Weight Loss: Maintenance of Loss,but for How Long?

Dear Sir:

During a programmed search of the recent bibliography on the use and benefits of endoscopic intragastric balloon treatment, I came across an article by Dr. Nikolić et al. ¹ dealing with the initial weight loss after bariatric procedures (namely intragastric balloon, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy) as predictors of mid-term weight maintenance. I believe there are seriously misleading statements in this article, which is mainly based on the results of Dogan et al. ² —as the authors consider that this is the only relative bibliography.

In a cohort of 50 intragastric balloon-treated obese patients, Dogan et al. ² conclude that a 5% weight loss after the first month of treatment predicts long-term outcome. This finding is of great interest to Nikolić et al., “because 50% to 75% of patients fail to maintain weight loss after bioenterics intragastric balloon (BIB) removal”. This phrase is surprisingly attributed to one of my articles. ³ This is where the false impression is created. My article refers to a retrospective study, where the results achieved after 6 months balloon treatment in an initial group of 500 obese individuals were analyzed critically after a follow-up period of 5 years. Our article states that 53%, 27%, and 23% of patients continue to maintain the initial weight loss, at 1, 2, and 5 years, respectively, after balloon removal.

Furthermore, Nikolić et al. ¹ not only repeat their earlier statement and bibliographic reference in their discussion but also state that “furthermore, 50% to 75% of patients treated with BIB gain weight once the BIB is removed”, with no time reference at all.

I would be grateful if misinformation could be corrected, so that later researchers are not, inadvertently, misled.