4. Medsil Balloon-Medsil Intragastric Balloon is a European made 6-month balloon that has been in use for several years in Europe and elsewhere. It has proven to be a trusted and reliable medical device that is effective and affordable compared to the American version, Orbera. It requires oral endoscopy for its insertion and removal. The silicone balloon is filled with normal saline and can be filled to a maximum of 700 ml. Patients can elect to have a 2nd Medsil after the removal of the 1st one if they choose to complete the treatment toward a normal BMI.