Sun, Nov-06-11, 01:29
This gastric pacemaker fills me up
From The Sunday Times
6 November, 2011
This gastric pacemaker fills me up
An obese mother-of-three will become first person to be implanted with a revolutionary new device that trains people to eat less food
A 17-stone (238lb) woman is to become the first person in Britain to be implanted with a revolutionary electronic device designed to train obese people to eat normally.
The “gastric pacemaker” works by stimulating the nerves linking the stomach to the brain, creating the impression of fullness, even when the patient has eaten very little.
The 53-year-old mother-of-three, from the south of England, is due to be fitted with the device at a private hospital in Southampton this Wednesday.
The device, known as the Abiliti, is seen as a potentially safer alternative to drastic procedures like gastric bypass surgery, and so could offer new hope for the 10m-plus Britons classed as obese.
The scientists who have trialled the device suggest it may one day also be offered to people who are simply overweight, as a way of preventing them ever becoming obese.
The woman, who asked not to be named, said she saw the £10,000 implant as her last chance of losing weight.
“I’ve been big ever since I was a child,” she said. I’ve tried everything, including exercise, dieting and drugs, but nothing works. I’d give anything to have a normal shape.”
The Abiliti has already been tested on nearly 200 obese people across Germany and Spain, and has just won formal approval for use in Europe.
The trial results show that people fitted with it lost on average 30% of their excess weight in a year.
One patient, a German man who weighed 25 stone when fitted with the device, has since cut down to just over 12 stone and has started competing in triathlons, according to Professor Thomas Horbach, director of surgery at Erlangen University’s academic teaching hospital in Germany, who oversaw the trials.
“Obesity is becoming a huge issue across Europe, but Britain has by far the highest problem. Only America is worse,” he said.
Obesity is defined as having a body mass index above 30. Across Britain, obesity rates have tripled in the past two decades, affecting about 24% of all adults. The NHS now spends 15-20% of its hospitals budget treating obesity-related conditions such as diabetes.
The Abiliti, made by IntraPace, an American company, works by targeting the branch of the vagus nerve that controls feelings of hunger.
When someone eats, the stomach becomes distended and produces various hormones and enzymes. The vagus nerve relays these changes to the brain, creating feelings of fullness that prompt most people to stop eating.
In many obese people, however, this system has effectively broken down so that they snack throughout the day.
Horbach said the Abiliti was designed to retrain over-eaters so that they went back to more normal eating patterns. The system works by using a sensor, embedded in the stomach wall, to detect when food has entered the stomach.
It relays this information to a “stimulator” embedded in another part of the stomach, close to the vagus nerve. This excites the nerve, creating powerful feelings of fullness.
However, since a key aim is to train obese people to eat at fixed meal times, the Abiliti has a timer that switches the device off at meal times. Horbach said: “We generally give people 20 minutes to eat their breakfast, then the device comes on.”
The operation on the British woman will be carried out at Spire Southampton hospital by James Byrne, a consultant surgeon who specialises in gastrointestinal surgery.
He said the Abiliti implant offered several potential advantages over conventional weight-loss procedures such as gastric bands or gastric bypass surgery.
“Those procedures do work but they are quite drastic because we have to remodel the gut,” he said. “The Abiliti is just a simple implant that can be reversed if necessary, so it is much less aggressive.”
The implant is fitted with an accelerometer, which measures movement, and wi-fi allowing data about a patient’s diet and exercise levels to be transmitted to a PC or smartphone where it can be viewed by the patient or doctor, or downloaded onto a social networking site (my.abiliti.com) to share with other people fitted with the device.