Update on weight management options

This post has been updated so please choose this link

approaches to weight loss.

First and always are lifestyle changes involving food choices, and eating habits.

Along with that, one needs to start or increase physical activity.

There are many different ways to achieve these, from books, videos, group activities, online programs, counselling and many combinations of these.

For those folks who still can’t reach goal, the next options are weight loss medications, and surgery.

someone standing on a scale
New weight loss options are good news.

Now there are FDA approved options which do not involve drugs or invasive surgery. These medical devices aid weight loss by affecting the amount of food that gets eaten and/or absorbed into the body.

The ReShape Integrated Dual Balloon System was approved by the U.S. Food and Drug Administration in July 2015. . Candidates for the device are

  • Adults
  • BMI 30-40
  • At least one obesity-related condition- hypertension, diabetes, elevated cholesterol

It is a device placed into the stomach by going through the mouth and down through the esophagus through a tube called an endoscope. It takes about 30 minutes and requires on a mild sedative, not general anesthesia. Once in the stomach the “balloons” are inflated; by taking up space in the stomach it can trigger a feeling of fullness.

Patients still continue to follow their eating and exercise plan and the device is removed in 6 months.

Like any medical procedure, there are potential adverse effects including headache, muscle pain, and nausea from the sedation and procedure; in rare cases, severe allergic reaction, heart attack, esophageal tear, infection, and breathing difficulties can occur. Once the device is placed in the stomach, patients may experience vomiting, nausea, abdominal pain, gastric (stomach) ulcers, and feelings of indigestion.

The Orbera Gastric Balloon works in a similar way, with a single silicone balloon. Potential adverse effects are similar to the ReShape.

The Maestro Rechargeable System is implanted under the skin; an intermittent pulse generator delivers an electrical signal to the vagus nerve in the abdomen. The vagus nerve controls stomach action; when slowed down, one feels full sooner and theoretically will eat less.


Another interesting device is AspireAssist.

This is a tube inserted into the stomach, from which a portion of the stomach contents can be “aspirated” (removed) after eating.

This device helped 10 out of 11 people loss 18% of total body weight in one year.

An application has been submitted to the FDA but it has not been approved for use in the United States.

People lost weight with all of these devices largely due to the intensive counseling and support they received along with use of the device.

Obesity is defined using BMI, body mass index, but waist circumference is also important and may be more accurate.

A success story

After gaining weight with her pregnancies, one woman , J.T. ,successfully lost weight with gastric bypass surgery.

Read about the lifestyle changes she made at this article from American Family Physician journal



Many news sources have reported  a recently published study about contestants in “The Biggest Loser” weight loss contest. In this contest, severely obese people have lost huge amounts of weight with strict diets and vigorous exercise.

Unfortunately, the study found that most of them gained most of the weight back over time, due to what the scientists called “metabolic adaptation”, popularly called slowed metabolism. This is discouraging news.

However, they also point out that even though the contestants regained a “substantial” amount of weight in 6 years post competition,

“they overall were quite successful at long term weight loss compared with other lifestyle interventions.”

Even though they regained weight, they still weighed less than when they started.

If you want to read the full report with all the graphs and statistical analysis, here is the link

Persistent metabolic adaptation 6 years after “The Biggest Loser” competition

statues of athletes jumping
Contestants in the Biggest Loser competition exercised several hours daily but did not continue this after it ended.

Finf other posts about weight management at these links (info current as of the publication date)

Obesity and BMI defined

How we should view excess weight 

How effective are weight management programs? 

A success story; how a doctor helped her patient lose weight

When diet alone doesn’t work

How my friend lost weight and inspired others with her example


Author: Aletha Cress Oglesby, M.D.

As a family physician, I explore the HEART of HEALTH in my work, recreation, community, and through writing. My blog, Watercress Words, informs and inspires us to live in health. I believe we can turn our health challenges into healthy opportunities. When we do, we can share the HEART of health with our families, communities, and the world. Come explore and share with me.

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