Gastric balloons: a plea for sanity in the midst of balloonacy.

Intragastric balloons have been suggested as a treatment for severe obesity, a degree of obesity associated with a relatively greater eating disorder or lack of control of energy balance. The premises that 250-500-ml balloons are able to simulate "satiety" in a 1700-ml stomach sufficiently to cause weight loss, that the stomach will not stretch to accommodate such a besoar (with or without ulcerating), and that behavioral modification is cost-effective in weight control in this population have not been corroborated. Experience from gastric restrictive surgery has demonstrated the conceptual failure of gastric satiety as a means of achieving and sustaining weight loss in a substantial percentage of morbidly obese patients. Other methods are needed to reduce the increased morbidity and mortality of severe obesity.