Weight loss isn’t easy and the diseases and complications associated with being overweight and obese are also not unknown. Along with being the ‘Diabetes Capital of the world’, India also has a high prevalence of obesity. Although, there are infinite number of products and supplements available in the market, there is a constant search for the most “convenient” and hassle-free way of losing weight among people.
On Tuesday, Allurion launched its swallowable gastric balloon capsule in the country. It is the world’s first and only swallowable gastric balloon for weight loss. During the press conference in New Delhi, the makers announced that they are officially launching in five cities of India which include: New Delhi, Mumbai, Ahmedabad, Hyderabad, and Chennai.
Financial Express.com reached out to Dr Shantanu Gaur, Founder and CEO, Allurion and he talked about their gastric balloon is different from conventional surgeries and procedures, eligibility, and their plans for the Indian market among others. Excerpt:
What is Allurion Gastric Balloon?
Allurion Gastric Balloon is a breakthrough revolutionary device. The reason it’s a breakthrough is, that it’s the first weight loss device that can be administered without surgery, without endoscopy, and without Anaesthesia. We call it procedure-less. That’s important because it becomes safer for the patient, more convenient, and also more affordable (Price in India is around Rs. 3 Lakh) when you compare how much more accessible our balloon is compared to bariatric surgeries or something more invasive it’s a night and day difference. The product comes in the form of a capsule and is attached to a very thin tube. You go to a doctor’s office and swallow the capsule and it goes down the stomach.
We take a quick X-Ray to make sure that the capsule is in the right spot. Then you attach the tube to a bag of fluid. The fluid goes into the bag of the balloon and the tube is removed. In just a 15-minute visit, you end up with a life-changing device inside your stomach. The balloon is filled with half a litre of water and it stays in your stomach for four months. At the end of four months, it opens ups on its own and passes out of the body through motion. The balloon itself is covered by 40 patents around the globe because of the innovative technology that we have developed which makes it swallowable and disappear after four months.
Along with this gastric balloon, what are the other parts of this weight loss treatment programme?
The balloon is a part of the programme that we have created and that programme has three pillars: First is the balloon, we like to say that it’s the hardware. The second pillar is the software. Every time someone gets a balloon they also get a weighing machine, they get our watch and downloadable mobile app. The mobile app collects all the data from the scale and the watch and that data is also made available to the patient’s doctor and the doctor’s team. We have built software now that allows the patient and the doctor to communicate in real-time and the doctor to monitor remotely all of the patients’ progress. The third pillar of the programme, is our behaviour change programme which really teaches people to lead a healthier lifestyle, reduce the quantity of their food, which the balloon naturally does, and improve the quality of the food they take so that after the balloon leaves the body they can keep that weight off.
On average, our patients lose 14-15 Kilograms in just four months and they only regain a kilogram or two over a subsequent 12 months. So, it’s a very effective programme that also can deliver long-lasting results. Also, patients who need more weight loss can always come back and get a second balloon or third or fourth balloon.
What makes this gastric balloon different and better than conventional gastric surgeries taking place across the world?
The most important thing is, that there is no surgery involved. This is something that you can literally get on a lunch break and a 15-minute office visit. For surgeries, you need to go to a hospital, get evaluated, and come back get your surgery, you may remain in the hospital for several days and there are complications associated with surgeries, its expensive, and its very difficult for patients to actually agree to get surgery because it’s a big step. With our balloon, you can achieve similar results without any of that hassle, without any of that expense, and without any of those serious complications. That’s what makes our balloon special.
But what makes our programme special, is that we combine our balloon with software, with a behaviour change programme that essentially turbo-charge the balloon. Those two pillars, the digital platform and behavioural change programme make the balloon to be even more effective and allow that effect to continue after it has left the body.
India has a different kind of diet. We sometimes eat spicy food, sometimes too sweet, or too oily. Will the user be required to change the diet?
The user with the balloon inside the stomach can continue with the normal diet. It’s just that the quantity of the food will be reduced. My father grew up in Lucknow and my mother grew up in Aligarh. So, I am used to eating rich and good food and that’s one of the best parts of Indian culture. The balloon allows you to still enjoy those foods but reduces the quantity substantially.
And what we have found is that as people reduce their quantity, as they start losing weight, they start making even healthier choices. So, instead of deep frying your samosas, you may now bake them in the oven. That’s one small step, but a little healthier. So, those baby steps you take for the four-month period end up really changing your lifestyle and the balloon helps you get there very quickly, the behaviour change programme and our software help you stay there. That’s the trick. But there are no restrictions on what you can or cannot eat. It’s just that the quantity needs to be kept in control.
What happens when the balloon is out of the body? Is it possible that the person can gain back the reduced weight?
It is possible. If you haven’t truly changed your lifestyle and you return to your previous habits, yes you can put the weight back on. However, what we have found is that most patients will achieve a very significant with our balloon for the first time in their life and it’s a very special moment for them and it’s a life-changing moment for them. It’s very difficult for them to even imagine going back to what they used to be. Because they worked so hard to lose weight. So, most of our patients are really motivated to stay at that weight. Now, it’s difficult.
But remember that our scale and watch and app stay with you forever. One of the most powerful weight maintenance mechanisms is simply weighing yourself periodically and having that daily reminder of “this is my weight” and when you do have a couple of days when you slip and see the Kgs coming back, you can revert back to healthier habits and that is our goal. To help you once you have lost weight and steady your lifestyle and keep you there. There will be small ups and downs but as long as you can re-stabilise, we can generate long-term results.
How did this gastric balloon happen? What inspired you and what has been your journey so far?
I really credit the founding of Allurion, mostly to my parents. My parents were born in India, raised in India and came to the United States and built a life for themselves and they taught me how to take risks. They taught me to think big and they taught me to deal with the ups and downs. As a founder and CEO of the business, there are a lot of ups and downs, and you have to take a lot of risks. I think it’s in my DNA to be an entrepreneur and it’s in the DNA of the Indian population to think big and do big things. That’s partly why I founded Allurion. As a medical student at Harvard, we got exposed to the world’s best researchers and scientists from all over the world who are studying all sorts of different diseases. But the one thing that kept coming up, again and again, was obesity. It seemed to be the centre of everything–Diabetes, Heart diseases, infertility, sleep Apnea, high cholesterol, all came back to obesity. So, it was the biggest problem to solve and no one has solved it before. That’s why we decided to start Allurion.
As a founder, my job is to keep us focused on the big vision. That big vision is to end obesity across the world and obviously end obesity in India after we are launched here. So, my job personally has evolved. Earlier, I was a scientist, I am the lead inventor with 40 patents on the balloon, then we came more of a clinical organisation doing clinical trials on animals and humans, then once we got approved we started selling it commercially and our business started to grow. Then we introduced software, AI and ML and as we have made each one of those steps, I have matured as the CEO and I have always prided myself on exploring the next frontier and the next frontier for us is not just weight loss, its long-term weight maintenance, its expanding into diabetes, leveraging AI and ML to make our programme smarter and scalable.
Alurion Gastric Balloon is one-of-a-kind in the world and now its launched in India which shares a huge burden not just in Diabetes but several other ailments too. Are you planning to diversify and planning to create similar products for other diseases too?
Actually, it’s already happening in front of our eyes. People are using balloons now in our programme to treat diabetes, heart diseases, to treat anything related to obesity. In fact, one of the initiatives that we will be launching is to establish a metabolic research institute in India where we can study other applications of our balloon programme and even study new technologies and new tools that we are developing in Allurion to bring to the Indian Market. As you said, India is a diverse country, a fast-growing country and now they are the number 5 economy in the world having overtaken the UK and I truly believe this is going to be India-centric. So, my lens on India is over the next 100 years. Can we become the number one provider of weight loss technology in India? or more broadly provider of wellness interventions in India? I think we can establish ourselves as the main player in India.
Who is suitable for this gastric balloon?
This product is indicated for patients who are either overweight or have obesity. So it’s a really broad indication. It is ideal for patients who have struggled to lose weight which means almost everyone. It is also ideal for patients who want to lose more weight than they could with just diet and exercise. That’s one segment. There is also a segment of patients who are considering surgery those with obesity and severe obesity and who don’t want surgery. 99 per cent of patients who qualify for surgery don’t get it. Only 1 per cent of patients get it. So, that’s another segment of the population that can use our programme and then there are patients who have excess weight but also have diabetes and other diseases related to their weight. So, that’s a wide variety of patients and the idea behind the programme is to make it safe enough and easy enough that almost anyone who needs to do lose weight can give it a shot.
Are there any side effects to the Allurion Balloon?
Anything that goes inside your stomach, can always have side effects. So, most of our patients will have some nausea, and they have a little bit of abdominal pain but just in the first 2-3 days as the stomach adjusts itself to the balloon. After that, these symptoms truly resolve. When you compare our rate of complications to that of bariatric surgery, it is a night and day difference. This balloon is incredibly safe and its already been tested commercially in over 100,000 patients. So, there is a lot of data to support how safe the technology is especially when you compare it to more invasive options.
How this product will be accessible to Indian patients?
We are establishing clinics in partnership with doctors all over India. We are here in India this week and launching officially in five cities: New Delhi, Mumbai, Ahmedabad, Hyderabad, and Chennai. But over the next year, we will most likely cover almost all of India, especially the urban centres and probably have the order of 150-200 doctors around the country placing the balloon. So, if anyone is interested in getting into the Allurion, they can go to their nearest Allurion Clinic, get a simple consultation, and get a quick screening to make sure they are the right candidate for this device and they will get the balloon. We have made it as easy and frictionless as possible. One of the important things that we were able to obtain in India is insurance coverage and it will depend on the type and other qualifications. We believe it will be very accessible to the Indian population and over time we expect to invest a lot of our profits in India, in fact, all of our profits in India over the next three years. We are committed to re-investing them back in India to make the programme even more accessible and to fund initiatives like metabolic research institutes.
How many people have benefitted from this programme so far?
So far, we have treated over 100,000 patients around the world and that’s just in the past five years. So, the company has grown very quickly but we like to measure the impact that the company is having, not in terms of revenue but in terms of the number of lives touched. So, we are already at 100,000 and our goal in India alone is to treat 100,000 Indians in the next 2-3 years because I believe this technology is applicable to a wide segment of the population.
In the past few years you have experienced exponential growth. What are your expectations from the Indian market?
Our expectations are very high if you look at the market research we have done so far in India. There are probably close to 100 million people in India who have the right weight for this technology and need this technology. So, as I said earlier, my lens on India is over the next 50-100 years and eventually, we will reach all 100 million of those people whether it’s with our balloon programme or the new technologies that we are introducing in the country. Our expectations are very high and so far they have been met with the initial launch that we have done in India the demand for this has been through the roof and the interest for this technology as you saw today is very significant.
There is a high prevalence of misinformation in the segment of weight loss. How should a person who wants to lose weight choose a procedure or method?
In India, the market for diet and supplements and other sorts of programmes is $5 Billion. So, people in India spend a lot of money unfortunately on things that do not work and one of the reasons that we have been so excited about our launch in India is that we are doing it in partnership with doctors all around the country. That’s a big difference between our technology and other things that we read about online. First, our technology came out of Harvard. I was a student at the Harvard Medical School and did my undergraduate studies at Harvard as well. In my DNA, it is to be a scientist and follow the data and seek the truth. We have developed a very big data set from our experience outside of India in over 100,000 patients.
This is a clinically proven technology and commercially proven technology even before it entered the Indian market. So, that’s the first thing we come with a lot of data and we are an extremely data-driven company. Second, we are partnering with doctors and doctors have the ability to screen the right patients and choose the patients who are going to get the best results with our programme be very careful about its initial use in the Indian population because we want to build the same data set in India. Third, we are a company that is based in the United States and regulated by agencies all over the globe not just in the US. So, when we put out a claim, when put out a new finding it’s based on a lot of different studies and a lot of science that goes on in our company every single day.
As you mentioned, that you are partnering with doctors, are you also planning to tie up with domestic players in India?
We are already in discussion with several of them, they have a large footprint in India. We want to very rapidly increase the accessibility of this product in India. India has a very complex healthcare market with a variety of players in them, some large, some very small and our goal is to put this technology in the hands of those who will use it responsibly but also those who will get the best results with as many as patients as possible as I really believe that every life we have the potential of changing it. So, we are in discussions already and even at this early stage with many of these players. We are hoping that next year we actually officially launch the partnerships that allow us to rapidly increase our footprint in India.
Anything else that you would like to add?
Just from a personal standpoint, I want to reiterate how proud I am that we are able to launch this technology here in India. This is a market that has very deep personal ties for me and also for a lot of our management team. It’s a market that we intend to invest in heavily over the next 3-5 years. This is a market that has incredible potential, unfortunately, it’s often overlooked, especially by US companies like I said this is India-centric and we intend to be right here on ground level to make sure we become and remain the number one player in the weight loss space in India.