New non-surgical weight loss options have emerged in the treatment of obesity. Many patients avoid surgery for many reasons: fear of “going under the knife,” high costs, risks, and associated mortality.

Most patients with mild to moderate obesity (BMI 30–35) do not qualify for bariatric surgery and are left without a real alternative to their disease.

The most popular non-surgical alternatives are endoscopic gastric sleeve and gastric balloons.


Non-surgical options are specially designed for patients with mild to moderate obesity, or those with severe obesity (BMI 40) who don’t want to undergo bariatric surgery.

They cost lessreduce the risks, are safe and effective.

There is no need for an operating room (OR) or general anaesthetic. Also, no wounds or scarring!

These types of procedures can also be seen as a jump-start in your weight loss journey. Some patients take it as the first stage to lose weight before going “under the knife”.

The non-surgical weight loss methods take the same principle of restrictive bariatric surgery to make you lose weight.

There are two options available:

  • Endoscopic gastric sleeveRemodel the stomach using endoscopic suturing devices, so that the internal surface of the stomach is folded and the capacity is reduced by up to 70%.
  • Gastric balloonsThe surgeon inserts a deflated balloon into your stomach through your mouth, and then it is inflated with saline water, so itreduces the stomach’s capacity.

Advantages of Weight Loss Non-Surgical Procedures

They don’t require you to go into an operating room. Your surgeon can perform them and give you the discharge on the same day!

Everything is done under sedation (no need for intubation) with a shorter recovery time.

Besides, you won’t have abdominal incisions or wounds, and for the most part, they are reversible. In fact, the gastric balloon removal is done after six months.

Are Non-Surgical Weight Loss Procedures Safe?

Non-surgical weight loss methods are among the safest choices available in the market. They carry risks similar to any routine endoscopy, with a mean rate of adverse events and complications of 2,2%.

In any case, you could present mild symptoms after the procedure, such as abdominal pain, cramps, nausea, or vomiting. Still, these symptoms resolve in a few hours or days with proper medication.

Efficacy of Endoscopic Options

Patients can have a significant mean body weight loss of up to 20% after 24 months, with sustained results over time.

Weight regain can occur after the gastric balloon, but patients always remain at a lower weight than before the procedure.

It is important to know that long-term weight loss results depend on the patient, and if they made big changes in their lifestyle. The bigger the changes, the bigger the weight loss!

The Swallowable Gastric Pill Balloon

This new alternative consists of a swallowable balloon that doesn’t require surgery or endoscopy for insertion or removal.

It is like a tiny capsule attached to a thin tube. You just have to swallow the capsule with water. This is easy to be done, but your doctor can help you with it in case it gets difficult.

Once the capsule is in the correct position in the stomach, your doctor will fill the balloon with 500-550 mL of liquid. No surgery, no pain, no sedation or anesthesia!

This device is designed to naturally empty through a release valve after around 16 weeks of treatment. After that time, the deflated balloon goes through your intestines, and it is naturally excreted. So, there is no need for endoscopy or surgery to remove the gastric balloon!

However, specialists in the ServiDigest clinic do not recommend Elipse balloon. The list of possible complications posted on the manufacturer’s website is significant.

Among the main risks, there is the possibility of not removing the balloon at the end of the 16-week treatment. Of course, this implies that the patient will have to undergo surgery to ensure removal.

On the other hand, the Orbera balloon offers more guarantees and less risk. It is the safest, non-surgical weight loss treatment. So far, more than 277,000 ORBERA365 balloons have been implanted worldwide.

Is Gastric Pill Balloon Effective to Lose weight?

After one year, patients can have a total weight loss from 10.9% to 12.8%. This weight loss procedure is beneficial for patients with mild obesity, below BMI of 35.

It has a good safety profile with less than 0.2% of serious adverse events, with a very similar rate as conventional gastric balloons.

During the treatment, the patient will re-educate his eating habits to maintain weight loss after removing the balloon. If necessary, team of specialists in endocrinology, nutrition, dietetics and / or psychology will propose a program of weight loss maintenance.

How Do Weight Loss surgical procedures Work?

Bariatric surgery is a successful treatment to lose weight, especially in patients with a BMI greater than 40, or greater than 35, with associated medical conditions.

There are different types of weight loss surgery, like gastric sleeve, gastric bypass surgery, and adjustable gastric band.

The Malabsorptive Method

This method is used with the gastric bypass, where our gut and/or stomach are modified so that food is not fully absorbed.

In this case, a small stomach pouch is created and connected to the intestines. This limits the calorie intake, and makes changes in gut hormones that suppress hunger and induce satiation.

The Restrictive Method

Examples of this method are the gastric band and the gastric sleeve.

In the gastric band, a band is placed around the top of the stomach creating a small pouch, so the shape of the stomach is reduced.

On the other hand, with the sleeve gastrectomy, a portion of the stomach is removed, so it ends up thinner and with the shape of a banana.

With this method, the reduced capacity leads to satiation by slowing the food passage from the stomach to the intestines. This means that you feel full in a shorter time, causing a change in your food intake.

This makes you more conscious of the amount of food you eat, so you retrain your brain and eat smaller portions!

A Final Word

Non-surgical weight loss options are considered effective tools.

However, a weight care strategy is needed to maintain their long-term effect and impact obesity-related diseases. This includes an intense diet plan with caloric control, lifestyle changes, and exercise. After all, they are considered the foundation of weight loss therapy.

No matter the procedure, it’s all about changing your mindset. You can have a smaller stomach due to a restriction method, but if you fill it with chocolate or junk food, you will gain weight!

Why choose Servidigest Barcelona (Spain) ?

Servidigest is a center specialized in the digestive system, endocrinology, nutrition, dietetics, obesity, digestive and metabolic surgery.

The clinic is run by Doctor Josep Merlo Mas, a recognized authority in the treatment of diseases of the digestive system, and in metabolic, nutritional and obesity diseases.

The medical coordinator of  the Servidigest clinic’s Obesity Surgery Service is Doctor Eduard Mª Targarona Solercurrent president of the Spanish Association of Surgeons (AEC).

Servidigest Barcelona clinic (Spain) is made up of a team of highly professional and scientifically trained specialists. Its facilities are equipped with the most advanced medical and surgical instruments.

Other articles that may interest you – External links – Bibliography

Bazerbachi, F., Vargas, E., & Abu Dayyeh, B. (2019). Endoscopic Bariatric Therapy: A Guide to the Intragastric Balloon. American Journal Of Gastroenterology114(9), 1421-1431. doi: 10.14309/ajg.0000000000000239

Vargas, E., Rizk, M., Bazerbachi, F., & Abu Dayyeh, B. (2018). Medical Devices for Obesity Treatment. Medical Clinics Of North America102(1), 149-163. doi: 10.1016/j.mcna.2017.08.013.

Hedjoudje, A., Abu Dayyeh, B., Cheskin, L., Adam, A., Neto, M., & Badurdeen, D. et al. (2020). Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis. Clinical Gastroenterology And Hepatology18(5), 1043-1053.e4. doi: 10.1016/j.cgh.2019.08.022

Singh, S., Hourneaux de Moura, D., Khan, A., Bilal, M., Ryan, M., & Thompson, C. (2020). Safety and efficacy of endoscopic sleeve gastroplasty worldwide for treatment of obesity: a systematic review and meta-analysis. Surgery For Obesity And Related Diseases16(2), 340-351. doi: 10.1016/j.soard.2019.11.012

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    ServiDigest Spain, Barcelona. Digestive system, bariatric surgery, Intragastric balloon. Sleeve, Endoscopic stomach reduction