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Bariatric endoscopy · UK

Orbera intragastric balloon, with the coaching that makes it work.

A 6-month silicone balloon, placed and removed endoscopically by a bariatric endoscopist - wrapped in 12 months of dietitian and psychology coaching. The balloon is the tool; the programme is what holds the weight loss.

A stethoscope on a clinical desk

Indicative pricing

What a private intragastric balloon costs in the UK.

Indicative ranges across UK units.

In short

A full Orbera programme with 12 months of coaching: £4,500–£7,500, home the same day.

Programme Indicative range
Bariatric consultation and screening endoscopy £800–£1,600
Orbera 6-month balloon (placement + removal + 12-mo coaching) £4,500–£7,500
Spatz3 adjustable balloon (up to 12 months, all-in) £5,500–£8,500
Allurion swallowable capsule (16 weeks, no endoscopy) £4,500–£6,500
Combined balloon plus GLP-1 programme (12 months) £6,500–£9,500
Second-opinion review of prior weight-loss plan £250–£450

A warning worth naming. There are cosmetic clinics in the UK offering balloons without a bariatric MDT, without screening endoscopy and without a coaching programme. We will not refer to them.

The journey

From first appointment to removal - what happens, in order.

One team from first message to the coaching year after removal - including screening endoscopy, placement, monthly dietitian sessions and removal.

  1. 03

    Before

    Bariatric consult and screening endoscopy

    Consultant assessment, dietitian and psychology screening, and an upper GI endoscopy to exclude a large hiatus hernia, ulcer disease or malignancy.

  2. 04

    Before

    Two-week PPI and three-day liver-shrink diet

    A proton-pump inhibitor for two weeks and a low-carbohydrate diet for three days shrinks the liver and makes placement safer and cleaner.

  3. 05

    On the day

    Balloon placement, 20 to 30 minutes

    Conscious sedation or brief general anaesthetic. The folded silicone balloon is passed transorally, inflated in the stomach with 500 to 700 mL of saline plus methylene blue, and position is checked.

  4. 06

    On the day

    Home the same day

    A short recovery, written aftercare and anti-emetics, PPI and antispasmodics in hand. You will need someone to collect you after sedation.

  5. 07

    After

    Coaching, then removal at six months

    Monthly dietitian and coaching for six months, then endoscopic removal (puncture, aspirate, extract) under sedation, and six more months of coaching to hold the loss.

When it helps

When a balloon is the right step - and when it is not.

The patients we say yes to most often, plus the situations where a balloon is the wrong tool and we say so.

  • BMI 27 to 40 with previous failed diets

    You have tried structured lifestyle change and medication, and the weight has not shifted or has come back.

  • You decline bariatric surgery

    Sleeve gastrectomy or bypass is not something you are willing to do, but you want a reset and a structured programme.

  • Bridge before surgery at high BMI

    A pre-operative balloon to lose 10 to 15% before major bariatric or orthopaedic surgery makes the operation safer.

  • A reset alongside a GLP-1 programme

    Semaglutide or tirzepatide has stalled, or you want an early kick-start while titrating up to a maintenance dose.

  • Regain after prior lifestyle success

    You lost weight before and it came back. A balloon with 12 months of coaching gives structure to the next attempt.

  • Large hiatus hernia (over 5 cm)

    Not suitable for a balloon. A hernia this size raises the risk of reflux, migration and mucosal injury and needs a different plan.

  • Undiagnosed eating disorder

    Binge, purge or restrictive patterns need psychological work first. A balloon in an unscreened eating disorder can cause harm.

  • Red flag: severe reflux, PUD, prior gastric surgery

    Active peptic ulcer, uncontrolled reflux, previous gastric surgery, coagulopathy or pregnancy are contraindications.

Procedure options

Orbera sits in a family of options - not on its own.

What each option actually involves, and which fits which patient. We will tell you which two or three are worth comparing for you.

  • Orbera (Apollo Endosurgery)

    The best-studied option. A silicone balloon placed endoscopically, filled with 500 to 700 mL of saline and methylene blue, worn for 6 months, then removed endoscopically.

  • Spatz3 adjustable balloon

    Similar placement but the volume can be adjusted up or down mid-course, and it can stay in for up to 12 months. Useful if early symptoms are hard to tolerate.

  • Allurion Elipse swallowable capsule

    No endoscopy at placement or removal. A capsule on a thin catheter is swallowed, filled with 550 mL of fluid, then passes naturally at 16 weeks. See our dedicated page.

  • Reshape dual balloon

    A twin-chamber balloon that was designed to reduce migration risk. Discontinued by the manufacturer and no longer offered in the UK.

  • Balloon plus GLP-1 programme

    A balloon for the first 6 months, a GLP-1 (semaglutide, tirzepatide) started before removal and continued for 6 to 12 months to hold the loss.

  • Endoscopic sleeve gastroplasty

    A stitched reduction of the stomach volume with a suturing device. More durable than a balloon, no foreign body left inside, longer procedure.

  • Bariatric surgery

    Sleeve gastrectomy, gastric bypass or SADI-S. Larger, more durable weight loss than any balloon, but real surgery with a longer recovery.

  • Coaching-only programme

    Dietitian, psychology and exercise support without a device. Slower results, but no procedure risk and every gain is your own.

Safety, side effects and long-term

What to expect - honestly.

The evidence: 10 to 15% total body weight loss at 6 months, roughly 30 to 40% maintain the loss at 12 months post-removal with a lifestyle programme. Weight regain is common without ongoing support.

  • Nausea, vomiting and cramping for 3 to 5 days

    The peak symptom window after placement. Anti-emetics, a PPI and antispasmodics are prescribed as standard. Hydration matters more than food.

  • Graduated diet over 2 to 4 weeks

    Liquid for the first few days, then pureed, then soft, then normal textures. The dietitian sends written instructions and reviews you weekly.

  • Persistent reflux in around 10%

    A daily PPI helps; a minority need early removal. A large hiatus hernia at screening is a reason not to place a balloon in the first place.

  • Early intolerance (2 to 5%)

    A small number of patients cannot settle after placement and need the balloon removed early. We plan for this rather than pretend it will not happen.

  • Balloon deflation is rare

    Methylene blue in the saline turns urine blue-green if the balloon leaks - a signal to attend urgently for removal before migration into the small bowel.

  • Migration and obstruction are very rare

    A deflated balloon can very rarely pass into the small bowel and obstruct. Symptoms are severe cramping and vomiting - go straight to A&E.

  • Gastric ulceration

    Mucosal ulceration under the balloon is uncommon on modern PPI regimens. Do not stop the PPI early, and flag any dark stools or coffee-ground vomit.

  • Weight regain without coaching

    Around 30 to 40% of Orbera patients hold the loss at 12 months post-removal - the ones who do are the ones who did the coaching work.

  • Red flags after discharge

    Severe pain, persistent vomiting beyond a week, blue-green urine, black stools, coffee-ground vomit, or fever - call the unit or go to A&E the same day.

Reading your placement report

Your balloon report in four parts. Read the last one first.

Whichever device is used, the report the endoscopist sends you keeps to the same shape.

  1. 01 Header

    Balloon type, fill volume and dye

    Which device (Orbera, Spatz3, Allurion), the fill volume (usually 500 to 700 mL of saline) and confirmation that methylene blue was added.

  2. 02 Technique

    Placement and position check

    How the balloon was passed and inflated, and the endoscopist's check that it is sitting freely in the gastric body away from the pylorus.

  3. 03 Findings

    Screening findings and complications

    What the pre-placement endoscopy showed - hiatus hernia size, ulceration, H. pylori status - and any events during placement.

  4. 04 Impression

    Coaching schedule and removal date

    Read this first: your dietitian follow-up dates, PPI regimen, red-flag symptoms, and the booked removal at 6 months.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Most insurers class intragastric balloons as lifestyle weight-loss and do not fund them.

Frequently asked

Everything we get asked about intragastric balloons.

Quick answers on Allurion versus Orbera, weight regain, cost, insurance, other balloons, and coaching.

  • Allurion versus Orbera - which should I choose?

    Both give similar 10 to 15% total body weight loss. Allurion is a swallowable capsule worn for 16 weeks with no endoscopy at either end - simpler, but a shorter reset. Orbera is placed and removed endoscopically and stays for 6 months, giving a longer window for behaviour change and more supervised coaching. If a screening endoscopy shows something that needs treating anyway, Orbera makes sense; if the endoscopy is clean and you want the least invasive option, Allurion is a reasonable pick.

  • Will the weight come back after the balloon is out?

    Around 30 to 40% of Orbera patients hold the loss at 12 months post-removal, and the group that holds it are the ones who did the coaching. That is why we only recommend Orbera as part of a 12-month package with monthly dietitian and psychology support. Adding a GLP-1 medicine (semaglutide, tirzepatide) around removal is now common and improves 12-month maintenance.

  • How much does an intragastric balloon cost in the UK?

    A full Orbera programme (placement, removal and 12 months of coaching) is usually £4,500 to £7,500. Spatz3 adjustable balloons are £5,500 to £8,500. Allurion swallowable capsules are £4,500 to £6,500. Adding a GLP-1 medicine programme adds roughly £1,500 to £2,500 over 12 months.

  • Will my insurance cover an intragastric balloon?

    Not usually. Most UK private medical insurers class balloons as a lifestyle or cosmetic weight-loss treatment rather than a medically indicated procedure, and pay only when a strict BMI threshold, documented comorbidity and a formal bariatric MDT decision are in place.

  • What other balloons and alternatives exist?

    The main options in the UK are Orbera (silicone, 6 months, endoscopic), Spatz3 (adjustable, up to 12 months, endoscopic) and Allurion Elipse (swallowable capsule, 16 weeks, no endoscopy). The Reshape dual balloon has been discontinued. Beyond balloons, endoscopic sleeve gastroplasty, TORe (for regain after bypass), SADI-S surgery and dedicated GLP-1 clinics all sit on the same map.

  • Why is the coaching programme non-negotiable?

    A balloon reduces stomach capacity for a fixed period. What changes long-term outcomes is what you eat, how you move and how you handle stress and reward while the balloon is in - and after it comes out. Monthly dietitian sessions, psychology input where needed and a maintenance plan around removal are what turn a 6-month device into a durable result. We will not arrange a balloon without a coaching package around it.

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