Intragastric balloon (IGB) is a minimally invasive and reversible endoscopic option for treating obesity. This systematic review and meta-analysis compared the effectiveness of IGB versus standard medical therapy (SMT) for obesity management, including studies with a minimum treatment duration of 6 months. Subgroup analyses were performed based on IGB type, baseline mean body mass index (BMI), and use of pharmacological therapy in the SMT group.

We searched for randomized controlled trials (RCTs) in MEDLINE, EMBASE, and Cochrane Library databases. Outcomes were evaluated at 6, 9, and 12 months after initiation of treatment. A random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI) for continuous outcomes.

We included 15 RCTs (1961 patients). Compared with SMT, IGB significantly improved the percentage of excess weight loss at 6 months (MD 16.80; 95% CI 9.22–24.38), 9 months (MD 14.36; 95% CI 7.67–21.04), and 12 months (MD 13.10; 95% CI 10.43–15.77). IGB also showed superior results in percentage of total weight loss, absolute weight loss, and BMI reduction at all time points compared with SMT. There were significant subgroup differences for some outcomes according to IGB type and baseline mean BMI.

In obese adults, IGB is more effective than SMT for weight loss at 6, 9, and 12 months.

Received: 14 January 2025

Accepted after revision: 05 August 2025

Accepted Manuscript online:
11 August 2025

Article published online:
03 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Bibliographical Record
Gabriel de Oliveira Amaral, João Pedro Schmitt, Lucas Monteiro Delgado, Gilmara Coelho Meine. Intragastric balloon for obesity treatment: Systematic review and meta-analysis of randomized controlled trials. Endosc Int Open 2025; 13: a26812859.
DOI: 10.1055/a-2681-2859