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Digestive Disease Week

Speakers Discuss Wide Array of New FDA-Approved Treatments for Managing Obesity

Christina Mattina
At a session during Digestive Disease Week 2017, held May 6-9 in Chicago, speakers highlighted some new approaches to managing obesity that are now approved by the FDA.
At a session during Digestive Disease Week 2017, held May 6-9 in Chicago, Illinois, speakers highlighted some new approaches to managing obesity that are now approved by the FDA.
 
First, Aurora D. Pryor, MD, FACS, professor of surgery at Stony Brook Medical Center, took the stage to summarize the current options in balloon therapy, 2 of which are placed endoscopically while another comes in a swallowable capsule. The idea behind all of these balloons is that they will take up space in the stomach, causing patients to cut back on portion sizes.
 
The 3 balloons currently approved by the FDA (ReShape, Obalon, and Orbera) have largely been tested on patients with a body mass index (BMI) between 30 and 40 who have been obese for at least 2 years and have failed at more conservative weight loss methods, Pryor explained, and they might be wary of more invasive surgical procedures like the laparoscopic band.
 
Pryor cautioned that the balloons, while “easy and straightforward, aren’t completely symptom free.” She mentioned that the FDA had issued a warning that balloons could result in spontaneous over-inflation or acute pancreatitis, but emphasized that these reactions were rare. Pryor ended her talk by discussing how clinicians are undertreating obesity. “This is a major epidemic and we’re not doing justice to our patients,” she said. “Balloons are a relatively safe and very effective therapy, and offering these increases interest in surgery and may help treat more patients.”
 
The next speaker was John Morton, MD, MPH, FACS, FASMBS, chief of bariatric and minimally invasive surgery at Stanford School of Medicine. He discussed the need for nonsurgical devices and interventions for patients uncomfortable with the risk-benefit tradeoffs of bariatric surgery, and presented one potential alternative.
 
Morton has been a leading researcher in developing vBloc, a device that sends intermittent signals through inserted leads to block the vagal nerve, which could potentially send satiety signals to the thalamus. The first randomized trial of the device was the ReCharge trial published in JAMA in 2014, in which Morton and his co-authors demonstrated that this therapy was effective long-term and had larger and more durable effects than a placebo surgery.
 
He ended his presentation by showing the audience a “brand-new, hot off the presses” abstract that detailed results for vBloc in the real-world environment. In the trial, 90% of participants achieved meaningful weight loss, meaning they shed at least 5% of their original body weight. Although no treatment options for managing obesity are ever going to be perfect, Morton said, the results seen from safe and effective treatments like vBloc demonstrate that weight loss interventions other than surgery can be successful.
 


 
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