Another tool in the arms race against obesity | Multidisciplinary

A swallowable balloon is now available to help obese people lose weight.

The Allurion swallowable balloon is touted as a minimally invasive option to bariatric surgery. Speaking at a roundtable discussion, Associate Professor Dato’ Dr Nik Ritza Kosai Nik Mahmood said obesity is fast becoming its own epidemic in Malaysia, with 50.1 percent of adults being overweight and 19.7 percent being obese, and an overall prevalence of 18.9 percent with diabetes. By 2035, it is anticipated that 41 percent of Malaysians will be obese, which will have an impact on the overall cost of healthcare in Malaysia. The balloon, together with other traditional methods of weight management such as lifestyle interventions, counselling, pharmacotherapy, and bariatric surgery, will help in the race to stem this onslaught. Nik Ritza is head of Upper Gastrointestinal, Metabolic and Bariatric Surgical Unit, Universiti Kebangsaan Malaysia.

The balloon can be inserted without endoscopy, surgery, or anaesthesia, and is claimed to be one of the safest methods for long-term weight management. Due to its design, the valve holding the water within the balloon disintegrates at 4 months (give or take a week) and the deflated balloon is either passed out naturally or, in rare cases, vomited out.

Nik Ritza also helms the Kitakurang obesity management programme that is backed by Allurion and K-Talyst, the sole distributor of the swallowable balloon. Kitakurang has an important patient tracking and counselling component that follows and closely monitors every patient for 12 months post procedure. The auxiliary team comprises dietitians and counsellors who track and follow up the patients. The patients also download an app to track their weight and health parameters. Nik Ritza said the follow-up aspect of the programme cannot be overstated, as some patients will go through periods where weight loss seems to stagnate or go up again. The role of dietitians and counsellors is to modify patient behaviour and mentor them in making permanent lifestyle changes for the better. These include food choices, portions control, and exercise decisions.

So far, Nik Ritza has placed the new balloon in over 500 patients, who have collectively lost 5,249 kg in weight. As with all diseases, persons with obesity can relapse. It is important not to give up and understand that relapsing is an acceptable and likely process during weight loss. The most important thing is to continue the efforts and stick to healthier lifestyle decisions until it becomes part of one’s life.

Kevin Toh, managing director of K-Talyst, said: “We mooted the Kitakurang campaign with the sole purpose to ensure sustainable weight management among patients. Under [the campaign], we have successfully inserted more than 1,000 balloons in as many patients. These patients have collectively lost over 10,000 kg. In fact, one of our first patients under Kitakurang has managed to maintain her weight until now, largely due to the change in habits and lifestyle.”

How it works
The swallowable balloon is inserted with the help of an x-ray via a thin catheter. Once the balloon is in place, sterile water is pumped into the balloon until it fills to the desired volume and a quick tug will release the catheter and seal the water within the balloon. Upon insertion of the balloon, the patient will be placed on a liquid diet for a week.

The balloon creates a sense of satiety and reduces the amount of food that can be consumed, thereby reducing the caloric intake of the patient. Patients must be prepared for the side effects eg, nausea, reflux, loss of appetite, and vomiting. However, these side effects are usually transient and are easily controlled with medications including anti-emetics and antacids. These symptoms will usually go away once the patient gets used to the sensation of the balloon.