Gastric balloon: indications, procedure, risks and follow-up

What a gastric balloon actually does

An intragastric balloon is a soft device placed in the stomach and then filled with liquid or gas, depending on the model. Its presence changes the sensation of fullness and can slow down the emptying of the stomach. You may therefore feel satisfied after smaller quantities, with an intensity that varies from one person to another.

The balloon does not stop calories being absorbed and does not permanently change the anatomy of your digestive system. Energy-rich drinks or frequent eating can limit its effect on your weight. That is why fitting one forms part of a programme of nutritional, behavioural and physical support, with goals adapted to your state of health.

Obesity is a chronic condition with many causes. A temporary device can support one stage of the treatment, but it is not enough to resolve all the mechanisms involved in hunger, in the regulation of weight or in difficulties with food. Drawing that distinction makes it possible to discuss the outcome without blaming someone whose weight goes back up after the balloon is removed.

Endoscopic balloons and swallowable balloons: the differences

The balloon fitted and removed by endoscopy

For an endoscopic balloon, the gastroenterologist uses a flexible tube fitted with a camera, introduced through the mouth. The examination makes it possible to inspect the oesophagus and the stomach, to check that there is no lesion that would rule the procedure out, and then to position the device. It is fitted under sedation or anaesthetic, depending on the protocol and on your situation.

Removal requires a further endoscopy: the balloon is emptied and then extracted with suitable instruments. It has to be planned from the very start of the pathway, at the time limit set for the model in question, often six or twelve months for the endoscopic balloons described by the French Society of Digestive Endoscopy (SFED). The absence of symptoms is not a reason to keep it beyond that period. Early removal may become necessary in the event of intolerance or of a complication.

Some models can be adjusted, others cannot. The exact name of the balloon is therefore a piece of useful medical information, not merely a commercial difference. It determines how long it can be used, the technique for removing it and certain precautions to take if you are seen at another hospital.

The swallowable balloon designed to pass out on its own

A swallowable balloon is swallowed in the form of a capsule attached to a catheter. Its position is checked before it is filled. Some devices are designed to empty after a set period and then to be passed naturally: the French medicines agency (ANSM) gives around sixteen weeks for Allurion. The initial pathway can therefore avoid an endoscopy, but only where the conditions of use for that model allow it.

An endoscopy or surgery may nonetheless become necessary in order to treat a complication or to remove a balloon that is causing problems. Presenting this type of device as a treatment that never requires an anaesthetic or a procedure would therefore be inaccurate. The centre has to be able to arrange that care even if it is not part of the usual course of events.

The labels “swallowable”, “silicone” and “liquid-filled” do not describe mutually exclusive categories. A single balloon may combine several of those characteristics. To compare two proposals, rely on the model, its instructions for use, how it is fitted, how it is removed and the follow-up on offer.

Who can benefit from one?

The decision is taken with a doctor trained in the management of obesity and in endoscopic treatments. It takes account of BMI, of associated conditions, of the treatments already attempted, of your expectations and of digestive risks. The eligibility thresholds vary from one device to another and from one regulatory framework to another; a figure found online does not amount to an indication for you personally.

The ASGE and ESGE recommendations refer to endoscopic treatments combined with lifestyle management in adults with a BMI of at least 30 kg/m², or between 27 and 29.9 kg/m² with an obesity-related condition. These recommendations are conditional and do not replace the restrictions specific to each product, nor the rules of the country where it is used. Your doctor should explain why the balloon being considered matches your situation.

The prospect of a temporary treatment may appeal to some people for whom an operation is not appropriate, or who do not wish to consider one at this stage. In other situations, treatment with medicines or with surgery offers a more coherent strategy. The aim is to choose a stage of the pathway that is genuinely useful, with a plan in place for when the mechanical effect comes to an end.

What BMI cannot decide on its own

Two people with the same BMI may present different risks and different needs. Diabetes, sleep apnoea, a digestive history or an eating disorder all change the assessment. The way your weight has varied over the years and your current treatments also have to be examined.

A psychological difficulty does not automatically rule out every treatment for obesity. It may, on the other hand, call for specific support or for a procedure to be postponed. The interview serves to understand the real obstacles, in particular episodes of loss of control over eating, unrealistic expectations or difficulty getting to appointments once the balloon is in place.

In which situations should fitting be avoided or postponed?

The exact contraindications appear in the instructions for use of the device and have to be checked by the doctor. They may concern previous surgery on the stomach or the oesophagus, an ulcer, certain anatomical abnormalities, an active digestive disease or a risk of bleeding. Plans for a pregnancy, and treatments liable to irritate the stomach, also call for discussion.

Report all previous operations, even ones long ago, along with the medicines and supplements you take. An online consultation does not always make it possible to check the anatomical points that matter. A further investigation may lead to the plan being changed or suspended for your own safety.

A balloon should not be presented as the usual answer to weight coming back on after a sleeve. A stomach that has already been operated on requires a specialist assessment, and a history of gastric surgery is among the contraindications for many devices. The treatment options after bariatric surgery rest on a different kind of work-up.

Before fitting: preparing the months that follow as well

The assessment takes an interest in your habits, in your digestive symptoms, in your associated conditions and in your nutritional state. A dietary consultation sets out how eating will resume and what goals are realistic. Depending on the device and on your medical history, an endoscopy or other investigations may be needed before the final decision.

You need to know which medicines to take, which ones to adapt and who to contact if nausea stops you drinking. Treatment for acidity and anti-sickness medicines are prescribed by the team according to the protocol. They should not be added to, or replaced, on your own initiative, particularly if new symptoms appear.

The follow-up timetable deserves as much attention as the date of fitting. Check the appointments planned, how to reach a doctor, the arrangements for an urgent removal and who is responsible for helping you stabilise your weight. These points have to be concrete, with contact details and appointments, rather than a simple mention of personalised follow-up.

The questions worth asking at the consultation

Ask for the name of the balloon, the maximum period planned, the way its position will be checked and what to do if it deflates. Have the conditions for an early removal set out clearly, including any costs involved. If you live far away, ask how an emergency would be dealt with near your home.

Set out your goals as well, in terms of health and of daily life. The expected result is not limited to a final weight: better mobility or a metabolic improvement may matter just as much. The team should nonetheless remain cautious about the size of the benefit and avoid guaranteeing a number of kilos lost.

The first few days: adapting and staying hydrated

Nausea, cramps, a heavy feeling in the stomach or vomiting can occur once the balloon is in place. Their intensity varies, and some patients tolerate the device poorly. The fact that a symptom is a known one does not mean you should put up with it without medical advice when it becomes significant or when it persists.

Drinks and then food are resumed according to the protocol the team gives you, with a progression through textures adapted to what you can tolerate. Hydration is a central point. Passing very little urine, feeling dizzy or being unable to keep liquids down should prompt you to seek advice quickly, because dehydration may need treatment.

Set aside enough free time after the balloon is fitted and avoid planning an immediate return to the demands of work or a long journey. How quickly you pick things up again depends on your condition, on the medicines you have been given and on the centre’s instructions. After sedation or an anaesthetic, the rules about being accompanied and about driving have to be followed.

Living with a balloon during the treatment

As tolerance improves, your diet has to regain a variety compatible with small portions. Follow-up helps you spread out what you eat, protect your protein intake and recognise when you are full. It also makes it possible to look for a solution if reflux or nausea restricts certain foods.

Useful support starts from the constraints you actually face: unsocial hours, family meals, your food budget or difficulty cooking. It does not rest solely on a list of forbidden foods. The changes built up while the balloon is in place have to be able to continue once it has been removed.

Physical activity resumes gradually according to tolerance and to any associated conditions. It contributes to cardiovascular health, to maintaining strength and to wellbeing, even when the scales move very little. What is recommended may begin with spending less time sitting down and with suitable activity, rather than with an intensive sports programme.

Making follow-up a space for adjustment

Appointments are there so that difficulties can be discussed before they become entrenched. Strong hunger, eating during the night or the gradual avoidance of solid food all deserve to be raised. The aim is to adapt your care and to spot a complication, not to check how obediently you are following a programme.

Treatments for diabetes or for high blood pressure may need adapting if your intake and your weight change. Only the prescriber decides on those changes. A medicine that has become poorly tolerated should be reported, but stopping it abruptly can expose you to other risks.

How much weight loss can you expect, and for how long?

The published results vary according to the balloon, to the characteristics of the patients and to how intensive the follow-up is. An average does not predict the course you will take individually. To compare figures, check whether they describe total weight lost or excess weight lost, and at what point the evaluation took place.

The result at the time of removal does not answer the question of what happens in the long term. Once the effect of the balloon has gone, your sense of hunger and the quantities you can tolerate may change. The programme therefore has to provide for stabilisation, with a medical review if your weight goes back up or if associated conditions remain insufficiently controlled.

Weight can come back on despite sustained effort. That leads to a fresh look at the options available, which may include a nutritional adjustment, treatment with medicines or a discussion about bariatric surgery where an indication exists. Fitting another balloon is not an automatic answer.

The complications that must be explained before treatment

Besides digestive intolerance, the balloon can encourage an ulcer, bleeding or significant reflux. If it deflates, it may move into the intestine and cause an obstruction. A perforation of the digestive tract, although less frequent than the nausea of the early days, is a serious complication that may require an operation.

The FDA has also reported cases of spontaneous hyperinflation and of acute pancreatitis with liquid-filled balloons. Intense pain, a swollen abdomen or pain radiating into the back need to be assessed. These alerts do not allow anyone to calculate your personal risk, but they confirm how necessary it is to have quick access to care.

Endoscopic removal carries its own risks too, in particular those linked to the anaesthetic and to handling the digestive tract. It is carried out by a team equipped for the procedure. The quotation and the explanations given at the outset have to cover the whole treatment, from fitting through to the device coming out.

Warning signs that should not wait

Contact a doctor promptly in the event of repeated vomiting, persistent abdominal pain, fever, blood in your vomit or black stools. Marked bloating, feeling faint, breathlessness or being unable to drink all require urgent assessment. In France, severe symptoms warrant a call to 15 or 112.

Show your device card and state the date the balloon was fitted. The emergency team needs to know which balloon is in place, because the way it is dealt with can vary. Do not wait for your usual practitioner to be back if you need care immediately.

The Allurion balloon: making sense of the regulatory information

In France, the ANSM suspended Allurion balloons in August 2024, then revoked that decision on 12 February 2025 following corrective action. That action concerned in particular the information given, the training provided and the follow-up arranged, with the indication restricted to people with a BMI above 30 kg/m², as a second-line option after the initial measures have failed.

It would therefore be inaccurate to claim that this suspension is still in force on the strength of an article from 2024 alone. It would be just as inaccurate to conclude that the device no longer carries any risk. The applicable instructions for use, the conditions for fitting and the way follow-up is organised should always be checked at the time you are making your plans.

This episode illustrates a frequent difficulty with online comparisons: they sometimes bring together different models, different countries and different dates. Authorisation abroad does not define the indications in France. Ask for information that corresponds to the exact product and to the framework within which it is being offered to you.

Price and funding: looking at the whole pathway

The cost depends on the device, on the technique, on the anaesthetic, on the number of consultations and on removal. A price covering only the fitting may leave out significant expenses. Ask for a detailed quotation that separates out nutritional follow-up, investigations and the management of an intolerance or an early removal.

The ANSM states that gastric balloons, their fitting and their removal are not covered by the Assurance Maladie in France. Any contribution from your private health insurer has to be checked directly against your policy and the quotation. Do not begin treatment on the assumption that a verbal promise of reimbursement is settled.

If the balloon is fitted far from where you live, the budget has to include travel, a possible extended stay and the continuity of your appointments. The cost of a treatment cannot be assessed properly without knowing where, and by whom, a complication or the removal will be handled.

Balloon, band or sleeve: options not to be confused

The balloon sits inside the stomach and can only be used for a limited period. The gastric band is placed surgically around the stomach and requires adjustments. The sleeve removes part of the stomach; it produces a lasting anatomical change, with different indications and different risks.

Endoscopic sleeve gastroplasty, sometimes called an endosleeve, is yet another technique: it uses internal sutures to reshape the stomach. Its name should not lead you to confuse it with the surgical sleeve. The results of one method cannot be transferred to another.

The choice rests on a consultation that compares the expected benefits, the risks, the treatments already tried and the follow-up that is possible. A method that is technically less invasive may still be unsuited to your anatomy or to your medical situation. Consent assumes that you understand these differences before the procedure is booked.

Frequently asked questions

Can you feel the balloon all the time?

A sensation of heaviness or of fullness may be present, especially at the beginning. It should not be confused with pain that persists or increases. Discomfort that stops you drinking, sleeping or eating should be reported so that tolerance can be assessed and a complication looked for.

Can you travel with a gastric balloon?

The plan should be discussed with your doctor, taking account of the device, the date it was fitted and the destination. You need to remain able to reach urgent care. Take your balloon card, the instructions and the medical contact details with you, and check the terms of your insurance.

What happens if the balloon is poorly tolerated?

The team assesses the symptoms and adapts treatment where that is appropriate. If tolerance remains poor, or if a complication appears, early removal may be necessary. That possibility has to be explained from the outset, with identified access to endoscopy and clear financial terms.

Sources

1. Société française d’endoscopie digestive. (2023, mai). Informations médicales avant la pose d’un ballon gastrique. https://www.sfed.org/wp-content/uploads/2023/05/Ballon-gastrique-2f5.pdf
2. Agence nationale de sécurité du médicament et des produits de santé. (2025, 12 février). Décision du 12/02/2025 abrogeant la décision du 02/08/2024 portant suspension des ballons gastriques Allurion fabriqués par la société Allurion Technologies, Inc, ainsi que retrait de ces produits. https://ansm.sante.fr/actualites/decision-du-12-02-2025-abrogeant-la-decision-du-02-08-2024-portant-suspension-des-ballons-gastriques-allurion-fabriques-par-la-societe-allurion-technologies-inc-ainsi-que-retrait-de-ces-produits
3. Agence nationale de sécurité du médicament et des produits de santé. (2024, mise à jour 2025). Ballons gastriques Allurion : recommandations pour limiter la survenue de complications graves. https://ansm.sante.fr/actualites/ballons-gastriques-allurion-recommandations-pour-limiter-la-survenue-de-complications-graves
4. U.S. Food and Drug Administration. (2017, 9 février). The FDA alerts health care providers about potential risks with liquid-filled intragastric balloons. https://www.fda.gov/medical-devices/letters-health-care-providers/fda-alerts-health-care-providers-about-potential-risks-liquid-filled-intragastric-balloons
5. Francisco, C. P. D., Ravi, R., Lopez-Nava, G., & Asokkumar, R. (2024). Endoscopic tips for intragastric balloon use for obesity: What you need to know. VideoGIE, 9(10), 460–462. https://doi.org/10.1016/j.vgie.2024.06.010
6. Boškoski, I., Matteo, M. V., Shamah, S., Abu Dayyeh, B. K., Bove, V., De Siena, M., Huberty, V., Maselli, R., Perretta, S., Pontecorvi, V., Stier, C., Sharaiha, R. Z., Facciorusso, A., & Fuccio, L. (2025). Devices and techniques for bariatric and metabolic endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review. Endoscopy, 57, 1033–1055. https://doi.org/10.1055/a-2630-2062