WEIGHT LOSS

C A S E S T U D Y

52 Aesthetic Medicine • June 2020

We take a look at the case study of a patient who underwent weight-loss treatment with the Elipse gastric balloon from Allurion

A weight off

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53

WEIGHT LOSS

Aesthetic Medicine • June 2020

C A S E S T U D Y

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ASSESSMENT Patient Rich Jones, 35 years old and from Bristol, began weight-loss treatment with the Allurion Elipse Balloon in August 2019 at Nuffiled Health in Bristol. His treatment was overseen by Mr Dafydd Wilson-Evans, a private practice specialist dietitian and lead dietetic practitioner within the bariatric surgery team at North Bristol NHS Trust. The patient presented for treatment with the swallowable gastric balloon after seeing it advertised on TV and being attracted because of its simplicity.

“I am an ex-competitive rugby player and have struggled with my weight for a number of years after leaving the Armed Forces,” said Jones. “I have been very active in the past, however, for the past few years I have lived a sedentary life due to work. I always kidded myself and tried a diet and exercise every now and again, but like a lot of people, I found excuses to fall off the wagon.”

The patient was given full support and information about

the procedure and its placement, the treatment programme and what could be expected post-placement. He was also consulted on the lifestyle changes it would be necessary to make for the best chances of weight-loss success.

TREATMENT JOURNEY The Elipse balloon is placed when the

patient swallows a capsule containing a deflated balloon attached to a thin tube.

Placement is confirmed with an x-ray before the balloon is filled with 550ml of water using a catheter. A second x-ray is performed to ensure the balloon is filled. Of the placement of the balloon,

patient Jones said: “I struggled slightly with the placement of Elipse, and so the

doctor used a stylet [to stiffen the catheter and aid navigation of the tube]. The first few

days after the balloon were uncomfortable, with some stomach pains and nausea, but after the initial

phase passed, I did not suffer any further side effects and nearly forgot I had the balloon in place. I was able to carry on

“The Elipse Balloon

is favoured in our practice to other intra-gastric balloons because

there is no need for anaesthesia or an

endoscopy”

Rich Jones before Rich Jones after

WEIGHT LOSS

C A S E S T U D Y

54 Aesthetic Medicine • June 2020

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PRACTITIONER Q&AMr Dafydd Wilson-Evans, lead dietetic practitioner in the bariatric surgery team at North Bristol NHS Trust and private practice specialist dietitian, weightloss and DWE nutrition.

How many patients have you treated with the Elipse balloon?22

What is the cost to the patient? From £4,000

How do you manage patients’ expectations? All potential Elipse Balloon patients will have a full assessment with an obesity consultant and specialist dietitian. Discussing the patient’s expectations is part of the assessment process and is managed on a case-by-case basis. Topics include; expected weight loss, health improvements, managing possible side-effects and life afterwards.

Who is an ideal candidate and who wouldn’t be suitable?The Elipse program can help a number of different patient groups. There are many reasons why patients may want to lose weight; this might be for aesthetic reasons, to improve related health conditions or as a way to reduce their weight to be eligible for other medical interventions. A patient is eligible for an Elipse Balloon if they have a BMI >27kg/m2 and have tried different lifestyle interventions in the past.

Are there any risks once the patient has ingested the balloon?As with any medical procedure, there are always risks to consider. However, the Elipse Balloon is very low risk in comparison to other weight-loss procedures and favoured in our practice to other intra-gastric balloons because there is no need for anaesthesia or an endoscopy.

How likely is it that patients maintain a reduction in weight after passing the balloon?We discuss the possibility of weight regain after the balloon has passed at the assessment consultation. The factors that will influence weight regain are multifactorial but include biological and behavioural elements. We aim to help patients during this transition phase and focus on weight maintenance initially. Supporting patients with their diet and exercise regimes at this time can help achieve this. AM

Total weight loss: 28kg (4.4 stone) Heaviest weight: 156kg (24.6 stone) Weight when the balloon passed: 134kg (21.1 stone)Weight now (April 2020): 131kg (20.6 stone) Weight loss to date: 25kg (3.9 stone)Date balloon swallowed: August 2019Date balloon passed: December 2019

with normal life.” Using the Elipse programme’s connected portable Smart

Scale and smartphone app, Jones “weighed in” every few days. To help adapt his eating habits to maximise success, part of the treatment plan involved telephone calls between the patient and Mr Wilson-Evans every few weeks to discuss Jones’s nutritional progress. He was also instructed to keep a food diary, which was sent to Mr Wilson-Evans weekly.

The patient was supported throughout the treatment programme by clinical psychologist Dr Vanessa Snowdon-Carr, “who helped me identify some bad eating habits that probably led to weight gain in the first place,” said Jones. “I received great support from the clinic and they stayed in touch with me all throughout the placement journey. When I started to lose weight and muscle mass, I decided to increase my frequency at the gym.”

RESULTS In the eight months from August 2019 when the balloon was placed to April 2020, when the patient’s case study was released, he had achieved a weight loss to date of 25kg (3.9 stone). The balloon was passed in December 2019. Commenting on his results, Jones said: “The balloon has focused my mind again and made me want to live a healthier life. It has got me back into the gym and making better choices about what I’m eating.” The patient’s weight loss plateaued around two to three months after the balloon was passed, fluctuating by 1-2kg up and down. However, he said, “It is fair to say I have maintained the weight loss. I’ve certainly not been gaining fat.”