51 Year old obese female with BMI 37.7kg/m2 with multiple comorbidities like Diabetes/Hypertension/Obstructive Sleep Apnoea/Osteoarthritis came for weight loss. Option of endoscopic balloon implementation, endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy were given to her. She has chosen minimal invasive method endoscopic balloon. Spatz 3 adjustable balloon was placed in stomach by endoscopy and 400ml of saline mixed with methylene blue instilled in ballon. Endoscopic balloon implantation cause 10-12% weight loss which is sufficient to prevent complications and morbidity of obesity.