Bariatric Arterial Embolization – New Obesity Injection

Last updated July 7th 2016

Bariatric arterial embolization is one of the latest possible solutions to the obesity crisis; this surgery has already undergone some clinical testing.

Many parts of the world are currently experiencing obesity crises and the UK is no different. In fact, one in four UK adults is technically obese – this means that the UK has the highest levels of obesity in Western Europe. In order to combat the obesity crises, new measures are regularly introduced in the hope that they will be able to help the many millions of obese people. One of the latest measures developed to tackle obesity is bariatric arterial embolization. It is hoped that bariatric arterial embolization can be used to reduce the number of people who are obese, though as of the time of writing, there is not much clinical evidence available.

What is bariatric arterial embolization?

Bariatric arterial embolization is a non-invasive surgical procedure whose aim is to prevent stomach bleeding, though it has also been linked with weight loss. This procedure has been linked with lowering levels of ghrelin, one of the two ‘hunger hormones’ that plays a role in body weight and is responsible for increasing appetite.This hormone is released in the stomach and is thought to work by sending signals to the brain, telling it the stomach is in need of more food.

The way bariatric arterial embolization works to combat obesity is by reducing hunger. This procedure works by having beads of a microscopic size injected into an artery through a small catheter that is inserted into a small nick of the skin in the wrist or groin. The beads are injected towards the fundus, which is the part of the stomach that produces the ghrelin hormone, in order to decrease the flow of blood. By decreasing blood flow, it is thought that these beads reduce the secretion of ghrelin, which should result in hunger being reduced and, over a period of time, weight being lost.

Clinical studies

Bariatric arterial embolization is still in the very early stages of testing and at the time of writing, only one major clinical study had been carried out to investigate the effects of this procedure on weight loss.

The study was led by Clifford Weiss, M.D., an associate professor of radiology and radiological science and the director of interventional radiology research at the Johns Hopkins School of Medicine in Baltimore, Maryland, US. Aravind Arepally, a former faculty member of the school, along with a group of researchers at the school, designed the study, entitled ‘The Bariatric Embolization of the Arteries for the Treatment of Obesity’, or ‘BEAT Obesity’ for short. The group of people who carried out the study included hormone specialists, gastroenterologists, physiologists, registered dieticians, weight loss physicians, surgeons and psychologists. A total of seven participants were recruited for the study; six of them were women and one was a man. The ages of the participants were between 31 and 59 and although all of them were severely obese, with BMIs of between 40 and 50, they were otherwise in good health. The participants were educated on ways to improve their health and lifestyle and then underwent bariatric arterial embolization.

The following measurements were then taken at one, three and six months after the injection: ghrelin levels, weight loss, satiety and hunger. The participants lost an average of 5.9% of their excess body weight after one month, 9.5% after three months and 13.3% after six months. Excess body weight refers to the amount of weight above the participants’ ideal body weight. Satiety and appetite were measured by using questionnaires. The participants’ hunger and appetite decreased by an average of 81%, 59% and 26% at two weeks, one month and three months respectively. It was also noted that the participants’ ghrelin levels had decreased by an average of 17.5% after three months. According to Weiss, the results of the study showed that bariatric arterial embolization appears to be effective at causing significant amounts of weight loss over a short period of time.

Even though this one clinical study has produced some promising results, more studies are needed to consolidate the surgery’s potential as an anti-obesity agent. Only seven people were involved as participants in this study and six of them were women; future studies should include more people and have more of a balance of men and women from different ages and backgrounds in order to gain a better idea of how the injection could affect a broader range of people. Weiss has said he wants a lot more data on the procedure so its potential cost savings can be accurately worked out; he has also said carrying out clinical studies involving more participants will help properly determine the efficacy of the procedure and its durability over long-term periods of time. It is currently unknown whether people would require a single injection to help with weight loss, or if they would require a number of injections; it is hoped that future studies on this procedure will determine how many injections obese people would require to help them lose weight in the long-term.

Side effects

The study carried out by the team at the Johns Hopkins School of Medicine reported that no adverse side effects were seen in any of the study’s seven participants. While this does appear to be a good sign that the procedure is safe, it is worth bearing in mind that the study involved a very low number of participants and that if the study had involved more participants, there is a chance that side effects may have been seen. Again, more studies involving larger number of participants are needed to determine whether the procedure is as safe is this initial clinical study shows it to be, or whether there are in fact some side effects associated with it.

Bariatric arterial embolization vs gastric bypass surgery

Gastric bypass surgery is a type of weight loss surgery used to treat people whose obesity is potentially endangering their lives. In the UK, weight loss surgery is only available on the NHS when other ways of treating obesity, such as exercise and diet, have failed to work. This type of surgery is only performed on people who cannot lose weight by any other means and whose weight is potentially life-threatening. The reason weight loss surgery is offered as a last resort is because, as with other types of surgery, there are a number of risks involved and after the procedure, you will be required to make a number of lifestyle changes to prevent yourself from putting the weight back on, such as sticking to a restricted diet and following a specified exercise regime. Some of the risks involved with weight loss surgery include deep vein thrombosis, internal bleeding and blockages or blood clots inside the lungs.

Because of the cost of weight loss surgery and the risks involved, most surgeons only offer it to people who genuinely need it for their health, not people who want it for purely cosmetic reasons. Gastric bypass surgery, along with sleeve gastrectomy and gastric band, is one of the three most common types of weight loss surgery and involves your digestive system being rerouted past most of your stomach. Surgical staples are used to create a small pouch at the top of your stomach, which is then connected to a part of your small intestine, bypassing both the bowel and the rest of the stomach. The result of this is that it takes less food for you to feel full and you absorb fewer calories from the food that you do eat.

Clifford Weiss has explained how bariatric arterial embolization is a better option to consider for combatting obesity: not only is the procedure less invasive than gastric bypass surgery because it just involves an injection, patients who undergo this procedure require much less recovery time than those who have gastric bypass surgery.

Would the procedure be enough?

As previously mentioned, it is unknown whether obese people would require a single injection or numerous injections to get them down to a normal, healthy weight. Clifford Weiss has mentioned that while bariatric arterial embolization is aimed at decreasing hunger, he sees the procedure as something to be used alongside diet and exercise. In other words, obese people who use this procedure have to make lifestyle changes in order to continue losing weight and to prevent weight from being put back on. Sticking to a healthy diet and doing lots of regular exercise are very often recommended as a means of achieving weight loss. Most weight loss supplements require you to diet and exercise in order to enhance the effects of the supplement and it would appear that bariatric arterial embolization is the same. Just as the participants in the study were educated on healthy lifestyle changes, it is likely that people who are eligible for this procedure in the future will receive similar educational information so that the weight loss effects of the injection are not reversed. In other words, the injection itself is not enough: those who get the injection would be responsible for maintaining their weight.

Bariatric arterial embolization in the future

This procedure has not yet been approved by doctors as a way of achieving weight loss, mainly because the procedure is still in the early stages of testing and development. The results of the study show that it does have potential to be an effective weight loss treatment, though as Clifford Weiss has explained, this procedure is still in the early stages of testing and more studies of a larger scale are required.

If further clinical studies do prove successful, it is unknown how readily available this procedure will become. Because it is non-invasive, and is likely to have fewer risks associated with it, there is a chance this procedure may be offered to obese people before the other invasive forms of weight loss surgery, such as gastric bypass surgery. Bariatric arterial embolization may well prove to be a much more effective and safer alternative than the types of weight loss surgery that are offered to obese people in extreme cases, though at this stage in the procedure’s development it is too early to say for certain whether it will go on to be a success.

Conclusion

Many procedures and measures have been developed to combat the obesity crisis and bariatric arterial embolization is one of the more recent procedures that is hoped to help obese people lose weight. The sole clinical study that has been carried out on this procedure has produced positive results, with all seven of the participants losing significant amounts of excess body weight, however, as the researcher who carried out the study pointed out, more studies are needed to further determine exactly how effective this procedure is at causing weight loss. The study did not report any major side effects, though there is a chance that future studies may report some side effects.

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