This document represents the official recommendations of the American Gastroenterological Association (AGA) and was developed by the AGA Clinical Guideline Committee and approved by the AGA Governing Board. Development of this guideline was fully funded by the AGA Institute with no additional outside funding.
Obesity is a global pandemic, affecting about 40% of adults in the United States. There is a vast area of unmet need with respect to weight-loss interventions, as only 1.1% of eligible patients with obesity are receiving primary bariatric surgery. Endoscopic bariatric therapies have evolved as an attractive tool for weight loss; however, <5% of patients with obesity seeking a weight-loss therapy are aware of endoscopic weight-loss options. Intragastric balloons (IGBs) launched nearly 4 decades ago have recently gained more popularity with multiple new devices introduced into the US market. Although IGBs are a plausible option for patients seeking weight loss, it is essential for providers, patients, and health care teams to understand how IGBs can augment the effect of lifestyle modifications with respect to important patient outcome measures, such as weight loss, improving metabolic parameters, and minimizing comorbid medical conditions. At the same time, it is also important for providers and patients to be aware of the adverse events and tolerability associated with IGBs, given that the devices have evolved over the years and newer models are available in the US market. This guideline can assist both patients and providers in determining whether IGB is a weight-loss option that should be considered and/or pursued in patients with obesity.