Dayyeh BKA, Maselli DB, Rapaka B, et al. - This prospective, multicenter, open-label, randomized clinical trial was conducted with the aim to evaluate the safety and efficacy of an adjustable intragastric balloon (aIGB) in adults with obesity.

• At seven US sites, researchers randomly assigned a total of 288 adults aged 22–65 years with obesity to aIGB with lifestyle intervention or lifestyle intervention alone (control) for 32 weeks.

• A total of 171 (92%) patients in the aIGB group showed a clinical response.

• For weight loss plateau or intolerance, 145 (80%) patients had adjustments to the aIGB.

• An additional mean 5·2% (4·5–5·8) total body weight loss was attained when an upward volume adjustment was done.

• Downward volume adjustment allowed completion of the full duration of therapy in 21 (75%) patients in the aIGB group.

• Overall, there appeared a significant weight loss among participants randomized to aIGB with lifestyle intervention, which remained maintained for 6 months following aIGB removal.

• Maximization of weight loss and tolerance was attained because of individualized therapy permitted by balloon volume adjustability.