA, et al. Treatment of obesity by a very low calorie diet, behaviour therapy, and their combination: a five-year perspective. Int J Obes. 1989;13 Suppl 2:39–46.PubMedGoogle Scholar
  20. 20.
    Patrick K, Calfas KJ, Norman GJ, et al. Outcomes of a 12-month web-based intervention for overweight and obese men. Ann Behav Med. 2011;42(3):391–401.PubMedCrossRefGoogle Scholar
  21. 21.
    Loveman E, Frampton GK, Shepherd J, et al. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technol Assess. 2011;15(2):1–182.Google Scholar
  22. 22.
    Pappachan JM, Chacko EC, Arunagirinathan G, et al. Management of hypertension and diabetes in obesity: non-pharmacological measures. Int J Hypertens. 2011;3:98–105.Google Scholar
  23. 23.
    Williamson DF, Pamuk E, Thun M, et al. Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years. Am J Epidemiol. 1995;141:1128–41.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Alfredo Genco
    • 1
  • Gontrand López-Nava
    • 2
  • Christian Wahlen
    • 3
  • Roberta Maselli
    • 1
  • Massimiliano Cipriano
    • 1
  • Maria Mara Arenas Sanchez
    • 2
  • Chantal Jacobs
    • 3
  • Michele Lorenzo
    • 4
    Email author
  1. 1.Laparoscopic Surgical Department, Medical School“La Sapienza” UniversityRomeItaly
  2. 2.Department of Digestive and EndoscopyMadrid Sanchinarro University HospitalMadridSpain
  3. 3.Centre Hospitalier ChrétienLiègeBelgium
  4. 4.ASL NA 3 SUDU.O.M.LNaplesItaly

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