Could I qualify for an Orbera balloon for weight loss with a BMI over 40?

Question

I'm considering getting a balloon to help me get my weight down. I've read that you have to be between 30-40 BMI. Can i still be approved for it if i am a bit over 40BMI? im currently 250-260 at 5'4. I don't want to get a serious surgery but i desperately need to lose this weight. I'm also looking for a good doctor who can do it in Portland, OR area.

Babak Moeinolmolki, MD, FACS · Answer

Hello,
Thank you for your question. I second Dr. Garcia's recommendation that the gastric sleeve may be better suited to your goal of losing weight and keeping it off..
I have seen patients most successful with long term weight loss when they are treated with a comprehensive weight loss program--including medical and surgical management along with psychosocial and nutritional support. Currently the the most successful, evidence-based treatment of obesity is weight loss surgery, using the laparoscopic (with tiny incisions and surgical cameras) to restrict the amount of food a patient can eat in one setting. The most common treatment of this type is the laparoscopic gastric sleeve.
Gastric balloons are most frequently used for individuals with a BMI >35 (and 30 with certain comorbidities. Gastric balloon placement can cost $7.5K to $8K and is not covered by insurance. Typically, particularly with patients with higher BMIs, the balloon must be reinserted repeatedly over time to maintain long term weight loss. I do offer patients a program that allows for balloon placement on a recurring basis with a monthly fixed payment.
To qualify for weight loss surgery, the American Society for Metabolic and Bariatric Surgery recommends you meet one of the following:
BMI ≥ 40, or more than 100 pounds overweight.BMI ≥35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
When criteria #1 or #2 are met, insurance often covers the cost of surgery.
I understand your hesitation to undergo surgery. It's also important to consider the health impact and risks of lifelong obesity. Your BMI is 40, putting you in the category of Class 3 (aka “severe” or “extreme”) Obesity. Obesity puts you at risk for obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, and heart disease. Thus you are wise to be concerned about your weight, its impact on your health, and the increased difficulty to lose weight or undergo surgery as you grow older.
Meeting with a bariatric surgeon in your area will allow you to further discuss the pros and cons of the gastric balloon and weight loss surgery as well as insurance coverage and the cost for the surgery in your geographic area. You can also check out the Patient Learning Center of the American Society of Metabolic and Bariatric Surgery (ASMBS) to educate yourself on surgical options. ASMBS also has a bariatric surgeon locator to help you find a bariatric surgeon in your area.
Best wishes,
Dr. Moein

Christopher E. McGowan, MD · Answer

Hi, 
The Orbera balloon system is FDA approved for a BMI range between 30-40. However, it can be used outside of this range. Your calculated BMI is approximately 42. That would not be unreasonable for Orbera. I typically do not recommend Orbera above a BMI of 45, as there are likely better options at that level. 
Most important, we need to ensure that an intragastric balloon is the right fit for your goals. In general, I recommend Orbera for those individuals who need a boost, or short-term jumpstart, to facilitate and motivate their weight loss. Most patient lose 20-50lbs, though many patients are able to lose more, depending on their starting weight and motivation.

Pablo Garcia, MD · Answer

The weight loss balloon is a non-surgical option for people with a BMI of 30 to 40. Paired with healthy diet and exercise, the balloon is a good option for those who don’t want, or qualify for, weight loss surgery, but the results are not as dramatic as what can be expected with gastric bypass or a sleeve gastrectomy. The Gastric Sleeve limits the amount of food that you can eat, it helps decrease the ghreline hormone who is responsible of the hunger, you will feel less appetite after the surgery. Your current BMI is to high to place a balloon, my recommendation is to consider the sleeve gastrectomy. Approach a certified bariatric surgeon who can give you a recommendation and discuss about the different options and proceed to take the better option for you based in your actual health status and BMI.Good luck in this journey, my best wishes,

Could I qualify for an Orbera balloon for weight loss with a BMI over 40?

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Could I qualify for an Orbera balloon for weight loss with a BMI over 40?

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