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Study found: Ablation of gastric fundus can reduce the ‘Hunger Hormone’ Producing

Obesity is one of the diseases that can’t be eradicated or prevented unless some good gene is inherited from parents. Most people have watched what to eat and how to eat, and the amount of food consumed daily to record for keeping healthy. However, reducing food consumption for diet, still, feel hungrier than before the diet had started. As soon as dieting for weight loss, the so-called, “Hunger hormone” ghrelin has its operation started under the gastric fundus where the mucosal lining contains 80-90% of cells that produce ghrelin hormone.

When ghrelin levels increase due to weight loss or reduced food intake, then this hunger hormone makes people feel hungrier than before to prevent sustained weight loss. According to Medscape.com.,
“Ablation of the gastric fundus to reduce production of the “hunger hormone” ghrelin resulted in decreased appetite and significant weight loss among participants in a small first-in-human trial.

“Patients reported a decrease in hunger, appetite, cravings, and an increase in control over [their] eating,” said senior study investigator Christopher McGowan, MD, a gastroenterologist in private practice and medical director of True You Weight Loss in Cary, North Carolina.”They generally described that their relationship with food had changed,” McGowan said in a press briefing during which his research (Abstract 516) was previewed for Digestive Disease Week (DDW) on May 9, 2024.

The result of the trial for this study was a very small group of people were middle-aged (mean age, 38) women with a BMI(of 40.2) on the ablation of gastric fundus mucosal through hybrid argon plasma coagulation in an ambulatory setting under general anesthesia from November 1, 2022, to April 14, 2023. The procedure took less than one hour on average, and the technique gave them easy access to the fundus, McGowan said.

Compared with the baseline, there were multiple beneficial outcomes at 6 months:

45% less circulating ghrelin in the blood

53% drop in ghrelin-producing cells in the fundus

42% reduction in stomach capacity

43% decrease in hunger, appetite, and cravings

7.7% body weight loss

Over the 6 months of the study, mean ghrelin concentrations dropped from 461.6 pg/mL at baseline to 254.8 pg/mL (P = .006).

In a standard nutrient drink test, the maximum tolerated volume among participants dropped from a mean of 27.3 oz at baseline to 15.8 oz at the 6-month follow-up (P = .004).

Participants also completed three questionnaires. From baseline to 6 months, their DAILY EATS mean hunger score decreased from 6.2 to 4 (P = .002), mean Eating Drivers Index score dropped from 7 to 4 (P < .001), and WEL-SF score improved from 47.7 to 62.4 (P = .001).

Repeat endoscopy at 6 months showed that the gastric fundus contracted and healed. An unexpected and beneficial finding was fibrotic tissue, which made the fundus less able to expand, McGowan said. A smaller fundus “is critical for feeling full.”

No serious adverse events were reported. Participants described gas pressure, mild nausea, and cramping, all of which lasted 1-3 days, he said.

It remains unclear whether gastric fundus ablation would be a stand-alone procedure or used in combination with another endoscopic weight-management intervention, bariatric surgery, or medication.

Not every patient wants to or can access GLP-1 medications, McGowan said. Also, “there’s a difference between taking a medication long-term, requiring an injection every week, vs a single intervention in time that carries forward.”

Ablation could also help people transition after they stop GLP-1 medications to help them maintain their weight loss, he said.

 

 

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