Informational Articles

Could This Little Pill Be The Answer To Your Weight Loss Problems?

weight loss in a pill

MEGHAN RABBITT

Everyone likes a quick fix—particularly when it comes to weight loss. Now there’s a pill recently approved by the FDA that can mimic a gastric bypass, and it’s helping people shed serious pounds. But like most quick fixes, the pill comes with caveats.

Here’s how the device—called the ReShape—works: You swallow a pill that dissolves in your stomach, leaving behind a gastric balloon. During an outpatient procedure, a doctor fills the balloon with fluid using a thin oral catheter that is snaked down to the stomach. About the size of a grapefruit, the balloon leaves little room in the stomach for food, with the result that you eat much less and lose weight. After six months, the balloon is deflated and then removed through the mouth during another outpatient procedure. A newer version, which is still under review, eliminates the catheter: Called the Ellipse, this pill contains a balloon that inflates on its own and, 6 months later, deflates and passes through the digestive tract.

In a clinical trial of ReShape involving 326 obese patients with a BMI between 30 and 40, patients who swallowed the pill lost an average of 14.3 lbs in 6 months—equivalent to 6.8% of their body weight. In contrast, the control group (who were told they were getting the gastric balloon but received a sham procedure instead) lost an average of 7.2 lbs, or just 3.3% of their body weight. Six months after the balloon was removed, the pill group managed to keep off an average of 9.9 lbs of the 14.3 lbs they lost. Another study published in the journal Obesity Surgeryfound that the balloon improves liver dysfunction and insulin resistance in obese patients.

In early trials, the Ellipse pill has led to a 22-pound loss after 4 months, and significant improvements in triglycerides and A1c levels, which are risk factors for heart disease and diabetes.

What’s The Catch?

gastric pill and nutrition

PHOTO BY IAN HOOTON/SPL/GETTY IMAGES

Without rigorous nutrition and lifestyle coaching, the procedure won’t be effective, according to ReShape. Patients must adopt a healthy lifestyle—exercising more, eating better, and downsizing their meals to several small ones daily. These steps are crucial not only for the procedure to work but to maintain weight loss once the balloon comes out.

Side effects include nausea and sometimes vomiting in the week after the gastric balloon is inflated, though these symptoms only last a few days and can be controlled with medication. While the $9,000 price tag is thousands less than that of bariatric surgery, it’s still too expensive for many people—and the pill isn’t yet covered by insurance.

Those aren’t the only drawbacks, says Garth Davis, MD, the medical director of the Davis Clinic at the Methodist Hospital in Houston, Texas, and a fellow of the American Society for Metabolic and Bariatric Surgery. He worries the procedure might cause patients to develop bad eating habits.

“When this gastric balloon is in your stomach, you can’t eat high fiber foods, which means no big, healthy salads,” he says. “And if you eat too much, you’re just going to vomit. So a patient might say, ‘Well, I can’t eat a salad, but I can drink a milkshake.’ You can see how that might foster really bad eating decisions.”

Should You Consider The Gastric Balloon?

gastric balloon

PHOTO BY DAN BURN-FORTI/GETTY IMAGES

Despite some misgivings, many weight loss surgeons see real potential for the procedure—as long as patients commit to making the lifestyle changes. Abraham Krikhely, MD, a surgeon in the division of minimally invasive, metabolic and weight loss surgery at Columbia University in New York City sees real potential for the pill: “While the gastric balloon is not a long-term solution, I do feel like it can help many of my patients who have a lot of medical problems associated with obesity.” He likes that the procedure is minimally invasive and that most patients can return to a normal, active lifestyle within a few days.

So, who’s an ideal candidate for the procedure? Someone with a body mass index between 30 and 40, which means they’re morbidly obese, says Krikhely. “This is a procedure for patients who need to lose weight quickly,” he says. Candidates include people prepping for actual weight-loss surgery or need an organ transplant: Losing weight can make the surgery safer.

Hooman Shabatian, MD, one of the pioneers in bringing the gastric balloon procedure to the U.S. adds that many of his patients are seeing dramatic results. “More than 220,000 successful balloon surgeries have been performed world-wide. This is a viable option for those looking to lose 30 to 40 pounds,” says Shabatian.

Adds Krikhely: “These gastric balloons are not meant to be the answer; they’re not a long-term solution. However, in conjunction with plenty of support when it comes to educating patients about proper diet and exercise support, it can be an excellent solution.”

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