BACKGROUND: Obesity is considered a chronic disease, difficult to treat, and is the first cause of death in the world predictable. The surgical approach is limited to patients with severe obesity, there is an intermediate group who are not candidates for immediate surgery, The BioEnterics Intragastric Balloon (BIB) and the Spatz Adjustable Balloon System (ABS) are currently recommended for weight reduction as a bridge to bariatric surgery. METHODS: We retrospectively studied patients who had received the BIB from January 2012 to July 2013, and we prospectively studied patients who had receive the ABS from July 2013 to August 2014. The aim of this study was to compare the two balloon systems in terms of weight loss, complications and maintenance of weight after removal. For both procedure median weight loss was 20 +/- 3 kg and median BMI at the end of the therapy was 32 +/- 2 kg/m(2). RESULTS: No major complications occurred. At 3-month follow-up weight loss was 4 +/- 2 kg with ABS and 3 +/- 2 kg with BIB. At 6-month followup weight loss compared to the previous measurement was 6 +/- 2 kg with ABS and 6 +/- 1.5 kg for with BIB. At 9-month follow-up weight loss compared to the previous measurement was 10 kg with ABS and 11 +/- 2 kg with BIB. CONCLUSIONS: The BIB and the ABS are effective in treating overweight patients with BMI. The rate of complication reported is the same. According to the literature, there are no significant differences between the two procedures in terms of outcomes.