About the Gastric Balloon Procedure
The IntraGastric Balloon (IGB), or the Gastric Balloon, is a non-surgical weight loss procedure that will make a patient feel full and create restriction similar to sleeve gastrectomy. In this procedure, a temporary balloon is placed in the stomach and then is inflated using an endoscope.
Gastric balloons work to reduce the available room in your stomach for food, causing you to eat less. The balloon also slows the passage of food and water in your stomach, causing you to feel full quicker and for a longer period of time. A proper Gastric Balloon Diet is the most effective component of long-term weight loss.
The balloon only remains within the stomach for 6 months (one year in case of Spatz) and then it is removed. At that time the patient can decide if they are satisfied with the results, or if they would like to proceed with a more aggressive weight loss surgery such as Gastric Sleeve or RNY Gastric Bypass.
Types of Gastric Balloons
There are four types of gastric balloon weight loss systems. These include:
- Obalon Balloon Systems (Obalon Gastric Balloon/Obalon Balloon Pill)
- ORBERA Intragastric Balloon System (ORBERA Weight Loss Balloon)
- ReShape Duo Balloon System (ReShape Dual Weight Loss Balloon)
- Spatz3 Adjustable Balloon System (Not FDA Approved)
Gastric Balloon Diet Plan Overview
As with any weight loss procedure or regime, proper diet is extremely important after the placement of the gastric balloon system to ensure success. Here we will go over the recommended gastric balloon diet, starting with the requirements immediately following the procedure, then transitioning to a healthy diet that can bring long-lasting results when adhered to.
Important Note: For each phase of the diet, it is recommended you stay on at least 3 – 5 days. Depending on your ability to transition to the next phase, the time may vary for each phase. You will want to make sure your body feels comfortable before moving to the next phase of the diet.
STAGE 1: Clear Liquid Diet
For 3-5 days after placement, you will need to follow a clear liquid diet. The sole purpose of this phase is to stay hydrated. The hydration goal should be 64 oz or more, with a minimum of 48 oz to prevent dehydration. Try to stick with water, unsweetened tea, or sugar-free beverages to avoid empty calories.
If consuming juice, it needs to be 100% fruit juice (no added sugar), and it needs to be diluted 50/50 with water to reduce sugar intake. If consuming a large amount of tea, alternate or stick with decaffeinated versions such as herbal teas to reduce the chance of dehydration. Tea is also acidic, so if you experience heartburn or acid reflux, discontinue drinking.
Stage 1 – APPROVED:
- 100% fruit juice (no added sugar) – clear juice (apple, white grape, cranberry) – dilute 50/50 with water
- Broth (chicken, beef, and vegetarian)
- No/low sugar coconut water
- Crystal Light, vitamin zero water, Powerade Zero, propel, or other sugar-free flavored beverages
- Unsweetened tea
- Sugar-free popsicles
- Sugar-free gelatin
- Water and/or ice chips
It is important to drink slow, small sips to avoid nausea. Start with½ ounce sips (1 Tablespoon), either using a measuring cup or the screw cap of a water bottle. Wait 60 seconds between each sip.
Stage 1 – AVOID:
- Drinks that will create gas such as carbonated beverages
- Sugary drinks, sweet teas, juice drinks, punch
- >Citrus juices (orange, grapefruit, pineapple, lemonade)
- Tomato Juice
- Caffeinated drinks such as coffee and energy drinks
STAGE 2: Thick Liquid Diet
The following 3-5 days (after completing stage 1: clear liquid diet) you can move on to stage 2: thick liquid/pureed diet. During this stage of the gastric balloon diet, it would be beneficial to use a blender or food processor to puree your meals.
Aim for items that are high in nutrients and low in sugar.
Stage 2 – APPROVED:
- Protein shake (pre-made or make your own using protein powder)
- Greek yogurt (plain or Dannon Triple Zero)
- Milk – Preferably Fairlife Milk but all types are acceptable (dairy, coconut, almond – unsweetened version)
- V-8 Juice
- Sugar-free pudding
- Blended soups
- No-sugar-added applesauce or other pureed fruits
- Pureed vegetables
Stage 2 – AVOID:
- foods with large chunks or pieces
- Foods with added sugar such as desserts
- Carbonated Beverages
STAGE 3: Semi-Solid Foods Diet
The next stage of the gastric balloon diet begins 7 to 10 days after balloon placement (after following both stage 1 and stage 2 post-op diet plan). At this time you can start stage 3: semi-solid foods.
The foods for phase three should encompass items that are mainly soft, moist, and can be easily mashed with a fork.
Stage 3 – APPROVED:
- Cottage cheese
- Ricotta cheese
- String cheese
- Soft fish
- Canned chicken, tuna, or salmon mixed with a little mayo
- Meat cooked in a crock-pot until tender.
- Well-cooked or mashed vegetables (squash, potato, sweet potato, green beans, etc)
- Scrambled eggs
- Deli meat
STAGE 4: Solid Foods Diet
When you are feeling ready you can transition to stage 4 of the gastric balloon diet, which is solid foods. This is where you can start eating normal foods again and adding a healthy variety back into your diet plan.
This is also when it is most important to create a balanced, healthy diet as well as the healthy habits that will set the stage for your long-term success.
Healthy Gastric Balloon Diet Guidelines (Stage 4 and Long-Term)
Calories: 1000 – 1200
Protein: 75 – 105g
Carbohydrates: less than 75g (25 – 50g for quicker results)
Fat: 40 – 50g
Sugar: <25 g
Sample Diet Plan (Meal Plan)
Breakfast: Protein shake, up to ½ banana (optional)
Snack 1: Cheese stick
Lunch: 3 oz chicken, ¼ avocado, 2 oz cooked vegetables, beans, or whole grain
Snack 2: 15 Almonds
Dinner: 3 oz salmon, 2 oz non-starchy vegetables, 1 TB oil or butter
Snack 3: Triple Zero Greek yogurt, ¼ cup berries
Focus your diet mostly on lean protein and non-starchy vegetables. Fat is a healthy addition as well but needs to be monitored, as too much can negatively impact weight loss. Fruit, whole grain, and beans are also healthy additions to a diet, but should be eaten in moderation and should always be paired with protein if possible.
Healthy Habits to Help Succeed Long-Term
- Eat small meals/snacks 5 times a day
- 3 small meals and 2 healthy snacks
- One protein shake a day (counts as a snack or meal)
- Try to always pair fruit or grain with protein, such as fruit with greek yogurt or cracker with cheese. Focus mostly on protein.
- Eat something every 2-3 hours
- Drink a minimum of 64 oz water
- Avoid sweets and processed foods
- Avoid “doughy” foods (may stick to balloon and cause bad breath)
- Take a good quality multivitamin every day (no gummies, which contain sugar)
- Track food intake in a food journal or mobile app
- Limit consumption of alcohol
Gastric Balloon Exercise
Exercise will help you burn calories and build muscle, which will help you lose weight quicker. Starting a regular exercise schedule as soon as a week after the procedure is highly recommended.
A good goal for exercise is 30 minutes at 5x a week. We recommend that you start slow with walking and slowly increase in exercise.
It is extremely important to continue this exercise regimen after the gastric balloon is removed to prevent the chance that you will regain the weight that is lost.
Discomfort and Nausea
After the placement of the intragastric balloon, most patients will experience some gastric discomfort for the first week after the procedure: cramping, nausea, and vomiting. This is normal, as your digestive system is adjusting to the presence of the intragastric balloon. The discomfort will rarely continue in the long term. You will be given medications to help you manage these symptoms. Please use these anti-nausea medications as prescribed.
Helpful Tips to Prevent Discomfort and Nausea
- Watch your posture during meals and while drinking fluids. Sit tall and do not slouch. This will help your balloon position properly and increase your tolerance for foods.
- Eat slowly and chew your food well before swallowing.
- Stop eating if you feel heartburn (acid reflux).
- No liquids 30 minutes before your meal and wait 30 minutes after to drink.
- Stop eating when you feel full or satisfied.
- No food 3 hours prior to bedtime
- Some discomfort may occur while trying to sleep; you may need to prop yourself up with a pillow.