Assessment of cognitive performance and psychological status in intragastric balloon treatment

Aims The intragastric balloon (IGB) is an effective method of treating obesity and related health problems. However, data on cognitive and psychological health problems and their association with weight loss with IGB are limited. Therefore, we investigated cognitive function and psychological status in patients undergoing IGB treatment.

Methods This prospective study included 33 patients who underwent Medsil and Orbera IGB placement, between January and May 2024, in a Private Clinic in Ankara. Balloon volume was adjusted between 500 and 700ml. Demographic data was collected at baseline and 6-months after IGB placement. Patients were followed up by a bariatric dietitian online or face-to-face for 6-months. Cognitive performance and psychological status were assessed before and at 6-months after IGB treatment. The cognitive battery consisted of two tests; Stroop Color Word Test (stroop) for executive functions and Digital Span Test (DST) for attention. Psychological status were assessed by Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Pittsburgh Sleep Quality Index (PSQI) [1].

Results A total of 33 patients with a mean age of 36.6±8.2 years, of whom 29 (87.9%) were female were included in the analysis. No severe procedure-related adverse events occurred. The values of body mass index before and after IGB were 33.8 (28.5-47.5) kg/m² and 28.0 (23.0-40.1) kg/m², respectively (p˂0.001). 6-months results after the IGB revealed that the percentages of total body weight loss (%TBWL) and excess weight loss (%EWL) were 14.1 (1.7-22.7) and 41.2 (5.1-110.6), respectively. In addition,≥5% TBWL,≥10% TBWL,≥15% TBWL and≥20% TBWL were achieved in 97%, 88%, 42.4% and 12.1% of the patients, respectively. Regarding cognitive tests, patients undergoing IGB showed significant improvement in the stroop (p˂0.001) and worsening in the DST forward (p˂0.001), whereas the results did not change in the DST backward (p=0.609). With respect to psychological status before and after the procedure, the BDI scores were 12 (0-35) and 6 (0-37) (p=0.002) and, BAI scores were 8 (0-29) and 7 (0-40) (p=0.599) respectively. Besides, PSQI scores were significantly better after IGB treatment (5.7±3.5 vs. 4.4±2.5) (p=0.002).

Conclusions IGB treatment was associated with better cognitive function, especially in the executive domain, along with improved depression scores and sleep quality.

Publication History

Article published online:
27 March 2025

• References

• 1 Jirapinyo P, Hadefi A, Thompson CC. et al. American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity. Endoscopy 2024; 56 (6): 437-456