Allurion Ballon: A Medical Innovation To Treat Obesity Without Surgery

Based on the National Health and Morbidity Survey (NHMS) 2023 report, around 54.4 percent of Malaysian adults were categorised as overweight or obese.

Its findings reflect a continued upward trend in the obesity rate over the past decade, surging by nearly 10 percent since 2011.

According to the latest data from ‘The World Factbook’ (2016-2024) by the Central Intelligence Agency, Malaysia ranks second in Southeast Asia, after Brunei, for the highest proportion of obese citizens.

Experts attribute it to the sedentary lifestyles and unhealthy eating habits of Malaysians, adding that obesity exposes them to chronic diseases such as diabetes, heart disease and hypertension.

 

Prof Datuk Dr Nik Ritza Kosai Nik Mahmood, a consultant in gastrointestinal and obesity surgery at Hospital Canselor Tuanku Muhriz (HCTM) here, said the rising obesity rates require serious attention as a significant portion of national funds is spent on treating diseases that are preventable.

While a healthy diet and regular exercise regime help with weight loss and management, people who can afford it may also opt for treatments such as bariatric surgery to shed their excess weight, thanks to advancements in medical technology.

“Over the past decade, demand for bariatric surgery has been on the rise, driven by increased awareness of the health risks and complications associated with obesity,” Dr Nik Ritza Kosai told Bernama in a recent interview here.

He explained that several bariatric surgical procedures are available, such as vertical sleeve gastrectomy, mini-gastric bypass and Roux-en-Y gastric bypass.

“All three procedures are performed using the laparoscopic technique (minimally invasive surgery).

“These procedures work by altering how the body processes food to reduce calorie absorption, directly limiting stomach capacity and rerouting a part of the small intestine to decrease the absorption of calories and nutrients,” he said.

 

However, as noted by Dr Nik Ritza Kosai, an increasing number of people are now opting for an innovative, non-invasive treatment, namely the swallowable intragastric balloon (IGB).

According to him, this procedure is recommended for individuals with a body mass index (BMI) of 27.5 and above, particularly those with severe obesity and others who are unable to achieve weight loss through diet and exercise.

“The IGB is a device inserted into the stomach either via endoscopy or by swallowing a special capsule. It works by limiting food intake and inducing a sense of fullness more quickly,” he said, adding the entire procedure takes only 10 to 20 minutes.

Elaborating on this weight-loss innovation, Dr Nik Ritza Kosai said there are various types of IGBs but only the Allurion balloon does not require an endoscopy for insertion.

“All a patient has to do is swallow a capsule, and once the balloon is inflated with 550 millilitres of water, it remains in the stomach for four months. After that, the balloon will naturally deflate and exit the body through the digestive system during bowel movements.

“The balloon is made of polyurethane or elastomer polymers, which are durable and flexible and designed to withstand the stomach’s internal pressure. The risk of balloon rupture is very low, making this procedure safe and simple,” he said.

 

The presence of the balloon in the stomach makes the patient feel full more quickly, sometimes after consuming just a quarter of a plate of food.

“When a calorie deficit occurs in the body, it burns more calories and fat, thereby helping the patient to lose weight,” he explained.

The Allurion IGB procedure, however, is not a quick-fix solution to obesity even though it has been proven to reduce body weight by 10 to 15 percent. As stressed by Dr Nik Ritza Kosai, patients must still commit to making lifestyle changes, including increasing physical activity and maintaining a controlled calorie intake.

“Try to reduce foods that contribute to weight gain – this is the most important step. And, exercise more frequently,” he advised.

He said the main purpose of this procedure is to reduce stomach capacity, making individuals feel full even with smaller portions, and help control appetite, thereby facilitating weight loss efforts.

Pointing to data derived from a one-year (2021-2022) analysis of 486 patients at a high-volume bariatric centre in Malaysia who underwent the swallowable intragastric balloon procedure, Dr Nik Ritza Kosai reported that after four months, patients experienced an average weight loss of 10.5 percent. Even after a year – despite the balloon no longer being in the stomach – weight loss continued to up to 13.7 percent of the original body weight.

 

Meanwhile, HCTM bariatric surgeon Dr Loo Guo Hou said patients undergoing the IGB procedure must follow a strict dietary regimen to ensure the treatment’s effectiveness and prevent complications.

“This includes observing a full-liquid phase for the first three days (after the procedure is done), during which patients are allowed to consume only clear fluids such as plain water, fat-free soup, sugar-free juices and isotonic drinks to allow the stomach to adjust to the presence of the balloon,” he said, adding patients are required to consume formula milk from the fourth to the seventh day.

During the semi-liquid phase (Day Eight to 14), patients are introduced to soft foods such as porridge, low-fat yogurt and fruit purées, with portion sizes controlled to prevent discomfort or nausea.

“In the soft food phase (third week), foods like boiled eggs, steamed fish or boiled vegetables are added to the diet in small quantities. Once they reach the regular food phase (fourth week), patients can return to a normal diet but are advised to choose low-fat, low-sugar and high-fibre foods,” he added.

 

Nur Amalina Elias, a 33-year-old civil servant, who is among the patients who underwent the IGB procedure at HCTM, lost four kilogrammes in two months.

On why she opted for IGB, Nur Amalina, who weighed 90 kilogrammes before the treatment, said: “I’m still young but I already suffer from knee pain, which makes it difficult for me to perform prayers. Moreover, my attempts to control my food intake were unsuccessful.”

However, she noted that her weight loss progress, following the IGB procedure, was slower and less impressive due to knee pain, which made exercising challenging.

Aqilah Yunus, 30, an administrative staff member at HCTM, said she experienced a remarkable weight loss of 23 kg. When she underwent the IGB treatment in January 2023, she weighed 114 kg. Today she weighs 89.5 kg.

“I saw results in the first week itself. Over four months, I reduced my sugar intake while doing exercises like brisk walking and now I feel much lighter. Climbing stairs is no longer a problem,” she said.

Syahirah Aqilah, 32, another HCTM employee who also had the same procedure done in August 2023, said her weight dropped from 82 kg to 68 kg over a 16-month period.

“In the first week itself, I lost three kg, followed by another two kg. I continued to lose more weight over the subsequent weeks,” she said, adding that while the IGB treatment is simple, it requires training and discipline to control one’s appetite.

“Portion control, eating (smaller meals) frequently and adhering to expert advice are the keys to success,” said Syahirah, who aims to reach her target weight of 60 kg by this month.

“Complete adherence to the plan recommended by dieticians and experts will produce great results. Weight loss becomes faster when combined with suitable exercises.”