Lose weight without diet or exercise! You’ve seen ads for devices and drugs that purport to melt away the fat without much help from you. They’ve been around for years and they make some companies a ton of money. You really like the idea (right?), but deep down inside, you know they don’t really work.
Typical Hoodia ad—take a pill and look like me! Hoodia, an extract of a cactus from the Kalahari desert, is all the rage. It is supposed to block your drive to eat and slash calorie intake in half. The problem is there are no good medical studies that I can find to show that it works. Further, some Hoodia products have been studied and found not to have any Hoodia in them. Remember that unlike the pharmaceutical industry, the nutritional supplement market is like the Wild West—anything goes.
That’s when a small article out of Australia caught my eye, mainly because of the involvement of Surgeon James Toouli, a Flinders’ Professor of Digestive Surgery who has written a ton of medical papers and even a couple of surgical text books. Apparently, his medical center in Adelaide is involved in testing a new obesity treatment called VBLOC. VBLOC stands for Vagal Blocking for Obesity Control. It involves the use of a pacemaker-like device that sends low power electrical signals that block the vagal nerve.
The vagus nerve has a number of different functions in the control and function of the gastrointestinal system. It is the nerve that allows communication between the brain and our digestive system. It not only plays a role in stomach function and control of digestive juices, but it also plays a role in the sensation or hunger and fullness.
In the old days, before the availability of effective drugs for peptic ulcer disease, people with intractable symptoms used to undergo an operation called a vagotomy. Many of these people lost their appetite, had reduced absorption of nutrients from the gut, and lost weight after the operation although they eventually gained both back for reasons that aren’t entirely clear.
The medical device behind VBLOC is made by EnteroMedics, a Minneapolis company whose tag line is “Orchestrating Obesity Solutions” (pretty nice). According to information on the company’s website, it is important to only block the vagus nerve intermittently so that the body does not develop ways to accommodate for the loss of information from the nerves that occurs when it is completely cut, such as in a vagotomy operation.
The company has farmed out its clinical trials to a variety of institutions. Prof. Toouli’s lab is one of the research centers that is testing whether or not the device works. The Mayo Clinic in Rochester, Minnesota is another center studying the device. If you want to participate in a clinical trial of the device, you can sign up online. Your information will be forwarded to one of the testing centers to determine if you are eligible to participate (Note: This is information only on my part and should not be considered a recommendation to participate. If you want to learn more about why your should participate in clinical trials, check out this link.)
According to the online news report that caught my eye, early results from Prof. Toouli’s lab are quite promising.
Graphic of VBLOC implantation
The first person (of ten people) implanted with the device lost 20 kilograms (that’s 44 pounds) “without changing her dietary habits or exercise regime.” Prof. Toouli is quoted as saying: “These nerves [the vagus] control the movement of the stomach and they control some of the secretions used for digestion, and by blocking these intermittently, what it does is it slows down the aching of the stomach so consequently people don’t feel as hungry.”
Sounds too good to be true. Well, it may be. But then again, it may actually end up working. We have to await the results of studies, such as the ones described above to be subjected to peer-review and published in reputable medical journals. Meanwhile, there are some peer-reviewed animal studies that support the contention that vagal nerve stimulation may cause weight loss in pigs (pigs!).
As exciting as it is to read that a handful of people lost weight with the device, it does not necessarily mean the results will hold up when larger numbers of people are tested in randomized controlled trials (the gold standard in medical research). The history of device and biotech companies is full of stories of companies who had promising early results only to fail when subjected to rigorous testing.
I think the best news of all about this story is that obesity research is now attracting the best and the brightest, innovators who understand the complex regulation of appetite and body weight. This fuels hope that one day, we will have an effective treatment that doesn’t require starvation and sweat. Until then, I’ll see you at the gym.