Excellent question. The Orbera intragastric balloon is made of extremely durable silicone and it is very unusual for it to develop a leak or to deflate. A review of 68 studies including a total of 8500 patients showed that balloon deflation occurs in approximately 0.3% of patients (meaning 3 out of every 1000), which is incredibly rare. If this were to occur, you might notice that you suddenly aren't as "full," or you could potentially develop symptoms of a blockage if the balloon tried to exit your stomach. Again, this is extraordinarily rare. An X-ray would tell us if this happened, at which point the balloon would be removed. You will not harm the balloon by doing pushups or sit-ups. We encourage all forms of exercise.