Obesity Clinical Trial
Official title:
Randomized Trial of Intragastric Balloon and Pharmacotherapy for Non-Morbid Obesity
To evaluate and compare the effectiveness of intragastric balloon and Sibutramine (Reductil®) in the treating of non-morbid obese in a randomized controlled manner
Obesity is a chronic devastating disease and is becoming a major health and socioeconomic
issue worldwide. Obesity significantly exacerbates many other chronic illnesses and
increases mortality and morbidities of patients.1-2 Although the situation in Asians is less
apparent and critical than in Caucasians, the problem is emerging rapidly. In Hong Kong,
there are approximately 29% of adults classified as obese according WHO Asian criteria 3 and
there is an increasing demand for obesity treatment in Asia-Pacific region.4 The first
practical aim of treating obesity nowadays should focus on a sustained body weight loss of
10-15% to alleviate obesity-related illnesses such as hypertension, diabetes and obstructive
sleep apnoea.
Intragastric balloon (IGB) was initially developed from observing the effects naturally
caused by bezoars and the first documentation in human use was reported in 1982.5 However,
earlier balloon designs were plagued by high balloon failure rates and serious
complications.6-8 Since then, balloon design has undergone several major modifications in
terms of material, shape and filling substances. The newer design of balloon (Bioenterics®
Intragastric Balloon (BIB®) system) was introduced in 1999 9 and has undergone extensive
evaluation recently in Europe with promising results.10-11 It is placed inside the stomach
endoscopically for a maximum of 180 days to decrease stomach capacity and gastric emptying.
It facilitates patient’s compliance to the restricted diet prescribed and together with
increasing level of physical activities, most reports have shown moderate body weight loss
of 15 % or more.10--12 More importantly, the newer design balloon (BIB) is more reliable and
predictable. The reported premature balloon rupture and serious complication is rare if it
is removed within the recommended period and followed up carefully by a dedicated obesity
team in a multidisciplinary approach.10-12 Sibutramine (Reductil®) is a serotonin and
noradrenaline reuptake inhibitor and is one of the FDA approved weight reduction
pharmacotherapy. Its central action on neurotransmitters causes an enhancement of satiety
(fullness) after eating. In addition, it causes sympathetically mediated thermogenesis,
which prevent the reduction in basal metabolic rate (BMR) normally seen in individual on
restricted diet and thereby effectively increases resting energy consumption and promotes
weight loss. A combination of sibutramine and lifestyle modification program has been shown
up to 10 % of body weight loss while intragastric balloon and sibutramine are the two most
commonly used non-surgical method for weight reduction. There is lack of randomized
controlled trial in comparing these two methods in the treatment of obesity. Since these two
types of therapy are most efficient in non-morbid obese patients, we are designing a trial
to compare the effect of the two different weight reduction therapies in this group of
patients in a double-blind manner.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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