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Treatment of morbid obesity by intraparietogastric administration of botulinum toxin: a randomized, double-blind, controlled study

International Journal of Obesity volume 31, pages 707–712 (2007)Cite this article

Abstract

Objective:

The stomach is the main target organ for bariatric surgery, but no medical treatment has been developed to increase satiety and decrease food intake via gastric pathways. The aim of our study was to investigate whether or not the intraparietogastric administration of botulinum toxin A (BTX), able to modify the motility patterns of the stomach, could be useful for treatment of obesity.

Design:

Double blind controlled study.

Subjects:

Twenty-four morbidly obese patients (mean weight (s.e.m.) 116.1±4.89 kg, mean body mass index (BMI) 43.6±1.09 kg/m2) were blindly randomized to receive 200 IU BTX or placebo into the antrum and fundus of the stomach by intraparietal endoscopic administration.

Measurements:

We evaluated weight loss, BMI changes, satiety score, the maximal gastric capacity for liquids and the gastric emptying time (octanoic acid breath test).

Results:

The two groups were homogeneous for anthropometric characteristics. Eight weeks after treatment, BTX patients had significantly higher weight loss (11±1.09 vs 5.7±1.1 kg, P<0.001) and BMI reduction (4±0.36 vs 2±0.58 kg/m2, P<0.001) and a higher satiety score on a visual analogic scale (7.63±0.38 vs 4.72±0.44, P<0.001) than controls. Furthermore, BTX patients showed a significantly greater reduction in maximal gastric capacity for liquids (266.6±48 vs 139±31, P<0.001) and a greater prolongation in gastric emptying time (+18.93±8 vs −2.2±6.9 min, P<0.05). No significant side effects or neurophysiologic changes were found.

Conclusions:

Topical intragastric BTX was effective in reducing food intake and body weight in morbidly obese patients.

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Acknowledgements

This study was supported by a grant from the Fondazione Romeo ed Enrica Invernizzi, Milan, Italy.

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Authors and Affiliations

  1. Department of Clinical Sciences L Sacco, I Unit of Surgery, San Siro Clinical Institute, University of Milan, Milan, Italy

    D Foschi, F Corsi & E Trabucchi

  2. Department of Clinical Sciences L Sacco, Chair of Gastroenterology, University of Milan, Milan, Italy

    M Lazzaroni, O Sangaletti & G Bianchi Porro

  3. Unit of Dietology, L Sacco Hospital, Milan, Italy

    P Riva & G La Tartara

  4. Unit of Endocrinology, L Sacco Hospital, Milan, Italy

    M Bevilacqua

  5. Unit of Neurology, L Sacco Hospital, Milan, Italy

    M Osio

  6. Unit of Psychiatry, L Sacco Hospital, Milan, Italy

    A Alciati

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  1. D Foschi
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Correspondence to D Foschi.

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Foschi, D., Corsi, F., Lazzaroni, M. et al. Treatment of morbid obesity by intraparietogastric administration of botulinum toxin: a randomized, double-blind, controlled study. Int J Obes 31, 707–712 (2007). https://doi.org/10.1038/sj.ijo.0803451

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