When you feel that the balloon has less effect or when weight loss diminishes, it is time for your balloon volume to be increased. Gastric balloon effect diminishes after 2 to 4 months, and you can expect to have your first balloon adjustment usually after 4 months. It can be done more than once and requires a simple 15 minute endoscopy procedure with sedation. The balloon volume can also be decreased in cases of balloon intolerance.