Kirtan Chauhan, BS1, Violeta Popov, MD, PhD, FACG2
1New York University School of Medicine, New York, NY; 2VA New York Harbor Health System, New York, NY
Introduction: The prevalence of obesity and the medical costs associated with it are steadily rising, both among the adult and adolescent populations. New procedures such as the intragastric balloon (IGB), can provide rapid improvement in overall health to help manage and maintain weight loss with few adverse events.
Case Description/Methods: A 61-year-old male patient with class III-IV obesity and multiple comorbidities had been in discussion with his gastroenterologist for over a year to undergo an IGB procedure. Peak weight was 302 lbs, with BMI of 43 kg/m2. He underwent intensive lifestyle and medical therapy, was started on Liraglutide 1.8 mg daily, with 15 lbs weight loss that plateaued. On his pre-procedure visit, hemoglobin A1C was 9.4, with a weight of 275 lbs and BMI 40.7 kg/m2. An intragastric Orbera™ IGB System (Apollo Endosurgery Inc, Austin, TX, United States) was placed and inflated with 600 ml of saline.
On 2-month follow-up, the patient had lost 34 pounds. A number of his chronic medications, including those for hypertension and diabetes mellitus, were held due to improvement in lab and exam findings. The IGB was removed after 6 months. The patient continued to lose weight and has maintained daily exercise and dietary guidelines. Most recently, the patient’s A1C level has trended down to 6.4%, with a weight of 202 lbs and a BMI of 29.9 kg/m2. Since starting the program, he has lost a total of 101 lbs.
Discussion: This case highlights the dramatic weight loss after a minimally invasive weight loss procedure in conjunction with proper diet and, exercise. The patient lost 27% of his body weight (275 lbs to 202 lbs) and went from class III obesity ( >40 BMI), to an overweight range (25.0–29.9 BMI) with the IGB. Overall, he has lost over 100 lbs with 34.4% total weight loss, making him the “biggest loser” in our program. The effect on the patient’s overall well-being has been extraordinary; over time, he has been able to start a regular exercise and dietary regimen, use less medication or experience remission of his chronic conditions. The typical weight loss expected with a gastric balloon is 10-12%. This patient’s results have far exceeded the expected trajectory. Given the chronicity of obesity, and improvements in health seen with even 5-10% weight loss, a relatively safe endoscopic procedure such as the gastric balloon can significantly improve the health status of patients with obesity and should be considered before more invasive interventions.
Citation: Kirtan Chauhan, BS; Violeta Popov, MD, PhD, FACG. P0771 - THE BIGGEST LOSER: A CASE OF DRAMATIC WEIGHT LOSS ACHIEVED WITH AN INTRAGASTRIC BALLOON. Program No. P0771. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.