Gastric Sleeve Surgery vs. a Swallowable Gastric Balloon

If you are looking into weight-loss procedures, you may be comparing very different options. Two you may come across are the gastric sleeve, which is surgery, and a swallowable gastric balloon, a temporary device. Here is how they differ, so you can ask the right questions.

How a gastric sleeve works

In a sleeve gastrectomy, a surgeon removes about 80% of the stomach through a few small incisions. The part that makes most of the hunger hormone ghrelin is removed, so many people feel full sooner and hungry less often. The change is permanent and cannot be reversed.

How a swallowable balloon works

The balloon is folded inside a capsule attached to a thin tube. You swallow the capsule, and once an X-ray shows it is in the stomach, the balloon is filled with fluid through the tube, which is then removed. Placing it does not need surgery, endoscopy or anesthesia.

The balloon takes up space, so you feel full sooner. After about four months, a valve opens, the balloon empties and it passes out of the body naturally.

Swallowable balloons are licensed medical devices in Canada. They are meant for short-term weight loss in adults with a BMI of about 30 to 40, with a lifestyle program.

Weight loss in studies

• Swallowable balloon: in a review of 11 studies with more than 2,100 people, people lost about 12% of their body weight on average over about four months. Less is known about how much stays off.
• Gastric sleeve: in a large U.S. study, people lost about 25% of their body weight on average at one year, and about 19% at five years.

These numbers come from different studies and different people, so they are a guide, not a promise. With either option, the habits you build matter for keeping weight off.

Side effects and risks

• Balloon: nausea, vomiting and cramping are common in the first days. In a study of 1,770 people, about 3 in 100 needed it removed early because they could not tolerate it. Rare serious problems include a blockage in the bowel, which can need surgery.
• Sleeve: as major surgery, it carries risks such as bleeding, a leak from the staple line and blood clots, which are uncommon but serious. Over time, reflux and low vitamin levels can occur, so vitamins and follow-⁠up are for life.

Follow-⁠up

Both work best with support. The balloon comes with a nutrition and coaching program, usually through an app and visits with the clinic that places it.

At 360 Sleeve, every sleeve comes with six years of 360 Complete Care: follow-⁠ups with your surgeon, nurse and dietitian, bloodwork at 6 months and then every year, the 360 SmartTrack scale and app, and a place in 360 Community.

Cost

A gastric sleeve at 360 Sleeve is $13,900, with taxes included, and financing is available over 6 months to 6 years. Clinics that offer the balloon set their own prices, so ask what is included, such as follow-⁠up, and what a second balloon would cost if you wanted one later. OHIP does not cover either at a private clinic.

Which one is for you?

It depends on your BMI, your health, your goals and how you feel about surgery. A balloon may suit someone who wants a short-term option without surgery. A sleeve is a permanent change for people who meet the criteria for surgery.

360 Sleeve does not offer gastric balloons. We offer the gastric sleeve, SADI-⁠S, ESG and revision surgery. If you would rather avoid incisions, ESG makes the stomach smaller from the inside, with stitches placed through the mouth. At a free consultation, a surgeon can talk through which options fit your situation.