Abstract
Obesity is one of the major public health problems in the world. While various methods have been investigated or introduced, bariatric surgical procedures are currently the only effective long-term therapies for treating obesity. Due to mortality and morbidity, the bariatric surgery is limited to a subset of patients with morbid obesity. In this chapter we present an overview of an emerging anti-obesity therapy: gastric electrical stimulation (GES). First, the scientific basis for GES as a potential therapy for obesity is introduced. Secondly, GES methodologies and configurations are presented. Methods of GES that have been used for treating obesity are then introduced, and their effects on food intake and body weight are presented, followed with the discussion on possible mechanical, neural and hormonal mechanisms involved in the anti-obesity effect of GES. Finally, our viewpoint on the potential of GES for obesity and future development of the GES therapy are provided.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aelen P, Neshev E, Cholette M, Crisanti K, Mitchell P, Debru E, Church N, Mintchev MP (2008) Manipulation of food intake and weight dynamics using retrograde neural gastric electrical stimulation in a chronic canine model. Neurogastroenterol Motil 20:358–368
Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB (1999) Annual deaths attributable to obesity in the United States. JAMA 282:1530–1538
Aviello G, Matias I, Capasso R, Petrosino S, Borrelli F, Orlando P, Romano B, Capasso F, Di Marzo V, Izzo AA (2008) Inhibitory effect of the anorexic compound oleoylethanolamide on gastric emptying in control and overweight mice. J Mol Med 86:413–422
Bohdjalian A, Prager G, Aviv R, Policker S, Schindler K, Kretschmer S, Riener R, Zacherl J, Ludvik B (2006) One-year experience with Tantalus: a new surgical approach to treat morbid obesity. Obes Surg 16:627–634
Bohdjalian A, Prager G, Rosak C, Weiner R, Jung R, Schramm M, Aviv R, Schindler K, Haddad W, Rosenthal N, Ludvik B (2009) Improvement in glycemic control in morbidly obese type 2 diabetic subjects by gastric stimulation. Obes Surg 19(9):1221–1227
Bray GA, Greenway FL (1999) Current and potential drugs for treatment of obesity. Endocr Rev 20(6):805–875
Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737
Camilleri M, Grudell AB (2007) Appetite and obesity: a gastroenterologist’s perspective. Neurogastroenterol Motil 19:333–341
Chen JDZ, Qian LW, Ouyang H, Yin JY (2003) Gastric electrical stimulation with short pulses improves vomiting but not gastric dysrhythmia in dogs. Gastroenterology 124:401–409
Cigaina V (2004) Long-term follow-up of gastric stimulation for obesity: the Mestre 8-year experience. Obes Surg 14(Suppl 1):S14–S22
D’Argent J (2002) Gastric electrical stimulation as therapy of morbid obesity: preliminary results from the French study. Obes Surg 12(Suppl 1):21S–25S
Deitel M (2003) Overweight and obesity worldwide now estimated to involve 1.7 billion people. Obes Surg 13:329–330
De Luca M, Segato G, Busetto L, Favretti F, Aigner F, Weiss H, de Gheldere C, Gaggiotti G, Himpens J, Limao J, Scheyer M, Toppino M, Zurmeyer EL, Bottani G, Penthaler H (2004) Progress in implantable gastric stimulation: summary of results of the European multi-center study. Obes Surg 14(Suppl 1):S33–S39
Dickey RA, Bartuska CDG, Bray GW, Callaway CW, Davidson ET, Feld S, Ferraro RT, et al. (1998) AACE/ACE Position statement on the prevention, diagnosis, and treatment of obesity (1998 revision) Endocr Pract 4(5):297–350
Di Marzo V, Capasso R, Matias I, Aviello G, Petrosino S, Borrelli F, Romano B, Orlando P, Capasso F, Izzo AA (2008) The role of endocannabinoids in the regulation of gastric emptying: alterations in mice fed a high-fat diet. Br J Pharmacol 153:1272–1280
Eagon JC, Kelly KA (1993) Effects of gastric pacing on canine gastric motility and emptying. Am J Physiol 265:G767–G774
Finkelstein EA, Trogdon JG, Cohen JW, Dietz W (2009) Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff (Millwood) 28:w822–w831
Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH (1993) Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 329:1008–1012
Hocking MP, Vogel SB, Sninsky CA (1992) Human gastric myoelectrical activity and gastric emptying following gastric surgery and with pacing. Gastroenterology 103:1811–1816
Imaz I, Martinez-Cervell C, Garcia-Alvarez EE, Sendra-Gutierrez JM, Gonzalez-Enriquez J (2008) Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg 18:841–846
Krentz AJ, Patel MB, Bailey CJ (2008) New drugs for type 2 diabetes mellitus: what is their place in therapy? Drugs 68:2131–2162
Li S, Chen JD (2010) Cellular effects of gastric electrical stimulation on antral smooth muscle cells in rats. Am J Physiol Regul Integr Comp Physiol 298(6):R1580–R1587
Lin ZY, Chen JDZ (2002) Advances in gastrointestinal electrical stimulation. Crit Rev Biomed Eng 30:419–458
Lin Z, Forster J, Sarosiek I, McCallum RW (2003) Treatment of gastroparesis with electrical stimulation. Dig Dis Sci 48(5):837–848
Liu J, Hou X, Song G, Cha H, Yang B, Chen JD (2006) Gastric electrical stimulation using endoscopically placed mucosal electrodes reduces food intake in humans. Am J Gastroenterol 101:798–803
Malinowski SS (2006) Nutritional and metabolic complications of bariatric surgery. Am J Med Sci 331:219–225
Mathus-Vliegen EM (2008) Intragastric balloon treatment for obesity: what does it really offer? Dig Dis 26:40–44
Mayer MA, Höcht C, Puyó A, Taira CA (2009) Recent advances in obesity pharmacotherapy. Curr Clin Pharmacol 4:53–61
McCallum RW, Chen JD, Lin Z, Schirmer BD, Williams RD, Ross RA (1998) Gastric pacing improves emptying and symptoms in patients with gastroparesis. Gastroenterology 114(3):456–461
McCallum RW, Sarosiel, Lin Z, Moncure M, USA Study Group (2002) Preliminary results of gastric electrical stimulation on weight loss and gastric emptying in morbidly obese patients—randomized double blinded trial. Neurogastroenterol Motil 14:422
Neshev E, Onen D, Jalilian E, Mintchev MP (2006) Pre-pyloric neural electrical stimulation produces cholinergically-mediated reverse peristalsis in the acute canine model of microprocessor-invoked gastric motility for the treatment of obesity. Obes Surg 16:510–520
Ouyang H, Yin JY, Chen JDZ (2003) Inhibitory effects of chronic gastric electrical stimulation on food intake and weight and their possible mechanisms. Dig Dis Sci 48:698–705
Ouyang H, Xing J, Chen JD (2005) Tachygastria induced by gastric electrical stimulation is mediated via alpha- and beta-adrenergic pathway and inhibits antral motility in dogs. Neurogastroenterol Motil 17(6):846–853
Ouyang H, Yin J, Chen JD (2006) Gastric or intestinal electrical stimulation-induced increase in gastric volume is correlated with reduced food intake. Scand J Gastroenterol 41:1261–1266
Peles S, Petersen J, Aviv R, Policker S, Abu-Hatoum O, Ben-Haim SA, Gutterman DD, Sengupta JN (2003) Enhancement of antral contractions and vagal afferent signaling with synchronized electrical stimulation. Am J Physiol Gastrointest Liver Physiol 285:G577–G585
Qin C, Sun Y, Chen JDZ, Foreman R (2005) Gastric electrical stimulation modulates neuronal activity in nucleus tractus solitarii in rats. Auton Neurosci Basic Clin 119:1–8
Sanmiguel CP, Haddad W, Aviv R, Cunneen SA, Phillips EH, Kapella W, Soffer EE (2007) The TANTALUS system for obesity: effect on gastric emptying of solids and ghrelin plasma levels. Obes Surg 17:1503–1509
Scheen AJ, Lefebvre PJ (2000) Antiobesity pharmacotherapy in the management of type 2 diabetes. Diabetes Metab Res Rev 16:114–124
Shikora SA, Bergenstal R, Bessler M, Brody F, Foster G, Frank A, Gold M, Klein S, Kushner R, Sarwer DB (2009) Implantable gastric stimulation for the treatment of clinically severe obesity: results of the SHAPE trial. Surg Obes Relat Dis 5:31
Soffer E, Abell T, Lin Z, Lorincz A, McCallum R, Parkman H, Policker S, Ordog T (2009) Review article: gastric electrical stimulation for gastroparesis–physiological foundations, technical aspects and clinical implications. Aliment Pharmacol Ther 30(7):681–694
Song GQ, Hou X, Sun Y, Yang B, Qian W, Chen JD (2007) Effects of retrograde gastric electrical stimulation with pulse trains on gastric emptying of solids and plasma hormones in dogs. Am J Surg 194(1):122–127
Sun X, Tang M, Zhang J, Chen JD (2006) Excitatory effects of gastric electrical stimulation on gastric distension responsive neurons in ventromedial hypothalamus (VMH) in rats. Neurosci Res 55:451–457
Tang M, Zhang J, Chen JDZ (2006) Central mechanisms of gastric electrical stimulation involving neurons in paraventricular nucleus of hypothalamus in rats. Obes Surg 16:344–352
Tang M, Zhang J, Xu L, Chen JD (2006) Implantable gastric stimulation alters expression of oxytocin- and orexin-containing neurons in the hypothalamus of rats. Obes Surg 16(6):762–769
Vazquez Roque MI, Camilleri M, Clark MM, Tepoel DA, Jensen MD, Graszer KM, Kalsy SA, Burton DD, Baxter KL, Zinsmeister AR (2007) Alteration of gastric functions and candidate genes associated with weight reduction in response to sibutramine. Clin Gastroenterol Hepatol 5:829–837
Xing J, Chen JD (2004) Alterations of gastrointestinal motility in obesity. Obes Res 12:1723–1732
Xing JH, Chen JD (2006) Effects and mechanisms of long-pulse gastric electrical stimulation on canine gastric tone and accommodation. Neurogastroenterol Motil 18:136–143
Xu L, Tang M, Chen JDZ (2005) Effect of gastric electrical stimulation on gastric distention responsive neurons and expression of nNOS in rodent hippocampus. Gastroenterology 128:A624
Xu X, Zhu H, Chen JD (2005) Pyloric electrical stimulation reduces food intake by inhibiting gastric motility in dogs. Gastroenterology 128(1):43–50
Xu J, Chen JDZ (2008) Effects of sibutramine on gastric emptying, intestinal motility and rectal tone in dogs. Dig Dis Sci 53:155–162
Yao S, Ke M, Wang Z, Xu D, Zhang Y, Chen JD (2005) Retrograde gastric pacing reduces food intake and delays gastric emptying in humans: a potential therapy for obesity? Dig Dis Sci 50:1569–1575
Yin J, Chen JD (2005) Retrograde gastric electrical stimulation reduces food intake and weight in obese rats. Obes Res 13:1580–1587
Yin J, Chen J (2006) Inhibitory effects of gastric electrical stimulation on ghrelin-induced excitatory effects on gastric motility and food intake in dogs. Scand J Gastroenterol 41(8):903–909
Zhang J, Chen JD (2006) Systematic review: applications and future of gastric electrical stimulation. Aliment Pharmacol Ther 24(7):991–1002
Zhang J, Tang M, Chen JD (2009) Gastric electrical stimulation for obesity: the need for a new device using wider pulses. Obesity 17(3):474–480
Zhang J, Maude-Griffin R, Zhu H, Sun Y, Starkebaum W, Firestone E, Chen JD (2011) Gastric electrical stimulation parameter dependently alters ventral medial hypothalamic activity and feeding in obese rats. Am J Physiol Gastrointest Liver Physiol 301:G912–G918
Zhu H, Sallam H, Chen DD, Chen JD (2007) Therapeutic potential of synchronized gastric electrical stimulation for gastroparesis: enhanced gastric motility in dogs. Am J Physiol Regul Integr Comp Physiol 293(5):R1875–R1881
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Yin, J., Chen, J. (2013). Therapeutic Potential of Gastric Electrical Stimulation for Obesity. In: Cheng, L., Pullan, A., Farrugia, G. (eds) New Advances in Gastrointestinal Motility Research. Lecture Notes in Computational Vision and Biomechanics, vol 10. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6561-0_7
Download citation
DOI: https://doi.org/10.1007/978-94-007-6561-0_7
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-6560-3
Online ISBN: 978-94-007-6561-0
eBook Packages: EngineeringEngineering (R0)