Intragastric Balloon for Obesity Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background and aims: Intragastric balloon (IGB) is a minimally invasive and reversible endoscopic option for treating obesity. This systematic review and meta-analysis compared the effectiveness of IGB versus standard medical therapy (SMT) for obesity management, including studies with a minimum treatment duration of 6 months. Subgroup analyses were performed based on IGB type, baseline mean body mass index (BMI), and the use of pharmacological therapy in the SMT group. Methods: We searched for randomized controlled trials (RCTs) in MEDLINE, EMBASE, and Cochrane Library databases. Outcomes were evaluated at 6, 9, and 12 months after the initiation of treatment. A random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI) for continuous outcomes. Results: We included 15 RCTs (1,961 patients). Compared to SMT, IGB significantly improved the percentage of excess weight loss at 6 months (MD 16.80; 95% CI 9.22-24.38), 9 months (MD 14.36; 95% CI 7.67-21.04), and 12 months (MD 13.10; 95% CI 10.43-15.77). IGB also showed superior results in percentage of total weight loss, absolute weight loss, and BMI reduction at all time points compared to SMT. There were significant subgroup differences for some outcomes according to IGB type and baseline mean BMI. Conclusion: In obese adults, IGB is more effective than SMT for weight loss at 6, 9, and 12 months.