Changes in Food Preferences Before and After Intragastric Balloon Placement.

BACKGROUNDS: In recent years, numerous studies have tried to decode the way bariatric surgery works toward weight reduction by the use of food preference questionnaires. The intragastric balloon has gained popularity, mainly due to its limited invasiveness, in patients with obesity not fulfilling criteria for bariatric surgery. However, there is no study assessing the changes in food preferences [FP]. We decided to analyze the FP of individuals prior to intragastric balloon insertion and following its removal, on the strict condition that participants must complete the 6-month treatment period and attend at least 4 of the 7 follow-up interviews. METHODS: Patients were asked to rate the frequency of consumption of 63 food items before balloon insertion, at monthly intervals and after balloon removal. The food categories were protein, carbohydrates, fruit and vegetables, and sweets and fats. RESULTS: The questionnaires of 320 participants were analyzed. A reduced frequency in consumption of meat and meat products, high-fat, and high-carbohydrate/sugary products and an increase in raw vegetables and fruit was found in all individuals. CONCLUSION: The intragastric balloon seems to exert analogically similar mechanisms to bariatric surgery for weight loss, both functioning through alterations in FP. These are dictated by the anatomical re-configuration of the stomach, but mainly by counseling of dieticians and the self-education of the patient after experiencing unpleasant postprandial discomfort.

Benchmarking the Discriminatory Performance of Body Mass Index and Body Fat for Obesity Detection in Patients Treated by Intragastric Balloon.

INTRODUCTION/PURPOSE: The accuracy of body mass index (BMI) in detecting obesity in patients treated by intragastric balloon (IGB) remains still speculative. We aimed to determine the discriminatory performance of BMI as an estimate of excess body fat (%BF) in an IGB-treated population. MATERIAL AND METHODS: Retrospective analysis of prospectively collected data of 476 patients who completed the 6-month IGB treatment period and were subjected to body composition analysis. We evaluated the relationship between BMI and %BF or lean mass and the diagnostic performance of BMI ≥ 30 kg/m2 for adipose tissue detection, stratified by age (< 40 and ≥ 40 years) and gender. Moreover, we identified anthropometric and body composition parameters serving as predictors of obesity according to %BF-based criteria (> 25% in men or > 35% in women). RESULTS: Gender emerged as an effect modifier in the quadratic polynomial relationship between BMI and %BF (R2 = 0.849 for men, R2 = 0.715 for women), while BMI was linearly associated with %BF in both age groups (R2 = 0.435 for men, R2 = 0.474 for women). BMI was strongly correlated with both %BF (r = 0.67) and lean mass (r = - 0.65). The overall area under the ROC curve for BMI ≥ 30 kg/m2 to detect %BF was 0.87 (95%CI 0.85-0.90). A regression model including lean mass, total body water, age, BMI, and female gender explained 0.970 of the variance in %BF. CONCLUSION: The discriminatory performance of BMI as an estimate of excess body fat is enhanced by the implementation of gender- and age-specific BMI thresholds for defining obesity, in IGB-treated patients.