Fighting the war on obesity with bariatric embolization

Preliminary results on bariatric embolization, a new interventional radiology technique for weight loss, suggest it has the potential to become a new tool in combating obesity.

Obesity is defined as a body mass index (BMI), or measure of body fat based on weight and height, of 30 or more.

Not only is obesity a major public health issue, but people with it face increased risk of diabetes, stroke and/or heart attack. To counteract this problem, patients are traditionally put on a low-calorie diet, exercise or medication. However, results are limited. Bariatric surgery has proven to be one of the more effective interventions, but comes with the possibility of significant complications.

A study published in Radiology explores if trans-arterial embolization, also known as bariatric embolization, a technique that has been used for decades to stop bleeding in the gastric artery, can be an effective approach to weight loss.

“A number of research papers in the 1990s found signs of hormonal changes after bariatric surgery,” said lead author Clifford Weiss, MD, in a statement. “In particular, there was a pretty rapid reduction in ghrelin, the most potent hunger-stimulating hormone we know. The hormone is produced in an area of the stomach called the fundus, which is fed primarily by the left gastric artery.”

Bariatric embolization involves very small bead-like particles being introduced into the left gastric artery, using imaging guidance and minimally invasive techniques. Once the particles are in place, they obstruct the circulation of blood, leading to ischemia and a reduction in ghrelin production.

The first five patients in the study had a mean BMI of 43.8. After one month, patients lost an average of 5.9 percent of BMI and 9 percent after three months. Serum ghrelin levels also dropped 17.5 percent in three months.

“These are very promising and exciting results,” said Weiss. “I think this paper and the additional data we’re compiling show that bariatric embolization is very well tolerated by patients, and there are signs that it could have medium- and long-term efficacy for weight loss.”

Despite these results, Weiss stresses that this technique is not made to be a first-line treatment for obesity or a replacement for bariatric surgery. The team of researchers will complete this study in the fall. When all data is collected by the end of the year, they will continue a more definitive study with more patients and focus on long-term results.