OBJECTIVES: To understand patients’ tolerability and perception of the effectiveness of the BIB system.  METHODS: A paper-based survey was completed by 186 patients through 5 physician’s practices in Europe, Canada and South America. Surveys were completed either in person or via phone by a health care professional. Questions focused on patient demographics, current or prior use of the BIB system, self reported weight loss, and tolerability. Univariate analyses were performed to evaluate the amount of weight loss, side effects associated with the BIB system, patients’ overall satisfaction with the system, and the likelihood of recommending it to others. RESULTS: Of the 186 respondents, 40% were currently using the BIB system. The mean age of the population was 37 years (range 17-76 years). The average weight loss for patients who had completed the full 6 months at the time of the survey was 17.7kg. While during the induction phase of using the BIB system, the majority of patients experienced moderate to severe nausea and vomiting, but their daily functioning was not greatly affected. While using the BIB system, more than half of the patients experienced nausea, cramping, and vomiting; however, most patients had complete resolution of symptoms within 7 days. About 87% of the patients were satisfied with the BIB system and 85% would recommend it to others. Reasons for satisfaction included: amount of weight loss and ability to effectively diet without feeling hungry.  CONCLUSIONS: Most patients were satisfied with the BIB system, despite early side effects they experienced, and would consequently recommend BIB to others.