I recently wrote a two part series on gastric bypass surgery. Since posting that content, some new information has come to light. Satiety Inc. has been developing and testing a procedure to shrink the stomach by inserting a stapler through the patient's mouth, rather than surgically opening a person's stomach, in order to reduce the surface area of the stomach/small intestine and facilitate dramatic weight loss in an obese person. Clinical trials from the Cleveland Clinic on this procedure showcased disappointing weight loss results. The lackluster performance of this new procedure known as the transoral gastroplasty leaves the arsenal of newer "non-surgical" treatments of obesity in a somewhat dismal state.
There still is ongoing research into the treatment of obesity including:
- A study looking at a pill, that when taken before meals, swells up to fill the stomach and limit the amount of food you can eat.
- A study looking at a pacemaker that is implanted and deliver jolts to the wall of the small intestine, allowing food to rapidly pass through and limit digestion.
- Another company is developing a device that slows the movement of food out of the stomach.
- The use of Botox injections into the lining of the stomach to reduce hunger
The enthusiasm behind a procedure like the transoral gastroplasty is that avoiding actual surgery will help to dramatically reduce the risk of infections that can occur with these kinds of weight loss surgeries. Non-surgical approaches can also significantly lower costs for the treatment of obesity. There has been one recent improvement on sleeve gastrectomy. It's a technique called plication, which allows the excess stomach area to be folded or tucked, rather than removed by surgery. One relatively new device currently approved in Europe mimics certain elements of bypass surgery. A tube is inserted in the patient's mouth and literally becomes in inner lining of the lining of part of the small intestine. Food going through the small intestine is then prevented from being absorbed by the intestine wall because of this liner barrier. The problem with most devices like this and others placed internally is that they should be removed after 6 months to a year, in order to prevent other secondary health problems like infections. Surgeons also question the overall value of these non invasive procedures/devices when compared to the track record of weight loss surgery. No matter how much weight the patient loses while a device is in place, there is high risk of regaining all or some of the weight if the device has to be removed.
The FDA has guidelines that are considered pretty tough for new implantable weight loss devices. Guidelines demand that a weight loss be sustained for a minimum of 6 months after an implantable weight-loss device is removed from the patient. Makers of the devices feel that these goals are too lofty for devices that are less invasive and risky. The bottom line is that currently the less invasive procedures do not showcase the kind of weight loss that bariatric surgery can achieve.
Published On: May 11, 2011