Dr Heba Tolba

Gastroenterologist & Hepatologist

Badr Al Samaa Hospital, Al Khoud

FRCPE, MRCP(GASTRO), MRCP, European Board in Gastro, AGA, ASGE, ESGE, IBUS member

Obesity is a complex disease that results from excess accumulation of body fat and may lead to negative health consequences. Obesity increases the prevalence of various diseases, including diabetes mellitus, hypertension, coronary heart disease, sleep apnea, stroke, gastroesophageal reflux disease, gall bladder disease, certain types of malignancy, Polycystic Ovarian Disease, and non-alcoholic fatty liver disease that might lead to liver failure. It is affect persons psychologically and cause them low self-esteem. Moreover, it is also a major avoidable health detriment.

Current therapeutic approaches to obesity are lifestyle changes, pharmacologic treatment, gastric balloons and bariatric surgery. Although intensive lifestyle modification was reportedly associated with only limited weight reduction, when it is combined with weight-loss drugs approved for long-term use, an additional weight reduction of 3%-9% can occur within 1 year. Such drugs are said to improve several cardiometabolic risk factors, but they are also related to harmful adverse effects. Although new obesity medications have recently been approved and introduced, they are associated with issues of safety and high costs.

Weight-loss surgery provides the most sustained and effective therapeutic choice for obesity. Accessible methods include the adjustable gastric band, Roux-en-Y gastric bypass, or sleeve gastrectomy. Regardless of its proven effectiveness, only 1% of obese patients eligible for the surgical procedure choose to undergo it. The major issues with surgery are difficult accessibility, high costs, patient non-preference, and significant morbidity and mortality. Although its associated mortality has decreased considerably, the complication rate in the early and late stages of the bariatric procedure persist at 17%, starting with palpitations, multiple vitamin deficiencies, pregnancy –related complications, gall bladder stones to major surgical risks as fistula or post surgical infections.

Therefore, minimally invasive and effective methods are needed for the treatment of obesity. As such, endoscopic bariatric treatment was recently introduced. It includes intragastric balloons, gastroplasty techniques, aspiration therapy, and gastrointestinal bypass sleeves.

Among them, the intragastric balloon has been the most frequently used in practice and the most studied for obesity treatment. It is associated with significant efficacy in body weight reduction and relief of co-morbid disease symptoms. Anatomically, this treatment is based on gastric space-occupying effects that increase the feeling of satiety and may also affect gut neuroendocrine signaling. The simplicity of the intragastric balloon procedure may account for its widespread role in obesity treatment and its applicability to various degrees of obesity.

Meanwhile, achieving the target weight loss needs dedicated team, that supports the patient and establishes physical healthy activity with a variety of diet advices and clinics follow up during the period of the treatment.

Dr Heba Tolba has been practicing intra-gastric balloon treatment for weightloss for many years at Badr Al Samaa Hospital, Al Khoud with promising results. She lays emphasis on healthy lifestyle, by adapting physical wellbeing schedules and good dietary habits, for effective results and long term impact of the treatment.