The end of the 20th century and the beginning of the 21st century, in the industrialized world, are characterized by an abundance of energy-rich, available, and cheap food, along with the development of technologies that allow achieving various goals with minimal physical effort, leading to a severe obesity epidemic.
Obesity and excess weight are conditions that pose a significant risk of serious illness and even death. Obesity is the most common disorder in developed countries, with an estimated 1.6 billion people suffering from excess weight, of which over 400 million are considered obese, and these numbers are continually rising.
Obesity affects people of all ages, including children, adolescents, and adults, and it is prevalent across all segments of society. In the United States and the Western world, approximately 50-60% of the adult population suffers from excess weight with a BMI above 25 or severe obesity with a BMI above 30. Around 18% of adults and about a quarter of children are classified as overweight. In Israel, the data is similar, with every fourth child considered overweight.
The World Health Organization has declared obesity as the number one health problem worldwide. The cause of obesity is not entirely known, but it results from an imbalance between energy intake and expenditure.
Several factors contribute to this imbalance: genetic and hormonal factors (PYY3-36, CCK, GLP1, Ghrelin, GIP), the number of fat cells in the body, behavioral factors, lack of physical activity, improper nutrition, medications, and more.
The assessment of excess weight is based on the calculation of the Body Mass Index (BMI), which is the ratio of weight to height and body surface area. A BMI up to 25 is considered normal, up to 30 indicates excess weight, above 30 signifies obesity, and above 40 indicates morbid obesity.
Morbid obesity is defined as a BMI above 40 kg/m² without accompanying diseases or a BMI above 35 with significant comorbidities such as hypertension, coronary heart disease, respiratory syndromes, diabetes, osteoarthritis, fatty liver, hyperlipidemia, gallstones, depression, tumors (ovarian, uterine, breast, etc.), and more.
In these cases, surgery is the most effective treatment. The benefits of surgery include rapid weight loss that is maintained over time and a reduction in associated diseases. However, the surgery's complication rate is 3-20%, with a 1% mortality rate.
In light of these facts, less invasive and safer endoscopic technologies have been developed, although the weight loss results are less rapid and modest.
Among these treatments, the oldest and more common one is intragastric balloon insertion.
The appropriate candidates for endoscopic treatments are high-risk surgical patients, non-severely obese patients who did not respond to medical and/or nutritional treatment, patients unwilling to undergo surgery, and those classified as superobese with an exceptionally high surgical risk. The treatment serves as a bridge to improve their clinical condition before surgery.
The intragastric balloon treatment was introduced in 1982. The idea of introducing a foreign body into the stomach occupies space, delays stomach emptying, and induces a sense of fullness. This allows patients to adopt new, healthier eating and behavioral habits. The most common balloon is the BIB - Bioenteric Gastric Balloon.
The balloon is inserted into the stomach in a deflated state through endoscopy under mild sedation, and then it is filled with saline solution up to 500 cc, with the addition of 10 cc of blue dye (methylene blue) to indicate if there is leakage when it appears in the urine. It remains in place for six months and can be removed by endoscopy with special forceps. The procedure takes about 20 minutes.
The side effects are mainly intolerance to the balloon (gastroesophageal reflux, nausea, vomiting, and abdominal discomfort) or leakage. Balloon leakage from the stomach to the intestines is an extremely rare phenomenon.
According to various studies, this treatment can achieve an average weight loss of about 17 kg. A high percentage of patients improved their metabolic disorders and others mentioned previously. Studies have shown that during follow-up after balloon removal, about 31% regained their weight, 40% regained up to half of the weight, 20% maintained the weight loss, and 9% continued to lose weight thanks to the new habits they adopted. Throughout the treatment period, the patients are closely monitored by a multidisciplinary team, including a gastroenterologist, dietitian, psychologist, and physical activity guide.
To enhance the treatment's results with the balloon, we have established a multidisciplinary team and an unusual collaboration with the Sha'arei Zedek Medical Center, enabling patients to engage in morning physical activity as an addition to other activities.
For more information, call: 02-6666616.