Clinical and psychological evaluation of the probable influence of the SARS-2 pandemic on the results of moderate obesity therapy with Bioenterics Intragastric Balloon. Review of the literature and our experience

BACKGROUND: Patients with moderate obesity are not candidates for immediate surgery, which is normally intended for patients with severe obesity. On the other hand, Bioenterics intragastric balloon (BIB) treatment is indicated, which can also be used for weight reduction as a bridging therapy for bariatric surgery.METHODS: In the two-year period (2021-2022) we analyzed 53 patients with moderate obesity, 3 and 6 months after the implantation of a BIB, in compliance with the health provisions issued for the COVID-19 pandemic, through a telephone interview. The questions used focused on the possible presence of important clinical and psychological symptoms.RESULTS: Analysis of responses to clinical symptoms revealed that gastrointestinal disorders were modest, in line with expectations based on various scientific society guidelines and literature reviews. The psychological evaluation showed that patients who underwent BIB placement during lockdown (N.=24) were significantly more likely to express a need for psychological support (Student’s t-test, P=0.042), compared to patients who underwent BIB placement after restrictions were lifted (N.=29).CONCLUSIONS: The literature review and the results obtained confirmed two of our hypotheses, firstly that COVID-19 significantly affected symptoms and clinical outcomes, exclusively and negatively during the lockdown period, resulting in poor weight loss, which was compensated for in the later phase, out of lockdown. Secondly, in the same phase the development of psychological disorders in some patients was detected. This picture has in fact become null and void in the second observation period. Another factor found was telemedicine, which was a valuable solution for collecting medical data and following up patients remotely.