A morbidly obese man who could walk no more than 20m at a time can now live a normal life thanks to a new weight-loss treatment introduced to New Zealand less than three years ago.
The Orbera gastric balloon has been used to treat more than 100 people since it was introduced in 2015 as a safer, less intrusive option than gastric bands.
Ormiston Hospital gastroenterologist Dr Ravinder Ogra had carried out 45 balloon procedures by May this year but his first patient remains one of his most successful.
When Ogra first saw the 55-year-old in 2015, he weighed 219kg, took six tablets and two doses of insulin a day to control his diabetes, had major blood pressure issues and required a rest after walking 10-20m.
Bariatric surgeons had refused to operate because of the dangers of treating someone with so many complicating factors caused by his weight.
But, the Orbera gastric balloon had just been approved for use and did not require full surgery.
The balloon works by being inserted down the throat and into the stomach where it is inflated with saline solution and left for about six months.
The man agreed to the procedure and lost 54kg. He no longer depended on insulin to control his diabetes and was able to run his business full time again.
Since then, the man has had two other balloons inserted and was planning a fourth treatment.
His weight had fluctuated between treatments hitting 158kg at his lightest, although leading up to his fourth procedure he weighed 190kg – still 29kg lighter than his original weight.
Ogra said the balloons had been a hugely successful in helping obese people lose weight. Of the 45 he had implanted, only three had to be removed early – two people found they could not tolerate it and it had no effect for the third.
The average weight of his patients before the procedure was 133kg and the average weight loss was 16.2kg, he said.
Ogra said it was originally thought the balloon made you feel full faster because it took up space in the stomach but it seemed the real reason was that the balloon delayed the emptying of your stomach.
Ogra stressed that while the procedure had worked wonders for some, there remained a lot of work to be done by the patient.
"Our success seems to be confined to patients who are very motivated to lose weight but also prepared to make a significant lifestyle change and understand that the balloons are only an aide to help them start that process."
While the balloon did help to change the body's metabolism, the lifestyle change had to continue after it was removed which was why each of Ogra's patients also saw a nurse, dietician and psychologist regarding the procedure.
Two other New Zealand centres also offered the procedure.
MacMurray Centre director Alasdair Patrick started offering the procedure last year and had treated more than 50 patients by May with another 25 scheduled to start the programme.
Those patients had seen an average weight loss of 10-15kg, he said.
Patrick said only patients with a Body Mass Index (BMI) between 30 and 40 were eligible for treatment at the MacMurray Centre but Ogra said Ormiston Hospital had no strict limit. Ogra had treated patients with BMIs ranging from 30 and 94.
Christchurch Weight Loss had also done a handful of Orbera procedures.
The product was part of a growing international trend of non-surgical weight loss options.
However, the US Food and Drug Administration issued a warning about such devices earlier last August, saying there had been seven unanticipated deaths in patients with liquid-filled intragastric balloon systems over 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.
Patrick defended the safety of the product saying they were five cases out of 277,000 and none were definitively due to the procedure.
Gastric balloon weight loss
• A soft silicone 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 lose 10-15kg.
• The cost of the programme in New Zealand starts from about $8500.