Bariatric Fundus Embolization Viable for Severely Obese Patients

Transarterial embolization of the gastric fundus in severely obese adults can suppress appetite and induce weight loss for up to 12 months, claims a new study.

Researchers at Johns Hopkins University (JHU; Baltimore, MD, USA), Mount Sinai Hospital (New York, NY, USA), and other institutions conducted a prospective study that recruited 20 severely obese adults (16 women; mean age 44 years) with a mean body mass index (BMI) of 45 kg/m2 to evaluate the safety and efficacy of bariatric embolization, an image-guided procedure that aims to induce metabolic changes by targeting the endocrine functions of the gastric fundus, which play a role in stimulating appetite.

Bariatric embolization was performed successfully in all participants, with no major adverse events. The mean excess weight loss was 8.2% at one month, 11.5% at three months, 12.8% at six months, and 11.5% at 12 months. Hunger or appetite decreased for four weeks after embolization, increasing again thereafter, but without reaching pre-embolization levels. Study participants also showed evidence of metabolic change, with decreases in hemoglobin A1c and total cholesterol (independent of weight loss), and concomitant increase in high-density lipoprotein (HDL) levels. The study was published on April 2, 2019, in Radiology.

“Weight loss of 5-10% has been found to reduce risks of cardiovascular disease and diabetes, including reduced hemoglobin A1c, increased HDL, reduced triglycerides, reduced blood pressure, and reduced need for diabetes and antihypertensive medications,” concluded lead author Clifford Weiss, MD, of JHU, and colleagues. “The changes in hemoglobin A1c, and the fact that they occurred independent of weight loss, may indicate that bariatric embolization alters the metabolic profile in ways similar to bariatric surgery, but to a lesser degree.”

Transarterial bariatric embolization of the gastric fundus delivers embolic microspheres into the gastric arteries to induce localized ischemia and modify appetite hormones, leading to weight reduction; early clinical trials have produced promising short-term results in animal models.

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Johns Hopkins University
Mount Sinai Hospital