Weight-Loss and Metabolic Outcomes of a Swallowable Fluid-Filled versus an Adjustable Intragastric Balloon in Adults with Overweight or Obesity: A Retrospective Single-Center Study with 12-Month Weight Outcomes.

INTRODUCTION

Intragastric balloons (IGBs) improve weight and metabolic parameters, but structurally different devices are rarely compared within one center and are conventionally assessed at very different time points. We compared a swallowable fluid-filled IGB with an adjustable IGB, both at the end of treatment and at a common 12-month horizon.

MATERIALS AND

METHODS

Retrospective single-center analysis of adults completing IGB treatment. Weight, glycated hemoglobin (HbA1c), fasting glucose, lipid profile and blood pressure were recorded before and at the end of treatment; weight was also recorded 12 months after placement. The primary outcome was percentage total weight loss (%TWL) at end of treatment. Between-device differences were adjusted for baseline value, age, sex, diabetes and dyslipidemia and by propensity weighting, and metabolic comparisons were corrected for multiple testing.

RESULTS

Of 357 patients treated, 239 were analyzed (133 swallowable, 106 adjustable; 76.6% women); attrition before analysis was far higher in the adjustable group (48.5% vs. 11.9%). Both devices reduced weight, HbA1c and atherogenic lipids and raised high-density lipoprotein cholesterol. At end of treatment the adjustable balloon achieved greater %TWL (10.2 ± 4.2% over ≈ 12 months vs. 8.9 ± 4.0% over ≈ 4 months; adjusted difference 1.27%, 95% CI 0.20 to 2.34). At 12 months, swallowable-group %TWL had fallen to 6.6 ± 7.1% and the difference widened to 3.6% (95% CI 2.2 to 5.1). No between-device difference in metabolic change survived correction for multiple testing. A tipping-point analysis showed the end-of-treatment difference to be fragile to the observed attrition, whereas the 12-month difference was not.

CONCLUSION

Both IGBs produced meaningful weight loss and metabolic improvement, but comparison between them is strongly time-dependent: the swallowable balloon's short-term advantage per month of dwell was not maintained at 12 months. Incomplete adjustable-group follow-up means the device comparison should be read as an upper bound. Metabolic improvement was similar between devices and not proportional to weight loss.