BMI – Page 4 – watercress words by Dr Aletha

Today I am answering a medical question about my recent post on a new option for weight loss without using drugs or invasive surgery.

The ReShape Integrated Dual Balloon System was approved by the U.S. Food and Drug Administration in July 2015. The device can be offered to adults with

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

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

ReShape Dual Balloon — The balloon sitting in the stomach. The esophagus is at the top entering the stomach.

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

My reader asked if people with heartburn, reflux or a hiatal hernia can use the device safely and effectively. So first let’s understand what these mean.

Heartburn should probably be called “esophagus burn”. It’s that painful sensation in the chest due to acid from the stomach flowing backwards into the esophagus- that’s called reflux, or gastro-esophageal reflux, aka GERD (the D is added to call it a Disease if it’s frequent, persistent, or severe).

A hiatal hernia is related to GERD but not the same thing. To enter the stomach, the esophagus passes through a hole or hiatus in the diaphragm – the large flat muscle that separates the chest from the abdomen. Sometimes this hole becomes stretched so much that part of the stomach gets pulled up into the chest (where it should not be). This enlargement is called a hernia, in this case a hiatal hernia.

In many cases a hernia is associated with reflux of stomach contents but the person may not experience heartburn. Or,a person can have reflux and heartburn without the hernia.

Here is an overview of heartburn from FamilyDoctor.org.

Thanks to Pixabay for this nice illustration of the digestive tract.

digestive organs — the human digestive system

Now to answer the question.

ReShape Medical writes on the web site that the device should not be used if the hiatal hernia is larger than 5 cm, about 2 inches. Even with a smaller hernia, it should not be used if reflux symptoms are severe and persistent.

Persons with any condition affecting the esophagus, stomach or intestines, or previous surgery in these organs probably should not consider this weight loss method. Unfortunately, since so many people experience gastrointestinal disease, this method’s use will be limited.

But there are other weight loss options so just because this one won’t work, don’t give up trying. Here are some other ideas to consider if you want to lose weight.

breaking up with junk food

using weight loss medication

how motivation helps manage weight

Thanks for asking and please, ask another medical question soon.

This post has been extensively updated at this link and you can also visit the post links at the bottom of this page.

Are advanced weight management options right for you?

So who should consider advanced weight loss options? Anyone whose weight is excessive enough to be a health problem.

by Aletha Cress Oglesby, M.D. October 14, 2020September 26, 2022

I have written about several approaches to weight loss. First and always is 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, which I have discussed previously, and surgery.