An Auckland clinic is offering obese Kiwis the chance to lose weight and feel full without resorting to stomach stapling.
One in three New Zealand adults are obese, making us the third-fattest nation in the world behind the USA and Mexico.
As many patients struggle to get in shape through conventional diet and exercise regimes, Remuera's MacMurray Centre has introduced a non-surgical weight loss system to help fight the epidemic - but there are risks involved.
The procedure involves a gastric balloon which can be inserted in 20 minutes and makes people feel full faster.
A soft, silicone balloon is inserted down a patient's throat, placed in the stomach, filled to the right size with sterile salt water and taken out six months later.
MacMurray Centre director Dr Alasdair Patrick said the Orbera balloon took up about a third of a person's stomach once inflated and helped to control over-eating.
"The person starts eating and they quickly feel full. It really does change their behavior," he said.
"They learn how to eat smaller meals. If you think about people carrying all that extra weight, they find it difficult to exercise. This gives them a second chance."
The product is part of a growing international trend of non-surgical weight loss options. A similar product, the Elipse Balloon, which is available overseas, can be swallowed like a pill and filled using a thin catheter. After about four months it spontaneously bursts and is excreted.
However, the US Food and Drug Administration issued a warning about such devices earlier this month, stating there had been seven unanticipated deaths that occurred in patients with liquid-filled intragastric balloon systems in the last 18 months - five of them with the Orbera system.
The agency said the root cause and incidence rate had not yet been established, nor had the deaths been definitively attributed to the devices. The organisation recommended close monitoring of patients with the devices.
Patrick said it was five cases out of 277,000 and none were definitively due to the procedure.
"These are often morbidly obese people who have significant health problems. When you take 277,000 of these sorts of patients there is a good chance that, unfortunately, some may have an unexpected event that may well have happened whether they had a balloon inserted or not," he said.
Patrick said he always warned patients of the risks and would inform future patients of the FDA warning but believed the benefits outweighed the risks, particularly because performing gastric bypass surgery on obese people was also risky.
Patrick said people using the Orbera technology could expect to lose three times as much weight as diet and exercise alone.
People typically lost 10-15kgs, about 10 per cent of their body weight, in the six months it was in place and 70 per cent of people kept the weight off, he said.
During the six months it was in place and the six months following, patients worked with weight loss experts on a personalised plan to adopt new eating and exercise habits.
Patrick said the procedure had been used to treat about 220,000 people around the world over the last 20 years and he believed Kiwis could benefit from it.
"The biggest problem we are facing in New Zealand is obesity. It's hard to believe we are the third most obese country in the world," Patrick said.
"Obviously because it's such an epidemic in New Zealand we need things to fight that."
Considering all the issues caused by obesity, including heart disease, strokes and diabetes, it was worse than cancer, he said.
Patrick said the clinic already had 10 patients enrolled and in various phases of the procedure, which costs at least $8850.
Anyone over 18 with a Body Mass Index between 30 and 40 was eligible but had to show they were determined to see it through.
"The person has to be motivated to understand that this is their second chance. The person has to be committed."
One patient signed up for the procedure when he realised, while planning a family holiday, that his weight meant he could not do the things he wanted to with his children.
He still had a month left until the balloon was removed but had already dropped down from 132kg to 114kg.
Dunedin School of Medicine dean and childhood obesity specialist Barry Taylor said gastric balloons had potential because they were less invasive and cheaper than bariatric surgery but more research was needed first.
More work was needed to reduce the risk and to study the long term outcomes for patients, he said.
Clinical trials did not yet have any long term data to show whether patients kept the weight off a few years down the track, he said.
Gastric balloon weight loss
• A soft balloon is inserted down a patient's throat and inflated in their stomach to make them feel full.
• Doctors using the procedure say patients typically lose10-15kgs - about 10 per cent of their body weight - and 70 per cent keep the weight off.
• An independent expert says gastric balloons have potential and are cheaper than surgery but the long term effects are not yet known.
• The cost of the programme in New Zealand starts from $8850.