A Multidisciplinary Intragastric Balloon Care Pathway for Weight Management in a Tertiary Malaysian Centre: Clinical Practice Framework

Theeran Gill, Guo Hou Loo, Guhan Muthkumaran, Nik Ritza Kosai Upper GI & Metabolic Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MalaysiaCorrespondence: Guo Hou Loo, Upper GI & Metabolic Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, Email looguohou@ukm.edu.myBackground: Obesity is a chronic disease with major metabolic, physical, and psychosocial consequences. Intragastric balloon (IGB) therapy is a minimally invasive endoscopic or device-based option that can bridge the gap between lifestyle intervention and bariatric surgery for selected patients. Despite expanding use, many centres lack a standardized multidisciplinary pathway to ensure appropriate selection, peri-procedural safety, nutrition support, and structured follow-up.Objective: To describe the development and implementation framework of a standardized multidisciplinary IGB care pathway in a tertiary Malaysian centre, including patient selection, peri-procedural pharmacotherapy, nutritional protocols, safety monitoring, and follow-up scheduling.Methods: This is a clinical practice framework describing protocol development based on local practice needs, alignment with national recommendations, and evidence-informed considerations. The pathway consolidates: (1) patient selection and assessment algorithm, (2) standardized medication regimen, (3) dietitian-led post-procedure nutritional support options, and (4) structured clinic follow-up milestones.Practice Framework: The pathway defines indications (including Asian population considerations), anticipated efficacy expectations, adverse effect management, serious complication awareness, nutrition regimens using commonly available oral nutritional supplements, and staged follow-up at 2 weeks, 4 months, 8 months, and 1 year. It also outlines local device options used in the institution and key counseling points for durability and weight regain prevention.Conclusion: A standardized multidisciplinary intragastric balloon care pathway provides a structured approach to delivering IGB therapy in routine clinical practice. Its clinical effectiveness requires validation through prospective outcome-based studies. It may serve as a practical reference for centres developing endobariatric services in similar healthcare settings.Keywords: intragastric balloon, obesity, bariatric endoscopy, patient care team, nutritional support, Malaysia