Obesity

Gastric balloon offers weight loss hope

From Thursday's Globe and Mail (Includes correction)

Kyriaki Antoniou of Chatham, Ontario recently underwent a new weight loss procedure which inserts a balloon into the stomach. Since the procedure a month ago she has lost over 20 pounds. (GEOFF ROBINS/Geoff Robins/The Globe and Mail)

It was her daughter's recent wedding photos that did it. Kyriaki Antoniou had tried everything to lose weight over the years, including spending more than $5,000 on Jenny Craig, but she kept losing and regaining the same 30 or 45 pounds. She couldn't stand to look at herself in those photos.

"I was so depressed," says the Chatham, Ont.-based 49-year-old.

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It didn't help that her family business is running a pizzeria.

So when Ms. Antoniou saw a magazine ad about a new gastric balloon procedure, she took it to her family doctor immediately. The $8,000 treatment, offered under the Canadian brand name Jump6, involves the insertion of a gastric balloon into the stomach via a tube through the esophagus. The balloon is then inflated with water and left in place for six months. The theory: Because the balloon takes up stomach space, patients feel full and eat less.

Ms. Antoniou's doctor gave her the okay, since the procedure was less invasive than others, such as gastric bypass surgery. It also involved lifestyle consulting for a full year.

After three weeks, she has lost more than 16 pounds from her 204-pound frame.

"I feel fantastic," she says. "I'm not hungry because my stomach is full. And I have back-up support."

Sanjeev Kaila, the Sarnia plastic surgeon who consulted with Ms. Antoniou in advance of her procedure, and the medical director for the whole Jump6 program, says the new balloon offers some of the benefits of more invasive weight-loss operations, but with the added boost of access to a dietitian, a physical trainer and a psychologist. Patients lose an average of about 40 pounds, he says.

"The balloon is like a cast," he says. "A cast takes pressure off the bone so it can heal. The balloon fills you up so you feel full, allowing your body and mind to redo themselves."

Indeed, obesity experts say that without a serious lifestyle makeover, gastric balloon patients have been shown to gain the weight back.

"Success hinges on the willpower of the individual and whether they can make the transition to more permanent habit changes over that six months," says diabetes and obesity expert David Lau, a physician and professor of medicine at the University of Calgary.

Robert Dent, who performs bariatric surgery as the medical director of the Ottawa Hospital Bariatric Centre of Excellence, says there is little scientific evidence that the gastric balloon will result in long-term success.

"Is it better than Weight Watchers? Maybe," he says. "But we don't know that."

Still, on the face of it, Dr. Dent says, offering a tamer version of more severe gastric surgery combined with the lifestyle counselling may be a good combination.

"This gives them the skills for keeping it off and gives them the encouragement by using a little surgical assist."

The balloon, trademarked the Orbera and manufactured by U.S.-based Allergan, which makes medical products ranging from breast implants to Botox, was approved by Health Canada in 2006. The U.S. Food and Drug Administration has not yet approved it, so about 20 per cent of the business at the four Ontario clinics offering the procedure is from the United States, according to Mario Cortis, the CEO of Canadian Gastric Ballooning Inc., which distributes the balloon under the Jump6 brand.

Experts such as Dr. Lau say that gastric procedures are becoming important tools for treating many of the chronic conditions associated with obesity, including diabetes and high blood pressure. Some restrict the size of the stomach and others alter the way the digestive system absorbs calories and nutrients.

Costs range from about $15,000 for a procedure that squeezes the stomach with a band to $25,000 for the gold-standard procedure called the Roux-en-Y bypass, which reduces the size of the stomach and rearranges the small intestine. It is the only gastric surgery covered by provincial health plans.

These procedures are currently considered for people with a body mass index over 40, or over 35 if they have additional conditions such as diabetes.

The Orbera gastric balloon, however, is recommended for a wider range of patients, starting with those considered merely overweight, with a BMI of 27 or higher.

A recent Canadian Institute for Health Information survey reported a 92-per-cent increase in bariatric procedures performed in Canadian hospitals between 2004/2005 and 2008/2009 - which added up to 2,385 procedures in total. Women are 80 per cent of the patients and their average age is 43.

As obesity rates continue to rise in Canada, the demand will likely increase, too. About 400 people have gone through the Jump6 program in 2 1/2 years, and the clinics are currently performing 40 to 50 procedures a month.



Ms. Antoniou is ecstatic about how the balloon has jump-started her own weight loss. She plans to shed about 45 pounds and be well on her way to keeping it off by her 50th birthday next May.

"This has changed my whole life," she says. "I'm not going to give up."

Editor's Note: Sanjeev Kaila is a plastic surgeon in Sarnia. He did not perform Ms. Antoniou's procedure. Inaccurate information appeared in the original version of this story.