Weight-loss balloon you swallow like a pill to avoid surgery
Late last year, Kayleigh Fellows tipped the scales at 19st. at 5ft 6in, with a body mass index (BMI) of 42 (severely obese), she realised it was time for something more drastic than another diet.
‘I’d tried lots of diets including a slimming club where I lost a stone, and a juice and shake diet which ended up giving me gallstones,’ says Kayleigh, 28, a business administration manager, who lives in West Drayton, Middlesex.
‘It was always the same: I’d lose a few pounds, then put it all back on again and more. Over the past six years, though, my weight became a serious health problem as I put on 5st. My knees began to hurt, and I’d been warned by my doctor that I was at risk of developing high blood pressure and high cholesterol.
‘I was a size 20 and couldn’t find clothes to fit and felt self-conscious when I went out with my slim friends. I tried to exercise at the gym, but I was embarrassed at people watching me wobble.’
So Kayleigh decided to look into bariatric — weight loss — surgery. the most common surgery is gastric banding, where a silicon band is used to reduce the size of the stomach, or gastric bypass, which works in a similar way but also bypasses some of the intestines, cutting the calories absorbed by the body.
However after reading about the need for a general anaesthetic and, in some cases, hours of surgery, Kayleigh was wary. ‘I’d also heard of people having quite a lot of side-effects from surgery and didn’t think I could put up with that,’ she says.
another option was a gastric balloon, inserted into the stomach under anaesthetic or sedation via an endoscopy — a long, thin tube inserted into the gut with a camera on the end. the balloon is filled with saline, making it impossible to eat anything but very small servings. after six months or a year, it is removed, the same way it was placed.
then Kayleigh found out about a new less invasive option — a gastric balloon in the form of a ‘pill’ you swallow.
the elipse balloon is made from a thin form of plastic that comes in a capsule with a catheter, or thin tube, attached to it.
the patient swallows the capsule as they would a large tablet. a surgeon then ensures it is in place using X-ray and fills the balloon with saline via the catheter. the balloon is sealed with a valve and the catheter is withdrawn.
AFter four months, the acidic saline inside the balloon degrades the valve, allowing the saline to leak out harmlessly. the deflated balloon is then naturally excreted from the body.
‘During the four months the balloon is in place patients can lose 15 to 20 per cent of their excess body weight,’ says Samer Humadi, a consultant bariatric surgeon at ashford and St Peter’s Hospital NHS trust in Surrey, who performs elipse insertion privately at Spire thames Valley Hospital in Wexham, Bucks.
‘the procedure only takes about 30 minutes, so people can literally have it done in their lunch hour,’ he adds. a study involving 38 patients, published last year in the journal Obesity Surgery found after four months the participants lost on average 12.7kg or 11.6 per cent of their body weight.
they also had a significant reduction in metabolic syndrome — a group of risk factors linked to heart disease, diabetes and stroke, including raised blood pressure, blood fats and blood sugar.
at the end of the four months, 37 balloons were excreted naturally, and one had to be removed by endoscopy — although why was not clear.
Similar results were found in a U.S. study involving 34 patients published in 2016 in the journal endoscopy. after four months they lost on average 10 per cent of their body weight and their waist circumference was reduced by 8.4cm. Side-effects included nausea and vomiting (these are usually temporary).
Heartburn affects around one in ten people with the balloon because it causes the stomach to empty more slowly and this causes a build-up of stomach acid.
Shaw Somers, president of the British Obesity and Metabolic Surgery Society, who also performs elipse insertion, emphasises the balloon itself is not a ‘permanent cure’ for obesity. ‘It’s just a way to kick-start weight loss — you still have to make dietary and lifestyle changes to lose weight in the longer term,’ he says.
Kayleigh had the balloon treatment last November.
‘I swallowed the capsule without too much difficulty,’ she says. ‘It took five minutes for them to fill the saline bag once it was in place. It was all quite straightforward. I was told I could eat immediately afterwards but the dietitian recommended I stick to soups for the first few days.
‘Initially I felt so full, as if I’d drunk ten jugs of water, but after four days I was able to eat again, but in smaller quantities. I could only manage portions about a third of what I had eaten previously.’
that dramatic cut in intake has resulted in her losing almost three stone. She now weighs 16st 2lb and her BMI is down to 36.5.
‘I’ve lost 25in all over and I can fit into a size 16 comfortably,’ says Kayleigh.
‘I was given the drug omeprazole to protect against heartburn for two weeks prior to the procedure and for a few weeks afterwards.’
the elipse isn’t cheap — it is only available privately in the UK and costs £3,200 — although this is less than the £4,000 that it costs to have an older-style balloon that stays in place for a year before it’s removed. Other weight-loss surgery, such as gastric bands, can cost between £5,000 and £10,000.
But question marks still remain about the long-term effectiveness of the new balloon. Studies so far have only looked at the shortterm results.
a one-year pilot study involving 12 people found they had lost more than 14 per cent of their body weight when the balloon was excreted, but after 12 months they had regained weight — with average weight loss falling to 5.9 per cent, according to the results published in the journal Surgery for Obesity and related Diseases.
Mr Somers says half of those with an older-style balloon regained all the weight they lost after two years.
‘research on other weight-loss balloons has shown that in the longer term they are no more effective than dieting alone,’ says Dr amanda Squire, spokesperson for the British Dietetic association, adding: ‘there is no easy fix for weight loss — it’s about changing your whole lifestyle.’
tam Fry, chair of the National Obesity Forum, suggests the elipse may help overweight people who are, paradoxically, not fat enough to qualify for bariatric surgery.
In order to meet the criteria for weight-loss surgery in the UK, you need to have a BMI of 40 or more, or a BMI of over 35 and a significant related health complaint such as high blood pressure or diabetes that could be improved with weight loss.
‘Of course, it’s best to try to lose the weight yourself but once you’ve put weight on it can be very difficult to shift,’ Mr Fry says.
‘the balloon is affordable and a good temporary solution for people who want to kick-start their weight loss who don’t want surgery, with minimal risks,’ adds Mr Humadi.
the elipse is only given to people with a BMI over 27; it is not suitable for people who have had previous abdominal surgery, or who have a stomach ulcer or inflammatory bowel disease.
For Kayleigh, the elipse has worked where diets have failed.
‘I’m trying to eat healthily, focusing on high protein and vegetables and some carbohydrates but in much lesser amounts, she says.
‘I’m too full to snack now. If I overeat, I feel so ill with nausea and heartburn I have to go to bed, so I don’t do it any more.’
She hopes to lose another stone and says her loss so far has helped her adopt a healthier lifestyle. ‘I’ve got the confidence and energy to go back to the gym and I’m now going three times a week. I’m confident I will be able to keep this up when the balloon deflates.’
10% Fail to lose expected weight after gastric band