AGA issues new guidelines on the use of intragastric balloons for obesity.
After a detailed review of available literature, AGA has released new clinical guidelines recommending the use of intragastric balloons (IGB) for patients with obesity who have not been able to lose weight with traditional weight-loss strategies (through a weight loss clinic with a weight loss coach). This treatment is most successful with accompanying therapy, such as lifestyle modifications, pharmacological agents, sequential IGB or bariatric surgery. These guidelines are published in Gastroenterology by Thiruvengadam Muniraj, Lukejohn W. Day, Edith Y. Ho, Shahnaz Sultan, Levi M. Teigen, Perica Davitkov, Raj Shah and M. Hassan Murad.
Key guideline recommendations:
- Patients with obesity seeking a weight loss intervention should consider intragastric balloon therapy with lifestyle modification over lifestyle changes alone.
- To maintain and augment weight loss, pair IGB with moderate to high intensity lifestyle modification.
- To minimize bleeding risk, treat patients undergoing IGB therapy with proton pump inhibitors (PPIs).
- To avoid nausea, sedate patients for the IGB placement with anesthetics associated with low incidence of nausea, and continue anti-nausea medication for two weeks.
- While screening for nutritional deficiencies isn’t needed, providing 1-2 multivitamins after IGB placement is suggested.
- To keep weight off after IGB removal, AGA recommends dietary interventions, pharmacotherapy, repeat IGB or bariatric surgery and that a strategy be determined based on a shared decision-making approach.