Would you swallow a ‘stone-like’ balloon that can assist you drop some pounds?

Emanuela Torrielli contemplates the massive plastic capsule she is holding in her hand, inspecting it like she would possibly a chunk of meals she is about to swallow – which is strictly what she’s about to do with it.

It’s no imply feat. The capsule is 3cm lengthy and 2cm large, the dimensions you would possibly count on of a horse pill: it additionally has a protracted skinny tube, 2mm large, connected.

Emanuela hopes it can assist her obtain one thing she has not managed her complete grownup life – to drop some pounds and maintain it off.

For contained in the capsule is a collapsed balloon. Once she has swallowed it, will probably be inflated to partially fill her abdomen, and this, it’s hoped, will dramatically reduce her urge for food.

‘I’ve all the time struggled with my weight,’ says the 40-year-old, who lives in Surbiton, South-West London, with husband Lee, 53, a warehouse supervisor. ‘When I attempt a eating regimen, it really works for somewhat bit – I misplaced 10 kg [1 st 8 lb] as soon as. But then I put the burden again on, and that will get to you. It makes you’re feeling like a failure.’

At 13 st 3 lb and 5 ft 5 in tall, Emanuela has a BMI of 30, simply within the ‘overweight’ class. Her intention is to lose 2 st.

‘Turning 40 has made me fear extra about my well being,’ she says.

The capsule incorporates an Allurion balloon, the ‘world’s solely swallowable gastric balloon’, because the maker calls it.

After Emanuela has swallowed it, an X-ray shall be used to verify it is appropriately sited in her abdomen and the connecting tube shall be used to fill it with 550ml of saline. When the balloon is full, the connection valve routinely seals itself. The tube is then eliminated.

The thought is that the balloon makes it unattainable to eat a lot, as your abdomen feels completely full.

It stays in place for 4 months. Over this era, sufferers lose greater than 10 per cent of their physique weight, in keeping with the maker’s personal analysis.

The small spherical valve that self-sealed dissolves after that point and the balloon then empties, earlier than being naturally handed out of the physique.

‘Having the balloon provides you a interval of diminished or no starvation, which provides you a chance to alter your relationship with meals,’ says George Vasilikostas, a marketing consultant common surgeon, who’s overseeing Emanuela’s process at a personal clinic in London.

Good Health was given unique entry to look at Emanuela’s balloon process. It’s uncomfortable viewing as Emanuela has three unsuccessful makes an attempt at swallowing the capsule earlier than Mr Vasilikostas steps in to assist.

‘It’s okay, 50 per cent of sufferers are like this,’ he says, as he pushes a skinny rod by way of the tube connected to the capsule to assist propel it down her throat.

Once an X-ray has confirmed the balloon is in place, the drip that pumps the saline into the balloon whirrs into life.

The inflated balloon is fabricated from polyurethane, a sort of plastic utilized in different implants, and is the dimensions of a grapefruit. I’m given an inflated one to carry and it feels weightier than a bag of sugar.

Tempted? The Allurion balloon has been out there privately since 2018, and prices round £4,000 (Emanuela had hers accomplished free of charge as she works as a supervisor on the clinic the place the process was accomplished), however sufferers are actually having the process on the NHS.

The National Institute for Health and Care Excellence (NICE) authorised it in 2020 in some circumstances for short-term use for many who must drop some pounds for medical causes,

The first two NHS sufferers had balloons fitted final November on the Musgrove Park Hospital, a part of the Somerset NHS Foundation Trust, with an extra three lined up subsequent month. A dozen others are scheduled to have it after that.

Professor Richard Welbourn, a marketing consultant bariatric surgeon on the belief, says they’re utilizing the balloons to make ‘those that are the sickest with the best BMI match for [obesity] surgical procedure. 

‘We are dealing with a tidal wave of illness of weight problems within the NHS and it is getting worse. We are attempting to deal with these sufferers and supply one thing, and this [the Allurion] most likely must be provided extra in future.’

Around 64 per cent of the inhabitants is obese or overweight, elevating their threat of a spread of issues from hypertension to coronary heart illness, sort 2 diabetes, joint issues and sure forms of most cancers.

Last month, NHS Digital revealed that there are actually 3,000 obesity-related admissions to hospital day by day in England – twice as many as six years in the past.

Bariatric surgical procedure (for instance, the place the abdomen is diminished utilizing a band or replumbed in order that fewer energy are absorbed) might be extremely efficient, resulting in weight lack of round 4.98 kg (11 lb) a month, which might be sustained for not less than 4 years, in keeping with a research in PLOS Medicine in 2015 of greater than 3,000 sufferers.

However, these procedures are usually out there solely to these with a BMI over 40, or a BMI over 35 however with an obesity-related situation, equivalent to hypertension or sort 2 diabetes.

Surgery additionally comes with dangers equivalent to an infection, blood clots and a blocked intestine, and requires a hospital keep, with weeks of restoration.

The swallowable balloon (out there in personal clinics to these with a BMI over 27; it is not appropriate if you happen to’ve beforehand had gastric surgical procedure) might sound, on the face of it, a extra interesting possibility – the entire strategy of swallowing and inflating it takes simply quarter-hour.

The maker even claims you’ll be able to have it fitted in your lunch hour – ‘Although for the primary 48 hours most really feel like they’ve overeaten, or some would possibly really feel a bit sick and a few may very well be sick or have a little bit of reflux’, says Mr Vasilikostas. ‘But within the majority of circumstances it settles down in a few days.’

A couple of minutes after swallowing the capsule, Emanuela seems to be somewhat disconcerted as she feels no totally different – then instantly one thing adjustments. Despite having skipped lunch, she says: ‘I really feel as if I’ve eaten certainly one of my massive lasagnes.’

Within half an hour she is driving dwelling with no trace of nausea.

While there are different gastric balloons out there (some sometimes utilized by the NHS), these are put in place – normally underneath sedation – by a surgeon utilizing an endoscope, a small versatile tube with a digicam on the top. This tube can be used six months later to puncture the balloon and take away it.

The Allurion is eliminated with out intervention – though in 2.6 per cent of circumstances, the balloon deflated earlier than the 4 months was up, in keeping with a research within the journal Obesity Surgery in 2023.

The rationale behind its four-month lifespan is that that is lengthy sufficient for individuals to alter their portion sizes and consuming patterns. ‘Humans want not less than 90 days to provoke new life-style adjustments to turn out to be behavior,’ says Dr Shantanu Gaur, CEO of Allurion, who got here up with the concept whereas a pupil at Harvard University medical faculty.

After 4 months, he says, there’s a hazard the abdomen will develop to accommodate the balloon.

Using scales that connect with an app, which sends data to their physician, means the weight-loss might be monitored; if sufferers are usually not assembly expectations, the physician will contact them to see what is likely to be mistaken. There are additionally classes with a dietitian and different specialists.

A multicentre research involving 1,770 sufferers, printed in Obesity Surgery in 2020, discovered they skilled a median 14 per cent drop in weight in 4 months (two of the research staff have been Allurion consultants).

Some had side-effects – 2.9 per cent could not tolerate it and wanted it eliminated with an endoscope, however the authors stated ‘severe hostile occasions have been very uncommon’: these included three circumstances of small bowel obstruction, and one affected person had a perforated abdomen, all requiring surgical procedure.

A evaluation within the International Journal of Surgery in 2018 stated nausea was a ‘very’ frequent side-effect of all forms of gastric balloon placement. 

And the burden loss achieved by gastric balloons was described by researchers on the University Medical Centre Göttingen in Germany, writing within the journal Annals of Translational Medicine in 2020, as ‘modest . . . contemplating that intensive life-style intervention studies a weight lack of 7-10 kg after six months’.

Alex Miras, a professor of endocrinology at Ulster University, who has researched approaches to tackling weight problems, says he has seen ‘individuals do very effectively with gastric balloons – with a weight lack of round 10 per cent after six months’, suggesting they can be utilized, for instance, ‘in sufferers needing to drop some pounds for bariatric surgical procedure’.

But he believes there are more practical long-term options, equivalent to weight-loss medication.

‘The balloon occupies plenty of house and the stress utilized to the receptors within the abdomen is elevated – these receptors ship indicators to the mind that they’re feeling full,’ he says. ‘When the balloon is eliminated, the indicators are misplaced and the individual regains the burden. There is not any legacy impact.’

When given alongside eating regimen adjustments and train, the drug Wegovy can result in a drop of round 15 per cent in physique weight over a 12 months. 

However, Professor Miras says as much as 10 per cent of sufferers can not tolerate such medication attributable to side-effects together with nausea and constipation, and the affected person could must take the drug for all times to maintain weight off.

For the primary few days after swallowing the capsule, Emanuela felt ‘as if I had a stone in my abdomen, like I’d eaten a giant meal – it was not good’, she says. 

But she’s had no nausea and the burden has fallen away – after a month she’s misplaced 5 kg (11 lb). ‘I eat the identical however much less of it,’ she says.

Will she maintain the burden off when the balloon goes? Only time will inform.