26 November 2013

Ulcer treatment causes weight loss

A procedure used to treat bleeding stomach ulcers could be used as a way to lose weight, a study suggests.

A procedure used to treat bleeding stomach ulcers could stand as a potential weapon in the battle of the bulge, a small preliminary study suggests.

The procedure is called gastric artery embolisation. It involves using a catheter to introduce some "obstructive agent" – like tiny beads or gel foam – into an artery supplying the stomach.

In the new study, researchers reviewed the records of 14 patients who underwent embolisation of the left gastric artery to treat stomach bleeding. Over the next three months, those patients lost 8% of their body weight, on average.

That compared with a 1% weight loss among 18 patients who were treated for the same problem, but had a different artery embolised.

That difference is "intriguing", the researchers said, because the left gastric artery supplies the area of the stomach that churns out the appetite-boosting hormone ghrelin.

Route to a trimmer physique

It's possible that the reduced blood flow to that stomach region curbed patients' ghrelin production, according to lead researcher Dr Rahmi Oklu, an assistant professor of radiology at Harvard Medical School, in Boston.

However, no one is saying embolisation is the new route to a trimmer physique.

"This is just an observation that deserves more study," Oklu said. "Our point is just to say, let's look at this. It still needs to be rigorously investigated."

The findings will be presented at the annual meeting of the Radiological Society of North America, being held next week in Chicago. In general, studies presented at meetings are considered preliminary until they are published in a peer-reviewed journal.

Lowering ghrelin levels

Since the results were based on patient records, Oklu's team does not actually know if embolisation lowered people's ghrelin levels.

But animal studies suggest that could be the case, according to Dr Mitchell Roslin, chief of bariatric (weight-loss) and metabolic surgery at Lenox Hill Hospital, in New York City.

"There is some science behind this," said Roslin, who was not involved in the study.

Still, he doubted that embolisation will help obese people see lasting weight loss. Ghrelin is only one of the hormones involved in appetite and metabolism. When one hormone's activity is altered, the body generally finds a way to compensate.

"With weight loss, you have to look at the long term," Roslin said. "My guess is, the response with [embolisation] will be fleeting."

Gastric embolisation is a minimally invasive procedure, and Oklu said it's a generally safe, same-day procedure. But it is normally used to treat bleeding – no one knows how it would work out as an obesity treatment.

Tinkering with hormones

Researchers have, however, already taken a first, small step. Earlier this year, investigators reported on the first five patients to have gastric artery embolisation specifically to manage obesity.

In that study, reported at an American College of Cardiology meeting, patients lost an average of 45 pounds in six months, and there were no complications. However, patients' ghrelin levels, which had dropped in the first few months after the procedure, were on the rise again by the sixth month.

And that is what you'd expect when tinkering with the hormone, according to Lenox Hill's Roslin. "I really can't imagine this will hold up in the long term," he said.

But study author Oklu said that even if ghrelin levels don't stay down, the procedure might give some people the weight loss jump-start they need.

And, he said, it might be appealing to patients who want an alternative to the extensive surgeries that, right now, stand as the only option for substantial, long-term weight loss.

More information

The US National Heart, Lung, and Blood Institute has more on managing obesity.


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