AGA Clinical Practice Guidelines on Intragastric Balloons in the Management of Obesity
Recommendation 1. In individuals with obesity seeking a weight-loss intervention who have failed a trial of conventional weight-loss strategies, AGA suggests the use of IGB therapy with lifestyle modification over lifestyle modification alone. (Conditional recommendation, moderate certainty). Implementation remark: Limited to a body mass index (BMI) range between 30 and 40 kg/m.
Recommendation 2. In individuals with obesity undergoing IGB therapy, AGA recommends moderate- to high-intensity concomitant lifestyle modification interventions to maintain and augment weight loss.
Recommendation 3. In individuals undergoing IGB therapy, AGA recommends prophylaxis with proton pump inhibitors.
Recommendation 4. In individuals undergoing IGB therapy, AGA suggests using the intraoperative anesthetic regimens associated with the lowest incidence of nausea along with perioperative antiemetics. AGA suggests a scheduled antiemetic regimen for 2 weeks after IGB placement.
Recommendation 5. In individuals undergoing IGB therapy, AGA suggests against perioperative laboratory screening for nutritional deficiencies.
Recommendation 6. AGA suggests daily supplementation with 1–2 adult dose multivitamins after IGB placement.
Recommendation 7. After IGB removal, AGA suggests subsequent weight loss or maintenance interventions that include dietary interventions, pharmacotherapy, repeat IGB or bariatric surgery. The choice of weight loss or maintenance method after IGB is determined based on patient’s context and comorbidities following a shared decision-making approach.
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