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3,087 reviewsof the Weight Doctors® Group · 97% recommendation rateBlog · 14 August 2025 · 4 min read
Meta-analysis on the Spatz3: safety and effectiveness of the adjustable gastric balloon
A 2025 meta-analysis of almost 5,000 people treated evaluates how effective and safe the adjustable Spatz3 gastric balloon is – and what its adjustable fill volume offers.
Medically reviewed byDr. med. Hans Werner SudholtSpecialist in internal medicineLast updated:
The adjustable gastric balloon
A meta-analysis published in 2025 provides extensive data on the Spatz3, a gastric balloon whose filling volume can be adjusted during treatment. It evaluated 12 international studies with a total of 4,981 patients treated with the Spatz3.
Source: meta-analysis “The Efficacy and Safety of Adjustable Intragastric Balloon for Weight Loss”, published in 2025 in the journal Obesity Facts.
Results
Weight loss with the Spatz3
- Average weight loss16.4% of body weight – with a starting weight of 100 kg, that is around 16 kg
- Treatment durationon average 9.9 months, up to 12 months possible
- Long term72% of the weight lost was still maintained 12 months after removal
- In the main study, the Spatz3 group lost 15% of its weight, the comparison group with lifestyle change alone 3%
The figures are averages from studies. Results vary from person to person.
Safety
What the analysis shows on safety
The Spatz3’s anchor system is designed to prevent the balloon from migrating into the intestine – even if it leaks, it stays in the stomach.
By comparison: conventional gastric balloons have to be removed early in 9–12% of those treated, whereas with the adjustable Spatz3 it was 5.7%. The ability to adjust the filling volume makes the difference here. The overall complication rate of the Spatz3 was below 2%; for surgical procedures, complication rates of 9–12% within 5 years are reported.
- Early removal (within 3 months)
- 5,7 %
- Stomach ulcers
- 1,1 %
- Migration of the balloon with bowel obstruction
- 0,04–1,8 %
- Deaths
- none in the studies evaluated
What sets it apart
A filling volume that can be adjusted
Unlike conventional gastric balloons, the volume of the Spatz3 can be changed throughout the entire time it is worn – during a short gastroscopy, usually once after 3–6 months. This helps with the two most common hurdles of balloon treatment: when weight loss stalls and when the balloon is not tolerated.
- More volume against a plateau34.2% of those treated had the volume increased. As a result, they lost an additional 6.3 kg on average; depending on the study, the figure ranged between 4.8 and 9.3 kg.
- Less volume in case of discomfort9.2% had the volume reduced. In 90.8% of them, the discomfort improved markedly, so they were able to continue treatment instead of having the balloon removed early.
Process
How treatment with the Spatz3 works
- PlacementThe balloon is inserted through the mouth during a gastroscopy, as an outpatient and under sedation (twilight sleep) or brief general anaesthesia; this takes about 30 minutes.
- FillingIn the stomach, it is filled with about 500 ml of saline solution and takes up roughly one third of the stomach volume.
- Getting used to itIn the first 3–4 days, nausea and a feeling of pressure are normal; they usually subside afterwards.
- AdjustmentIf needed, the volume is adjusted, usually after 3–6 months.
- RemovalAfter 12 months at most, the balloon is removed endoscopically as an outpatient procedure.
Conclusion
The meta-analysis shows that the adjustable Spatz3 can be a scientifically well-studied, effective way of losing weight without surgery. Its adjustable filling volume addresses the two main problems of conventional gastric balloons: if weight loss stalls, more volume can help; if the balloon is not tolerated, less volume can.
Whether the Spatz3 or another balloon suits you is clarified by specialists in a personal consultation. More about the balloons in the gastric balloon guide and on the page Gastric balloon for 12 months.
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Frequently asked questions
Questions and answers
Your question isn’t listed? Your specialist will take time for it during the consultation.
What distinguishes the Spatz3 from other gastric balloons?
Its filling volume can be adjusted throughout the entire treatment. It can also stay in the stomach for up to 12 months, whereas many other balloons are removed after 6 months.
How much weight can I lose with the Spatz3?
In the meta-analysis, the average weight loss was 16.4% of body weight. Results vary from person to person and depend on how you change your diet and exercise.
How is the Spatz3 gastric balloon inserted?
During a gastroscopy through the mouth, as an outpatient and under sedation (twilight sleep) or brief general anaesthesia; this takes about 30 minutes. In the stomach, the balloon is filled with around 500 ml of saline solution.
How long can the Spatz3 gastric balloon stay in the stomach?
Up to 12 months – in the meta-analysis 9.9 months on average. It is then removed as an outpatient during a gastroscopy.
How safe is the Spatz3?
In the meta-analysis of almost 5,000 treated patients, the complication rate was below 2%. The anchor system is designed to prevent it from slipping into the intestine. As with any procedure, though, inserting a gastric balloon carries risks, which are discussed in the informed-consent discussion.
What side effects does the Spatz3 gastric balloon have?
In the first 3–4 days, nausea and a feeling of pressure are normal; they usually subside afterwards. In the meta-analysis, the balloon was removed early in 5.7% of those treated, within the first 3 months.
What happens if I cannot tolerate the Spatz3?
In that case, the volume can be reduced during a short gastroscopy. In the meta-analysis, this improved the discomfort markedly in 90.8% of those affected, and they were able to continue treatment.
Will I regain weight after removal?
The long-term data are encouraging: 72% of the weight lost was still maintained 12 months after removal – provided the new habits are kept up.
Who is the Spatz3 suitable for?
For adults who are overweight with a BMI of 26 or above and have not made progress with other methods so far. In the studies, the average BMI was 36.6.
Can I eat normally with the Spatz3?
Yes, but in smaller portions. Because the balloon takes up about a third of the stomach, you feel full more quickly. The study participants reported a pleasant feeling of fullness without cravings.
How often do I need check-ups?
After insertion, regular check-ups follow. If you wish, the filling volume is adjusted as an outpatient during a short gastroscopy.
Is the Spatz3 approved?
Yes. In 2021 the Spatz3 received approval from the US authority FDA as an adjustable gastric balloon and is CE-certified in Europe.
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