Weight Loss Surgery: One New Approach, One Intriguing New Insight

Ft. Lauderdale, Fla. (October 12, 2003) - New research presented today at the North American Association for the Study of Obesity's (NAASO) Annual Scientific Meeting offers a new treatment approach and some new insight into the mechanisms that help severely obese people lose weight and keep it off. While researchers still don't fully understand why weight-loss surgery works, these studies help explore the process by which the body sheds pounds.

One study, by researchers at Tufts-New England Medical Center, looked at a novel approach to surgical treatment. The Transcend Gastric Stimulation System, unlike most surgeries that treat obesity, does not alter gastrointestinal anatomy and has been shown to be safe in 450 subjects worldwide through a series of individual studies. This system uses an implantable electronic pulse generator to deliver electrical stimulation to the stomach, which reduces feelings of hunger.

In this study of 30 subjects, two bipolar leads were implanted in the muscular wall of the stomach using a laparoscopic procedure that takes about one hour. The leads were connected to an electrical generator (similar to a pacemaker) placed under the abdominal skin. The generators are activated two weeks after the surgery, and are set individually for each subject.

None of the subjects in this study reported complications. Eighty percent of the subjects lost weight after a follow-up of 8-9 months, with 60 percent of the subjects losing more than 10 percent of their excess weight.

"We hope this procedure will provide severely obese people with a low-risk and effective alternative to traditional surgeries," said lead researcher Scott Shikora, MD, Chief of the Bariatric Surgical Division in the Department of Surgery at Tufts-New England Medical Center.

A separate paper presented today reported that people who undergo Roux-en-Y gastric bypass surgery lose their taste for buttery or fatty foods and develop greater cravings for fruits and vegetables, suggesting that food preferences might be regulated at least in part by physiological signals.

In Roux-en-Y surgery, a small pouch (about the size of a walnut) is created at the top of the stomach. The small intestine is then cut and sewn to this pouch to provide an outlet for food. Food enters the second part of the small bowel about 10 minutes after the beginning of a meal. The food bypasses the main part of the stomach, but the digestive juices from the stomach enter the intestine as usual.

"The increased desire for fruits and vegetables and decreased desire for fatty foods lasted long after the surgery was completed," said lead researcher Alison Hoppin, MD, Associate Director for Pediatric Programs of the Massachusetts General Hospital Weight Center. "That means people who undergo this procedure tend to maintain a healthy diet. More importantly, this phenomenon may suggest that there are hormonal changes produced by the surgery that may also be a mechanism through which people lose weight after surgery."

Both studies were presented as part of a joint effort by NAASO and the American Diabetes Association (ADA) to increase awareness of the rising problem of obesity and its related health problems in the United States.

According to new data from the 1999-2000 National Health and Nutrition Examination Survey, published October 8, 2002 in the Journal of the American Medical Association (JAMA), obesity continued to increase dramatically during the late 1990s for Americans of all ages, with nearly one-third of all adults-almost 59 million people-now classified as obese. This data confirms a nearly two-fold increase in the number of obese Americans in the last two decades, and emphasizes the need for more aggressive approaches to obesity treatment and prevention. Obesity can significantly increase a person's risk for a number of serious conditions, including type 2 diabetes, heart disease, stroke, high blood pressure, and some types of cancer.

The North American Society for the Study of Obesity (NAASO) is a leading scientific society dedicated to the study of obesity. NAASO is committed to encouraging research on the causes, treatment and prevention of obesity as well as to keeping the scientific community and public informed of new advances in the field. For more information about NAASO and obesity, visit www.naaso.org or call (301) 563-6526.

The American Diabetes Association is the nation's leading voluntary health organization supporting diabetes research, information, and advocacy. Founded in 1940, the Association has offices in every region of the country, providing services to hundreds of communities. For more information about the Association and diabetes, please visit www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).