May 19, 2013

Can We Really Control Our Eating Behavior?

IntraPace has designed a novel obesity intervention system, with a half-inch, battery-powered implant called Abiliti, which sends low-energy electrical pulses to the stomach and signals to the brain to create sensations of fullness with smaller meals. We asked our Zintro experts whether they believe Abiliti will be effective in changing eating patterns in the U.S.

Renata Maslowski, an expert in scientific marketing and communications, reminds us that many overweight individuals have only been able to find temporary solutions to sustain weight loss, which later have led to long-term failure. “In dire situations, these individuals have turned to gastric bypass surgery that claims to offer more substantial and permanent reduction in weight. These surgical procedures come with numerous side effects including deficiencies in vitamins and vital nutrients,” she explains. “One new surgical approach, Abiliti that uses a gastric pacemaker technology to signal fullness is aimed at combining moderation in food intake without restrictions on what is eaten with full monitoring of daily activity level.” Maslowski expresses her major concerns for Abiliti’s effectiveness. “The stimulator will discourage eating of vegetables and fruits as well as high-fat, high-sugar foods. This does not lead to improved nutritional choices by patients. Patients may also be able to tolerate the stimulus over time or during emotional stressful triggers and continue unhealthy eating habits,” she continues. From Maslowski’s point of view, more patients must be studied over longer periods of time and under various circumstances that induce overeating, in order to decide whether Abiliti will be able to change eating behavior. “Since the device has been tested in less than 100 patients thus far and for only up to a year in most, it is uncertain whether the results will be significant and sustained over time in the majority of qualified candidates for the procedure,” she notes.

 According to Mike Parker, an expert in public health, we need to take into account the impact and influence of the wider environment over individual behavior. “Individuals’ food cravings are driven by a wide spectrum of emotional and environmental factors and as with all addictions there is no magic pill -there is a need for a sustained multifaceted approach to behavior change,” he explains. “There will be a miniscule number of individuals that would sign up to use such technology and only a small percentage would adhere to its use and make long-term change.” Parker’s advice is to have a much wider approach, which will go beyond the individual consumer behavior. “The only way to combat obesity at a population level is to get companies to improve the quality of their produce through policy and legislation (trans fats, salt levels, restrictions of fast food outlets, fat tax, subsidized F and V etc etc) and create an environment that supports active travel and active play,” he adds. “This is more of an upstream population based approach and has been shown to be effective in other areas – most notably tobacco – that demonstrated that with significant pressure on governments, real policy change can be implemented.”

Clinical research scientist, Arline Salbe, thinks that IntraPace has come up with an extremely interesting approach to several aspects of nutrition. “For many years, my colleagues and I fantasized about a mini-camera that might be implanted in a tooth and which would provide a photographic record of foods eaten. This sounds like a great device to both assess as well as control energy intake. Apparently after a somewhat simple implantation procedure, intake is registered by an intragastric food detection sensor that signals the device to provide feedback stimulation indicating fullness,” she says. Salbe expects significant market potential from Abiliti in the U.S. once the device receives FDA approval. “While the procedure likely offers fewer digestive side effects compared to gastric banding or gastric bypass, success will depend on the patient’s desire to respond to the signals,” she notes. “Many people have been known to burst their bypass staples and bands; if the patient becomes inured to the fullness stimuli, compliance rather than body weight will likely be reduced. However, given the paucity of available obesity treatments, it sounds like something that will be very well-received in the US.”

By Idil Kan

Zintro, Inc

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