Systematic review on gastric electrical stimulation in obesity treatment

ABSTRACT

Introduction: Obesity is a very common public health problem worldwide. However, there is a lack of effective therapies. Only a small portion of patients with morbid obesity are accepting bariatric surgery as the last option due to the risks associated with invasive therapy.

Areas covered: In this paper, we review an emerging weight loss treatment: gastric electrical stimulation (GES). The feasibility of GES as a potential therapy for obesity is introduced. Methodologies and parameters of GES are presented. Several GES methods for treating obesity and their effects on food intake and body weight are presented. Possible mechanisms involved in the anti-obesity effect of GES are discussed. Finally, our comments on the potential of GES for obesity and expectations for future development of the GES therapy are provided. The PubMed central database was searched from inception to May 2019. The literature search used the following terms: 'Gastric electrical stimulation' combined with ‘obesity’ and 'Implantable gastric stimulation' and ‘pharmaceutical therapy’ and ‘bariatric surgery’.

Expert opinion: There is a potential to use GES for treating obesity. However, more efforts are needed to develop appropriate stimulation devices and to design an adequate therapy for treating obesity in humans.

KEYWORDS:

• Obesity
• weight loss treatment
• bariatric surgery
• gastric electrical stimulation
• gastric motility
• implantable gastric stimulation

Article Highlights

• Gastric electrical stimulation (GES) is an emerging weight loss treatment.

• Compared with the surgical treatment, GES is much less invasive, reversible and adjustable.

• Brain–gut axis plays an important role in therapeutic mechanism of GES.

• There is a great potential to use GES for treating obesity.

• Developing appropriate stimulation device and design an adequate therapy for treating obesity in humans are essential.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

One peer reviewer has been involved with studies with the Tantalus device for many years. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was partially funded by a grant from the National Institutes of Health (grant no. R01DK107754).