Review
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World J Gastroenterol. May 21, 2012; 18(19): 2309-2319
Published online May 21, 2012. doi: 10.3748/wjg.v18.i19.2309
Gastric stimulation for weight loss
Meir Mizrahi, Ami Ben Ya'acov, Yaron Ilan
Meir Mizrahi, Yaron Ilan, Ami Ben Ya’acov, Gastroenterology and Liver Units, Hebrew University-Hadassah Medical Center, Ein-Karem, Jerusalem, POB1200, Israel
Author contributions: Mizrahi M and Ben Ya’acov A contributed equally to this work; all three authors made substantial contributions to collect the relevant data, drafting the article revising it critically for important intellectual content; all authors approved the version to be published.
Correspondence to: Ami Ben Ya’acov, PhD, Gastroenterology and Liver Units, Hebrew University-Hadassah Medical Center, Ein-Karem, Jerusalem, POB1200, Israel. amib@hadassah.org.il
Telephone: +972-2-6778231 Fax: +972-2-6431021
Received: July 11, 2011
Revised: September 2, 2011
Accepted: April 28, 2012
Published online: May 21, 2012
Abstract

The prevalence of obesity is growing to epidemic proportions, and there is clearly a need for minimally invasive therapies with few adverse effects that allow for sustained weight loss. Behavior and lifestyle therapy are safe treatments for obesity in the short term, but the durability of the weight loss is limited. Although promising obesity drugs are in development, the currently available drugs lack efficacy or have unacceptable side effects. Surgery leads to long-term weight loss, but it is associated with morbidity and mortality. Gastric electrical stimulation (GES) has received increasing attention as a potential tool for treating obesity and gastrointestinal dysmotility disorders. GES is a promising, minimally invasive, safe, and effective method for treating obesity. External gastric pacing is aimed at alteration of the motility of the gastrointestinal tract in a way that will alter absorption due to alteration of transit time. In addition, data from animal models and preliminary data from human trials suggest a role for the gut-brain axis in the mechanism of GES. This may involve alteration of secretion of hormones associated with hunger or satiety. Patient selection for gastric stimulation therapy seems to be an important determinant of the treatment’s outcome. Here, we review the current status, potential mechanisms of action, and possible future applications of gastric stimulation for obesity.

Keywords: Obesity; Gastric stimulation; Gastric motility; External pacing; Gastric pacing; Intestinal pacing