Intragastric Balloons (IGBs) are used for obesity management; however, uncertainties persist regarding long-term efficacy due to variability in device types and follow-up durations. This systematic review and meta-analysis evaluated short- and long-term efficacy of IGBs for weight loss, stratified by device type, study design, and geographic region. Following PRISMA 2020 guidelines, 27 studies (5,842 patients) were identified from PubMed, Embase, Cochrane Library, and Web of Science (2000–2023), reporting weight/BMI outcomes pre- and post-IGB removal with ≥6 months of follow-up. Data extraction and random-effects meta-analyses were conducted independently by two reviewers. Primary outcomes were mean weight loss and BMI reduction at device removal; secondary outcomes assessed weight regain at 6, 12, 24, and ≥60 months post-removal. Pooled short-term results showed significant efficacy at removal: mean weight loss 14.9 kg (95% CI 12.7–17.0; I² = 44.05%) and BMI reduction 5.31 kg/m² (95% CI 4.22–6.40; I² = 0%), with BioEnterics Intragastric Balloon outperforming Heliosphere. Long-term outcomes demonstrated durable weight maintenance over 6–60 months (mean 8.01 kg, 95% CI 4.93–11.09; I² = 60.55%; BMI reduction 4.96 kg/m², 95% CI 3.29–6.62; I² = 0%), with effects persisting at 5 years (weight 7.26 kg; BMI 1.5 kg/m²). Subgroup analyses showed regional disparities: Middle Eastern cohorts achieved 8.6% greater excess weight loss and 1.2 kg/m² greater BMI reduction versus European cohorts, while prospective studies reported higher weight loss than retrospective analyses (13.1 vs. 11.8 kg; p = 0.04). These findings confirm IGBs, particularly BioEnterics devices, achieve sustained weight loss and underscore the importance of adjunct dietary interventions and multidisciplinary care in optimizing outcomes. The results provide actionable insights for evidence-based device selection and post-procedural management in obesity care.

Zenusha Hafeez Edathodu is a Resident Doctor and Clinical Teaching Fellow in the Diabetes and Endocrinology Department at Great Western Hospital, Swindon, UK. She obtained her MBBChBAO from Queen’s University Belfast. She is actively involved in undergraduate medical education within the Severn Deanery and has a strong interest in endocrinology, metabolic medicine, and academic teaching.