S2313 Efficacy of Intra-Gastric Balloon versus Intra-Gastric Balloon and Anti-Obesity Medications for Weight Loss: A Systematic Review and a Meta-Analysis

Introduction: Intra-gastric balloons (IGB) are synthetic balloons placed in the stomach to help patients with obesity to achieve weight loss. While multiple studies have demonstrated the safety and efficacy of IGBs alone, the potential benefits of combining IGBs with anti-obesity medications (AOM) remain understudied. We aimed to conduct a systematic review and a meta-analysis to evaluate the impact of IGB versus IGB + anti-obesity medications (AOM) on weight loss. Methods: Bibliographic databases (PubMed, Medline, Embase) were systematically searched for studies assessing the impact of IGB versus IGB + AOM on weight loss. All randomized controlled trials (RCTs) and observational studies comparing these interventions were included and analyzed using the Inverse variance method and Random-effects model. Results: Four studies containing 309 patients were included (2 observational studies and 2 RCTs). Patients in both groups were instructed about lifestyle modifications. The follow-up period was 6 months for most studies, except Farina et al. (2012) which followed patients for 12 months. The primary outcome was the weight loss difference between the IGB + AOM group versus the IGB group which was measured as Mean Difference (MD). IGB + AOM resulted in significantly greater weight loss, with a mean difference of 4.05 kg (95% CI [1.52, 6.57], P = 0.002) compared to IGB alone. Subgroup analysis by age showed consistent results favoring IGB + AOM: patients <35 years achieved an additional weight loss of 5.93 kg (95% CI [1.63, 10.22], P = 0.007), while patients >35 years achieved an additional weight loss of 1.80 kg (95% CI [1.20, 2.39], P < 0.00001). Conclusion: In this systematic review and meta-analysis, adding anti-obesity medications to IGB treatment resulted in significantly greater weight loss compared to IGB alone.