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Weight loss procedure draws overweight Americans to Canada

Only the border and a few thousand dollars separates some overweight Americans from a procedure that takes them off the path to obesity.

It’s the intragastric balloon procedure, and it is awaiting approval by the U.S. Food and Drug Administration. But in an obesity epidemic, the promise of losing 30 or 40 pounds for $8,000 is drawing overweight Americans across the border to have a balloon shoved down their throats.

Plastic surgeon Sanjeev Kaila runs Bluewater Surgical Centre in Windsor, Ont., which performs about 10 of the procedures a week. Roughly one-third of patients coming from the United States.

“The average weight loss from the procedure is about 40 pounds,” Kaila said. “Our highest has been 97 pounds and the lowest, 17 pounds.”

Kaila, hailed by the New York Times as a pioneer of the method, is one of about 10 doctors in Canada who offer the procedure.

The procedure is not new — in fact, it was approved by Health Canada in 2006— but the balloons have changed from a version sold in the 1980s.

“It is really like a saline-filled breast implant,” Kaila said. “It’s flexible and adjustable.”

During the out-patient procedure, a surgeon slides a deflated balloon down the esophagus and into the stomach. Then the balloon is filled with salt water dyed blue — if it breaks, the patient’s urine will turn a blue-green, signifying a problem. The process takes just an hour, and is not covered by OHIP.

The presence of the balloon signals stretch receptors in the stomach lining, which in turn tell the brain the stomach is full. The balloon fills about half the volume of the stomach, which means food consumption is cut in half.

“So even though they’re dieting and losing weight, the body is fooled into thinking it’s full,” Kaila said.

But the stretch receptors stop firing their message to the brain about five months after the surgery. Six months after the balloon goes in, it comes out — it’s only meant for the short term. A month after the balloon is removed, the stretch receptors start working again.

During those six months, Kaila’s clinic offers nutritional and exercise programs designed to change eating habits.

“Putting a balloon in without nutritional support is a bad idea because the patient is not changing or learning anything,” Kaila said. “You want to change the lifestyle habits.”

The first few days after the surgery are usually the worse, because “you feel like you’ve eaten a Thanksgiving dinner every time you eat.”

There are risks, however.

That satiety feeling can be so overwhelming for some that they won’t drink water and become dehydrated. Vomiting and nausea are common in the first few days after the surgery.

The balloon can rupture and clog the stomach like a drain plug, which could lead to perforation, which is life-threatening. And, Kaila said, there have been a few deaths related to the procedure, but the risk of any serious side effects is less than 1 per cent.

But the risks related to obesity are far greater, said David Jenkins, a researcher at the University of Toronto who developed the glycemic index.

“We’re in favour of preventative matters in the early stages, from diet and exercise to the balloon procedure to prevent people from falling into the morbidly obese stage,” Jenkins said.

“We need to commend everyone who is fighting obesity, from the doctors performing the balloon procedure to Loblaws for their Blue Menu,” Jenkins said.

“Even (Toronto Mayor) Rob Ford — although he should be adding bicycle lanes to promote a healthy lifestyle — but if he can get back on track on his weight loss program, that will be inspirational and life changing.”

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