Skip to main content

Advertisement

SpringerLink
Log in

Gastric Electrical Stimulation for Obesity

  • Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract (S Rao, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Obesity is a growing health problem worldwide with a major impact on health and healthcare expenditures. Medical therapy in the form of diet and pharmacotherapy has limited effect on weight. Standard bariatric surgery is effective but is associated with morbidity and mortality, creating an unmet need for alternative therapies. One such therapy, the application of electrical stimulation to the stomach, has been studied extensively for the last two decades. Though pulse parameters differ between the various techniques used, the rationale behind this assumes that application of electrical current can interfere with gastric motor function or modulate afferent signaling to the brain or both. Initial studies led by industry failed to show an effect on body weight. However, more recently, there has been a renewed interest in this therapeutic modality with a number of concepts being evaluated in large human trials. If successful, this minimally invasive and low-risk intervention would be an important addition to the existing menu of therapies for obesity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. WHO Fact sheet N311, May 2014

  2. Cunningham SA, Kramer MR, Venkat Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. 2014;370(5):403–11.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States. J Am Med Assoc. 2014;311(8):806–14.

    Article  CAS  Google Scholar 

  4. Dee A, Kearns K, O’Neill C, Sharp L, Staines A, O’Dwyer V, et al. The direct and indirect costs of both overweight and obesity: a systematic review. BMC Res Notes. 2014;7:242.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity payer-and-service-specific estimates. Health Aff (Millwood). 2009;28:w822–31.

    Article  Google Scholar 

  6. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32(9):1431–7.

    Article  CAS  Google Scholar 

  7. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102–38. Annotation: A critical assessment of the medical and surgical management of overweight and obesity. The document is endorsed by many national societies and associations.

    Article  PubMed  Google Scholar 

  8. Guaraldi F, Pagotto U, Pasquali R. Predictors of weight loss and maintenance in patients treated with antiobesity drugs. Diabetes Metab Syndr Obes Tarets Ther. 2011;4:229–43.

    Article  Google Scholar 

  9. Sarwer DB, Green AVS, Vetter ML, Wadden TA. Behavior therapy for obesity: where are we now? Current opinion in endocrinology. Diabetes Obes. 2009;16(5):347–52.

    Google Scholar 

  10. Wadden TA, Sternberg JA, Letizia KA, Stunkard AJ, Foster GD. Treatment of obesity by very low calorie diet, behavior therapy, and their combination: a five-year perspective. Int J Obes. 1989;13 Suppl 2:39–46.

    PubMed  Google Scholar 

  11. Yanovski SZ, Yanovski JA. Long-term drug treatment for obesity. J Am Med Assoc. 2014;311(1):74–86.

    Article  CAS  Google Scholar 

  12. Weintraub M, Sundaresan PR, Cox C. Long-term weight control study. Individual participant response patterns. Clin Pharmacol Ther. 1992;51(5):619–33.

    Article  CAS  PubMed  Google Scholar 

  13. Chang SH, Stoll CRT, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery an updated systematic review and meta-analysis. 2003-2012. JAMA Surg. 2014;149(3):275–87. Annotation: Most recent assessment of mortality, complications, reoperations, weight loss, and remission following bariatric surgery, using up-to-date, comprehensive data and meta-analytic techniques.

    Article  PubMed  Google Scholar 

  14. Birkmeyer JD, Finks JF, O’Reilly A, Oerline M, Carlin A, Nunn A, et al. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369:1434–42.

    Article  CAS  PubMed  Google Scholar 

  15. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  16. Kumar N, Thompson CC. Endoscopic solutions for weight loss. Curr Opin Gastroenterol. 2011;27:407–11.

    Article  PubMed  Google Scholar 

  17. Coté GA, Edmundowicz SA. Emerging technology: endoluminal treatment of obesity. Gastrointest Endosc. 2009;70(5):991–9.

    Article  PubMed  Google Scholar 

  18. Pullan A, Cheng I, Yassi R, Buist M. Modelling gastrointestinal bioelectric activity. Prog Biophys Mol Biol. 2004;85(2–3):523–50.

    Article  PubMed  Google Scholar 

  19. Camilleri M. Integrated upper gastrointestinal response to food intake. Gastroenterology. 2006;131:640–58.

    Article  CAS  PubMed  Google Scholar 

  20. Morton GJ, Meek TH, Schwartz MW. Neurobiology of food intake in health and disease. Nat Rev Neurosci. 2014;15:367–78. Annotation: Up to date review describing the control of food intake by energy homeostasis mechanisms in health and in times of stress, and impairment of such mechanisms in disorders of body weight.

    Article  CAS  PubMed  Google Scholar 

  21. Phillips RJ, Powly TL. Tension and stretch receptors in gastrointestinal smooth muscle: re-evaluating vagal mechanoreceptors electrophysiology. Brain Res Rev. 2000;34:1–26.

    Article  CAS  PubMed  Google Scholar 

  22. Gonzalez MF, Deutsch JA. Vagotomy abolishes cues of satiety produced by gastric distension. Science. 1981;212:1283–4.

    Article  CAS  PubMed  Google Scholar 

  23. Eagon JC, Kelly KA. Effects of gastric pacing on canine gastric motility and emptying. Am J Physiol. 1993;265:G767–74.

    CAS  PubMed  Google Scholar 

  24. McCallum RW, Chen JDZ, Lin Z, Schirmer BD, Williams RD, Ross RA. Gastric pacing improves emptying and symptoms in patients with gastroparesis. Gastroenterology. 1998;114:456–61.

    Article  CAS  PubMed  Google Scholar 

  25. Yao S, Ke M, Wang Z, Xu D, Zhang Y, Chen JDZ. Retrograde gastric pacing reduces food intake and delays gastric emptying in humans: a potential therapy for obesity? Dig Dis Sci. 2005;50:1569–75.

    Article  PubMed  Google Scholar 

  26. Xing JH, Brody F, Brodsky J, Ponsky Soffer EE. The effect of gastric electrical stimulation on canine gastric emptying, food intake, and body weight. Obes Res. 2003;11:41–7.

    Article  PubMed  Google Scholar 

  27. Onen D, Jalilian D, Neshev E, Mintchev MP. Parametric study of neural gastric electrical stimulation in acute canine models. Trans Biomed Eng. 2007;54(3):429–35.

    Article  Google Scholar 

  28. Peles S, Petersen J, Aviv R, Policker S, Abu-Hatoum O, Ben-Haimm SA, et al. Enhancement of antral contractions and vagal afferent signaling with synchronized electrical stimulation. Am J Physiol Gastrointest Liver Physiol. 2003;285:G577–85.

    CAS  PubMed  Google Scholar 

  29. Bohdjalian A, Prager G, Ricardo A, Policker S, Schindler K, Kretschmer S, et al. One-year experience with Tantalus™: a new surgical approach to treat morbid obesity. Obes Surg. 2006;16:627–34.

    Article  PubMed  Google Scholar 

  30. Burneo JG, Faught E, Knowlton R, Morawetz R, Kuzniecky R. Weight loss associated with vagus nerve stimulation. Neurology. 2002;59:463–4.

    Article  CAS  PubMed  Google Scholar 

  31. Sarr MG, Billington CJ, Brancatisano R, Brancatisano A, Toouli J, Kow L, et al. The EMPOWER study: randomized, prospective, double-blind, multicenter trial of vagal blockade to induce weight loss in morbid obesity. Obes Surg. 2012;22:1771–82.

    Article  PubMed  Google Scholar 

  32. Cigaina V, Hirschberg AL. Plasma ghrelin and gastric pacing in morbidly obese patients. Metab Clin Exp. 2007;56:1017–21.

    Article  CAS  PubMed  Google Scholar 

  33. Sanmiguel CP, Haddad W, Aviv R, Cunneen S, Phillips EH, Kapella W, et al. The TANTALUS™ system for obesity: effect on gastric emptying of solids and Ghrelin plasma levels. Obes Surg. 2007;17:1503–9.

    Article  PubMed  Google Scholar 

  34. Xing J, Felsher J, Brody F, Soffer EE. The effect of gastric electrical stimulation on lower esophageal sphincter pressure and release of regulatory peptides in a canine model. Dig Dis Sci. 2005;50:1481–7.

    Article  PubMed  Google Scholar 

  35. Liu S, Hou X, Chen JDZ. Therapeutic potential of duodenal electrical stimulation for obesity: acute effects on gastric emptying and water intake. Am J Gastroenterol. 2005;100(4):792–6.

    Article  PubMed  Google Scholar 

  36. Shikora SA, Bergenstal R, Bessler M, Brody F, Foster G, Frank A, et al. Implantable gastric stimulation for the treatment of clinically severe obesity: results of the SHAPE trial. Surg Obes Relat Dis. 2009;5(1):31–7.

    Article  PubMed  Google Scholar 

  37. Kral JG. Vagotomy for treatment of severe obesity. Lancet. 1978;1:307–8.

    Article  CAS  PubMed  Google Scholar 

  38. Tweden KS, Anvari M, Bierk MD, Billington CJ, Camilleri M, Honda CN, et al. Vagal blocking for obesity control (VBLOC): concordance of effects of very high frequency blocking current at the neural and organ levels using two preclinical models. Gastroenterology. 2006;130:A-148.

    Google Scholar 

  39. Camilleri M, Toouli J, Herrera MF, Kulseng B, Kow L, Pantoja JP, et al. Intra-abdominal vagal blocking (VBLOC therapy): clinical results with a new implantable medical device. Surgery. 2008;143(6):723–31.

    Article  CAS  PubMed  Google Scholar 

  40. Camilleri M, Toouli J, Herrera MF, Kow L, Pantoja JP, Bilington CJ, et al. Selection of electrical algorithms to treat obesity with intermittent vagal block using an implantable medical device. Surg Obes Relat Dis. 2009;5(2):224–9.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Jenny D. Chiu and Edy Soffer declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human subjects performed by any of the authors.

With regard to the authors’ research cited in this paper, all institutional and national guidelines for the care and use of laboratory animals were followed.

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology, Keck School of Medicine at USC, 1520 San Pablo Street, Los Angeles, CA, 50033, USA

    Jenny D. Chiu & Edy Soffer

Authors
  1. Jenny D. Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Edy Soffer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edy Soffer.

Additional information

This article is part of the Topical Collection on Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chiu, J.D., Soffer, E. Gastric Electrical Stimulation for Obesity. Curr Gastroenterol Rep 17, 4 (2015). https://doi.org/10.1007/s11894-014-0424-y

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-014-0424-y

Keywords

Search

Navigation