The gastric balloon procedure (aka, “endoscopic intragastric balloon”) leaves 1 to 3 inflated silicon balloons in the stomach for 6 months, making less room for food. As a result:
- You will feel full sooner while eating, so you will eat less and lose weight
- You will lose about 30% of their excess weight in 6 months (when the balloon(s) are removed)
- A patient who is 100 pounds overweight will lose 30 pounds in six months
- Your health will improve, including improvement for diabetes, joint/bone disease, and heart-related issues
Read the sections below for everything you need to know about the gastric balloon procedure.
TABLE OF CONTENTS
Click on any of the topics below to jump directly to that section
- How the Balloon Works
- Weight Loss
- Health Benefits
- Cost & Insurance
- Types of Balloons
- Preparing for the Procedure
- Diet And Life After
- Balloon Removal
- Gastric Balloon Vs Other Weight Loss Procedures
- Start to Finish
- Test Your Knowledge
- Patient Community & Expert Advice
- Find a Balloon Surgeon
- A deflated balloon is inserted through your mouth and down the esophagus
- The balloon is expanded in your stomach
- The expanded balloon causes you to feel full sooner while eating, so you eat less and lose weight
Why the Gastric Balloon Works
- Between 1 and 3 inflated balloons in the stomach (depending on the balloon type chosen) leave less room for food and cause patients to feel full sooner and eat less.
How the Gastric Balloon Procedure Is Performed
The gastric balloon procedure is performed differently depending on which balloon type you choose:
The Orbera and ReShape gastric balloon procedures usually takes no more than a half hour to perform (compared to about 2 hours for gastric sleeve), and most patients are out of the hospital on the same day.
Once you are set up in the treatment room, following are the steps:
- Your throat will be numbed with a special spray. The numbing sensation may feel strange, but it will help your throat tolerate the instruments used in the procedure. If you wish, you can also ask for an injection to make you feel sleepy, but these options will be discussed with you beforehand.
- After you are comfortable, the nurse will insert a plastic mouth guard between your teeth to keep your mouth open for the scope.
- The scope will be passed through your mouth and into your stomach. This will not be painful, and you will be able to breath without worry. The doctor may also need to pass some air down the scope to have a clear view. This too can be a strange feeling, and it may make you want to belch.
- The scope will be removed.
- The deflated balloon will be passed into your stomach and inflated with either air or saline solution.
- The scope will be passed into your stomach one final time to double check that the balloon is in the right position and properly inflated.
The Obalon balloon procedure is the same as Orbera and ReShape above, except:
- The balloon is swallowed in pill form (3 balloon pills swallowed one at a time over 3 months) rather than being inserted with an endoscope.
- A scope is not used until the Obalon balloons are removed.
- You will lose up to one-third of your excess weight in 6 months
- For example, if you are 5’4″ and weigh 220 lbs, you will lose about 25 lbs. in 6 months
- If you are 5’9″ and weigh 300 lbs, you will lose about 40 lbs. in 6 months
The average gastric balloon patient loses a moderate amount of weight very quickly after the procedure:
- Month 3: Approximately 15% of excess weight
- Month 6: Approximately 30% of excess weight
Actual weight loss could be higher or lower.
The most popular types of balloon must be removed after 6 months, so long-term weight loss depends entirely on the patient’s diet and lifestyle choices. In other words, gastric balloon should not be viewed as a “long-term fix.”
In fact, some patients use the balloon to lose weight before having a more involved procedure like gastric sleeve. More involved procedures have a lower complication rate when patients weigh less before surgery, so you may want to discuss this option with your surgeon.
- A gastric balloon may improve your diabetes, cardiac health & joint/bone issues
Gastric balloon patients are more likely to see health improvements than people of similar weight who do not have the procedure.
While studies are limited, one of the broadest was a 13-year study of 261 gastric balloon patients across multiple bariatric centers (6). It documented the following improvements 3 years after patients received the balloon:
|Patients with Health Condition
|Decreased from 15% to 10%
|Decreased from 20% to 18%
|High Cholesterol (hyperlipidemia)
|Decreased from 32% to 21%
|High Blood Pressure (hypertension)
|Decreased from 29% to 16%
|Joint/Bone Disease (osteoarthropathy)
|Decreased from 25% to 13%
Or, you can click here to learn more about obesity-related health problems.
- A body mass index (BMI) of 30 – 40 is required
You could be a good candidate for the gastric balloon procedure if you:
- Are at least 18 years of age
- Have a body mass index (BMI) in the following ranges by country:
- For some types of balloons, such as the ReShape Balloon, you must have a health risk associated with obesity (also known as a “comorbidity”) like diabetes, high blood pressure or sleep apnea. For other balloon types, like the Orbera balloon, no comorbidities are required.
For a list of frequently asked questions about qualifying, see our “Do I Qualify For Weight Loss Surgery?” page.
- On average, the cost is $8,150
- The gastric balloon is not covered by insurance
- You can get a medical loan to pay for the procedure
- Tax savings can help lighten the burden of payment
The average gastric balloon cost in the United States is $8,150.
It is usually not covered by insurance, although your doctor may be able to get some of the costs covered.
The price can often be reduced through tax deductions and special doctor-specific discounts.
See our Gastric Balloon Cost page for more information.
- There are 3 types of gastric balloons available in the U.S. (Orbera, ReShape, & Obalon)
- The procedure takes 20 to 30 minutes
There are currently 3 types of gastric balloons to choose from in the United States: Orbera, ReShape, and Obalon. Several other types, including the Spatz balloon, are available in other countries or are still in the development process.
- Take the proper steps to improve your outcome
Your doctor and their office will work closely with you to prepare for your gastric balloon procedure, including:
- Conduct a pre-procedure health assessment, where you will be asked questions about your medical history and medications.
- Review your surgical history, as some complications can arise if you’ve had prior procedures on your stomach.
- Order certain tests like an ECG, x-ray, and blood tests.
- Instruct you to fast (no food) for at least 24 hours before surgery, with nothing to eat or drink 12 hours before surgery.
- You will leave the hospital on the same day (outpatient)
- 3 days until you are “fully recovered”
After the procedure, gastric balloon patients usually:
- Leave the hospital and return home the same day.
- Have someone who is willing and able to drive them home and take care of them for at least 24 hours. The patient’s throat will probably be sore following the procedure since the balloon was inserted through the mouth.
- Have fully recovered and are back to work within 3 days.
- You will be on a 14-day transition diet
- You won’t have many diet restrictions
- The balloon will help you achieve better diet & lifestyle habits
- The balloon will be removed after 6 months
Life with the gastric balloon will be very similar to life before, with a few exceptions:
- You will feel full sooner while eating, causing you to eat less and lose weight
- If food sticks to your balloon, you may experience vomiting. To reduce this risk, you should avoid foods that are likely to stick to your balloon, like pasta, and sip water after you eat to rinse your balloon.
- Regularly attending online or in-person weight loss surgery support group meetings (luckily, many are free) can be a huge help and is highly recommended.
The following sections give you an idea about what to expect after surgery.
Food & Drink: Your 14-Day Diet Transition Schedule
Improving your food choices and lifestyle habits will be the most important change after the procedure. The gastric balloon provides a great opportunity to “jumpstart” a longer-term diet and exercise program. However, since it is not a permanent solution (no more than 6 months to one year), many patients wisely use this time to change long-term habits.
Your surgeon’s dietitian or nutritionist, and sometimes a personal trainer, will help get you on track for long-term success. Here is what your diet transition will look like:
|Clear Liquids Only
In the first 24 hours, you should only drink clear liquids. Your dietitian will probably recommend you drink:
Additional recommendations may include:
|Days 2 through 7
For Days 2 through 7 after surgery, you must still maintain a liquid diet, but you can begin to include non-clear liquids. Try to sip about 8 cups (2 liters) a day with no more than 3 – 3.5 ounces (100 ml) in one sitting.
Additional recommendations may include…
|Days 7 through 14
|Pureed Food Diet
About a week after surgery, you will switch to a pureed food diet. Your doctor will work with you regarding the exact timing and what foods you should be eating.
This diet will likely consist of pureed lean protein foods, such as fish, poultry, eggs, cheese, or dairy and soy products. These should always be accompanied by high ratios of pureed fruits and vegetables.
After your balloon is removed, your surgeon will discuss options such as continuing your new diet and exercise regimen, replacing your balloon with a new one, or potentially transitioning to a more permanent type of weight loss surgery.
Exercise: 2.5 hours per week, spread out over 2 to 4 days
Exercise is almost as important as your diet when it comes to long-term success:
- Patients who exercise regularly lose more weight over the long-term
- Physical and mental health benefits are incredible
How much exercise do you need to for noticeable results?
While no studies exist for the gastric balloon procedure, one study of gastric bypass patients found that 2.5 hours per week resulted in 5.7% greater excess weight loss (16).
To help you stay on track, block out time to exercise at the same times on the same days of the week.
Also, spread your 2.5 hours per week out over 3 or 4 days (in other words, 30 to 45 minutes 3 or 4 days per week). This will make it less intimidating to get started each day and will help you build endurance.
There should be 3 main goals of your exercise routine:
- Endurance – walking, stationary bike, and especially swimming
- Flexibility – a good stretching routine. Yoga is best since it incorporates proper breathing and uses your own body weight to build strength
- Strength – exercise balls, weights, and yoga
Your Brain: Careful About Food Addiction, New Mentality Will Change Behavior & Relationships
Our bodies secrete certain hormones that tell us when we’re hungry. Junk food may override those hormone signals by overstimulating our reward centers. This is just like the way our bodies and brains react to an addictive drug.
You may have food addiction if your desire for food takes priority over other important parts of your life, such as:
- Personal health
- Your appearance
- Avoiding obesity related health issues like hypertension, sleep apnea, or diabetes
If left unchecked, food addiction can lead to obesity. If not addressed before surgery, it can also lead to weight regain.
To find out if you may be suffering from food addiction, take our Food Addiction Quiz.
Relationships After Weight Loss
Being thinner again, or being thinner for the first time, may be a shocking experience. Many patients express amazement at:
- Less obesity discrimination. For example, strangers tend to be nicer to thinner people.
- Being treated with more respect
- Getting more romantic interest from others
- Building deeper relationships by being able to physically keep up with kids and more physically fit friends
- Getting more compliments from others
- Increased self-confidence and the effect that has on others
- Improvements in quality of sexual life (17)
But there may be negatives to being thinner as well.
People who you’ve known for a long time will not be used to the way you look and may not know how to act around you. For example:
- How will overweight friends or family members feel when you’re losing weight but they are not?
- Will your new healthier diet and smaller portion sizes make meals with others awkward?
- Could intimacy with your spouse or partner be affected?
- Could your spouse or partner become jealous now that others are noticing you more?
- How will your coworkers react? Should you even tell them you are having surgery?
- Will your friends or family make it difficult for you to stay on track by making bad diet choices?
- Could your new self-confidence create conflict with people who are used the “old” you?
And what about the new “skinny lens” you see the world through? For example:
- Would this person be treating me the same way if I hadn’t lost all this weight?
- How do I handle obesity discrimination now that I’m on the “other side”?
Be prepared for both the good and the challenging “shocks” of weight loss following your gastric balloon procedure.
For real life experiences and advice from other patients, see our Relationships After Weight Loss surgery page.
- You will be required to remove the balloon from your stomach after 6 months
The gastric balloon is not designed as a long-term fix. Because of the risk of it interfering with your stomach, the balloon is usually removed after 6 months. However, it could be left in place anywhere from 12 weeks to 1 year, depending on your results and the type of balloon you receive.
Since the balloon procedure is temporary, it is usually used in tandem with one or both of the following:
- A managed diet and exercise program – After removal, it is recommended you stick with a managed weight loss program, and then maintain your newly established diet going forward. Most practices combine the balloon with a lifestyle management program for 6 months after the removal of the balloon. This will ensure you maintain the weight you lost while the balloon was in place.
- An additional bariatric procedure, like the gastric sleeve or Lap-Band, which is performed after the balloon is removed. Any weight loss that results from the balloon will reduce the risk of complications and increase the likelihood of long-term success of a more involved bariatric procedure.
It is also possible to have another balloon inserted after removal. However, because the balloon is used in tandem with a diet and exercise program your surgeon will likely ask you to wait a little while to determine whether there are less invasive ways to maintain a healthy weight.
A qualified surgeon will help you make the best choice.
Gastric Balloon Removal Procedure
The gastric balloon removal procedure takes about 20 to 30 minutes and is very similar to the insertion procedure for the Orbera, ReShape, and Spatz systems (Obalon uses swallowed pills for balloon insertion):
- No food 24 to 48 hours before surgery (depends on surgeon)
- No food or drink 12 hours before surgery
- Scope and instrument passed through mouth to deflate balloon(s)
- Balloon is removed through the mouth
- Return home the same day
- Mild & temporary side effects are possible
- There is a low risk of complications
- You can regain weight once the balloon is removed
The intragastric balloon is relatively low-risk and issue-free. However, as with any medical procedure, there are potential risks and side effects.
Gastric Balloon Side Effects
Cramps, Nausea, & Vomiting – Because your stomach will be readjusting to the presence of the balloon, in the first couple weeks after the procedure you will probably experience some combination of cramps, nausea, and possibly vomiting.
After the first couple of weeks, if food sticks to your balloon, you may experience vomiting. To reduce this risk, you should avoid foods that are likely to stick to your balloon, like pasta, and sip water after you eat to rinse your balloon.
Bloating – Some people also report feeling bloated. Most likely this is from the feeling of the balloon in the stomach, however, if you are concerned, speak with your surgeon’s office. Don’t let this feeling discourage you – the feeling is probably an indication that the balloon is doing its job.
Rare Gastric Balloon Complications
More serious health issues are possible during the course of gastric balloon treatment.
The FDA & Gastric Balloon
The FDA has investigated gastric balloon health issues and released a statement about balloon products. You can read that statement here.
They found that in rare cases, life-threatening complications may occur, including balloon deflation, gastrointestinal obstruction, ulceration, and gastric and esophageal perforation. Other rare conditions that can be addressed if caught early include acute pancreatitis and spontaneous hyperinflation.
Ask your doctor how you will be monitored for these issues throughout your course of treatment.
Acute pancreatitis is a sudden inflammation in the pancreas. It may occur due to the inflated balloon compressing internal organs. Symptoms can be felt as soon as a few days after the balloon is implanted and include severe abdominal/back pain, bloating, nausea, and loss of appetite.
Early removal of the balloon is likely the only fix. Fortunately, removal of the gastric balloon can be done on an emergency basis if severe complications arise.
Risks associated with any endoscopic procedure and sedation (being “put to sleep”). Many gastric balloon patients do not require full sedation.
If your balloon is overinflated, you may experience strong abdominal pain, abdominal swelling, vomiting, or difficulty breathing as soon as one week after the balloon is implanted. Early removal of the balloon may be required to resolve the issue.
Because the surgeon uses a scope when performing the procedure, there is a slight chance that the scope could puncture the esophagus. However, this is very rare, with one practice saying that in the several hundred procedures they have performed, they have never encountered the problem.
It is possible for the balloon to deflate in the stomach and cause a blockage. This is why one system, the ReShape Integrated Dual Balloon System has two, independent balloons – if one deflates the other will keep the entire apparatus in the stomach. Most balloons are also filled with a dye designed to turn your urine an unusual color (like blue or green) so you know to alert your surgeon about an issue with your balloon.
Stomach Ulcer or Rupture
To reduce the risk of an ulcer, your surgeon will most likely prescribe anti-ulcer medication for the entire time the balloon is in your stomach. Stomach rupture is extremely rare, and usually will only happen if you have already had some kind of stomach surgery, which means that most surgeons you speak with will most likely not be willing to perform the procedure if you have already undergone another stomach procedure.
If, in the middle of the procedure, the surgeon discovers an ulcer or a very large hiatus hernia, the procedure will be ended prematurely by the surgeon for safety reasons.
See our Bariatric Surgery Complications page for more information about each of these points.
Preventing Gastric Balloon Complications
Behaviors that will dramatically reduce the already low risk of gastric balloon complications include:
- Pick a good surgeon
- Follow your surgical team’s advice to the letter
- Talk with your surgeon about the above list of potential complications. A couple of the issues (acute pancreatitis and over-inflation) are recent discoveries and therefore not included in the device labeling, so your surgeon may be unaware of them unless one of their patients has experienced the issue.
- Educate yourself
- Educate your family
- Eat a healthy diet in the months leading up to your procedure
- Plan for at least 3 days of recovery time
- Have an effective support system of friends, family, and weight loss surgery support groups
Unless you establish and maintain a proper diet and exercise program or transition to a more involved bariatric surgery, you will regain all of your weight when your balloon is removed.
See the Diet & Life After section above for more information.
- The balloon results in moderate weight loss, but is safer and temporary compared to other procedures.
Compared with other procedures, the following is generally true about the gastric balloon procedure:
- Lower BMI range for approval (30 to 40 vs the usual 35+)
Cost & Insurance:
- Lowest cost if you don’t have insurance that covers weight loss surgery
- 2nd highest cost if you do have insurance that covers weight loss surgery
- Fewer qualified surgeons available than gastric sleeve, gastric bypass, duodenal switch, and Lap-Band
- One of 4 reversible weight loss procedures (alongside Lap-Band and AspireAssist)
- Quickest and easiest recovery (only procedure with no incisions)
- Temporary solution (no longer than 6 months); all other procedures are intended to be permanent or long-term
- Less weight loss and less dramatic health improvement than the more involved gastric sleeve, gastric bypass, DS, and Lap-Band
- Similar weight loss and health improvement as AspireAssist
- Among the lowest complication and mortality rates
- Fewer diet restrictions than sleeve, bypass, DS, and band (AspireAssist also has minimal diet restrictions)
- Less severe side effects than sleeve, bypass, DS and band
For a more-detailed comparison, see our Types of Bariatric Surgery page.
- 9 steps to long-term weight loss if you undergo the gastric balloon procedure
1. Start Working with a Top Doctor As Soon as Possible
Top doctors will help you navigate the various procedure choices, pre-surgery steps, financing, and insurance options.
- As a first step, many doctors offer a free initial consultation to give you a better understanding of what to expect.
- Many will also provide a free insurance check to help you figure out how much insurance will cover, and, if necessary, appeal any denials or find additional financing. Most insurance companies require you to complete a medically supervised diet and exercise program before they will approve your surgery, so your doctor will set this up for you if you haven’t done so already.
- Your doctor will also push you towards new habits that will be essential to long-term success after surgery. Many doctors will recommend that you attend support group meetings so you can listen to feedback from actual patients.
2. 2 Weeks Out
By 2 weeks out you will have completed your pre-op tests, physical, and any other necessary steps required by your doctor or insurance company. You should have insurance approval (if applicable), and you should be well on your way towards developing your new long-term lifestyle and diet habits.
In the week or two leading up to surgery you’ll be seeing the hospital pre-surgery department for an EKG, blood work, and any last minute instructions or other pre-op tests. You’ll see the doctor one more time for consents, a pre-operative physical, and any last minute details.
The night before surgery you’ll be asked to not eat or drink anything starting at midnight.
3. Surgery Day
The gastric balloon is one of the quickest and simplest of all weight loss surgery procedures. It usually takes no more than 30 minutes to perform, and most patients return home the same day.
You’ll likely need someone to drive you home from the hospital and care for you for at least 24 hours following surgery, and your throat may be sore from insertion of the balloon. Full recovery generally happens within 3 or 4 days.
5. Adjust to Your New Post-Surgery Diet & Lifestyle
Over the course of the first two weeks following gastric balloon surgery you will slowly transition from a clear liquid diet to your “new normal” balloon diet, and you should continue your transition into a more active lifestyle. Your doctor’s dietitian or nutritionist will help you determine an appropriate diet which will look similar to any “healthy diet” with the exception of:
- Avoiding pasta and other foods that may stick to the balloon (to reduce risk of vomiting)
- Needing to sip water after you eat to rinse the balloon (to reduce risk of vomiting)
6. Attend Support Groups Regularly
Regular weight loss surgery support group participation has been found to:
- Reduce post-op recovery time
- Lead to as much as 12% more long-term weight loss
Your weight loss doctor will provide you with details about local support groups.
7. Ongoing Doctor Visits
Your doctor may schedule a follow up visit within the first 2 weeks following surgery to ensure that you are recovering well and to answer any questions. Subsequent doctor visits will be scheduled on an as-needed basis.
8. Remove or Replace the Balloon
The gastric balloon is not meant to be a long term fix. It will be removed between 3 months and 1 year after it was placed, depending on the type you received.
9. Maintain New Diet & Lifestyle to Continue Losing Weight & Avoid Weight Regain
To maintain or increase weight loss and health improvement after it’s removed, your doctor will discuss options such as continuing your new diet and exercise regimen, replacing your balloon with a new one, or potentially transitioning to a more permanent type of weight loss surgery.
Gastric Balloon: Test Your Knowledge
Well-educated patients are more likely to be successful over the long-term. Test your knowledge to ensure that you’re ready to take the next step!
- You can read about other patients’ experiences with the gastric balloon
- You can “ask the expert”
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- You can ask a local bariatric practice for a free insurance check or cost quote
- You should schedule a phone or in-person consultation (both often free), if you are interested in learning more about the gastric balloon
Search the gastric balloon surgeon directory below to find a weight loss surgeon by country and region: