A Prospective, Randomized Multicenter Study to Evaluate the Safety and Efficacy of the ReShape Duo™ Intragastric Balloon System in Obese Subjects

Inclusion criteria

• Patients 21 to 60 years of age
• Body Mass Index (BMI) ≥ 30 kg/m^2 and ≤ 40 kg/m^2
• At least 5 years of obesity (with BMI ≥ 30)
• Stable weight, defined as a subject who has not gained or lost ≥ 5% of body weight in the 3 months preceding the screening assessment
• Failure to lose weight, within the 36 months preceding the screening date, after participation in either of the following:

• A medically or commercially supervised weight loss program involving regular counseling regarding both diet and exercise.
• Use of a United States Food and Drug Administration (FDA)-approved diet drug
• The presence of one or more obesity-related comorbid conditions
• Willing and able to provide Informed Consent
• Willing and able to comply with study procedures and visit schedules as specified by the protocol
• If female, the patient must

• be postmenopausal for at least 1 year OR
• be surgically sterile, OR
• if of child bearing potential, must be practicing birth control, be willing to avoid pregnancy for the year of study participation, have a negative serum pregnancy test at screening, and a negative urine pregnancy test at baseline
• Residing within a reasonable distance from the Investigator's treating office and able and willing to travel to the Investigator's office to complete all routine follow-up visits.

Exclusion criteria

• History of and/or ongoing clinically significant conditions or disorders of the gastrointestinal (GI) tract
• Clinically significant and uncontrolled/unstable hepatic, reproductive, gastrointestinal, renal, hematologic, pulmonary, neurologic, psychiatric, respiratory, endocrine, or cardiovascular system diseases
• Significant acute and/or chronic infections of any kind.
• Severe coagulopathy, hepatic insufficiency or cirrhosis
• Uncontrolled or severe asthma, or any asthma requiring or likely to require inhaled steroid therapy during the anticipated duration of trial participation
• Severe obstructive sleep apnea
• Incompletely controlled hypothyroidism or hyperthyroidism
• Severe systemic disease [consistent with an ASA (American Society of Anesthesia) Physical Status Classification Score of 3 or greater]
• Eating disorders, especially binge eating
• Inability to walk 200 yards without assistance
• Known allergies to any of the device materials or accessories, i.e. silicone, methylene blue, corn starch
• Active drug or alcohol addiction within 12 months of enrollment
• Insulin-dependent diabetes (either Type 1 or Type 2) or a significant likelihood of requiring insulin treatment in the following 12 months
• Depressive disorder with total Beck Depression Inventory (BDI) score > 16 points, and/or BDI affective subscale score > 7 points at screening
• Ongoing treatment, or anticipated need for such treatment, with anticoagulants, known gastric irritants such as aspirin (ASA) or non-steroidal anti-inflammatory drugs (NSAIDs) or agents that can promote gastrointestinal bleeding, within 1 month prior to enrollment, or unwillingness to forego these medications during the study period
• Participation within 60 days of screening date in previous or ongoing clinical trial or current usage of an investigational drug or device
• Any use of an intragastric device prior to this study.
• Genetically caused obesity, such as Prader-Willi syndrome
• Any prior bariatric surgery or likely to undergo bariatric surgery during study follow-up period
• Concomitant use of, or unwillingness to avoid any use of, weight loss medications, weight loss supplements, weight loss herbal preparations and/or participation in any non-study-related organized weight loss program (commercial or medical) at any time during the study, including online or smart phone applications to track or modify food intake, exercise regimens or weight
• Chronic opiate use (> 3 months continuous use) or likely need for opiate use during study participation
• Contraindication or allergy to, or unwillingness to use, proton pump inhibitor medication throughout study follow-up duration-Pregnancy, breast feeding, or intention of becoming pregnant during the study
• Any screening laboratory values outside of the normal range deemed clinically significant by the Investigator
• Anemia defined as either:

• Hemoglobin (Hgb) value for females of < 11.0 g/dl, for males < 12.0 g/dl
• Abnormal red cell indices and iron deficiency
• Smoking cessation within 3 months of study entry or plans to quit smoking during the study
• Major surgery, open biopsy or significant traumatic injury within 3 months prior to enrollment.
• History of significant adverse experience with sedation or anesthesia
• Serious or uncontrolled psychiatric illness or disorder that could compromise patient understanding of or compliance with study procedures
• Any condition that, in the opinion of the Investigator, would compromise the well-being of the patient or the study or prevent the patient from meeting or performing study requirements, including:

• Inability or unwillingness to sign the patient informed consent document.
• Inability to participate in all necessary study activities due to physical or mental limitations.
• Inability or unwillingness to return for all required follow-up visits.
• Employees/family members of ReShape Medical® or any of its affiliates or contractors
• Employees/family members of the Investigator, sub-Investigators, or their medical office or practice, or surgical, bariatric or hospital organizations at which study procedures may be performed
• An immediate family member (by marriage or blood relationship) of another subject already enrolled in the REDUCE Pivotal Trial

Endoscopic exclusion criteria:

• Peptic ulcerations
• Clinically significant hiatal hernia (> 3 cm)
• Patulous pyloric channel
• Erosive esophagitis
• Varices
• Angiectasias
• Barrett's esophagus
• Esophageal stricture
• Gastric mass
• Any other subject characteristic that would prevent the successful insertion of a ReShape Duo™ or that in the opinion of the Investigator preclude safe use of the ReShape Duo™