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Stomach Aspiration Helps Bariatric Patients Lose Weight

Stomach Aspiration Helps Bariatric Patients Lose Weight
Device removes gastric contents through tubes and pump

by Ed Susman, Contributing Writer, MedPage Today
November 02, 2017
This article is a collaboration between MedPage Today® and: Medpage Today
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NATIONAL HARBOR, Maryland – A device that literally sucks gastric contents from a patient and deposits the food into a container that drains into the toilet appears to help obese patients lose weight, researchers reported here.
After one-year on the AspireAssist device, 160 obese patients were able to achieve an average weight loss of more than 50 pounds (24 kg), reported Evzen Machytka, MD, PhD, a medical faculty researcher at University Hospital Ostrava in the Czech Republic.

In an oral presentation reported here at Obesity Week, Machytka said patients achieved an average 59 pounds (27 kg) weight loss after 2 years and a 66-pound (30 kg) weight loss after 3 years on the system. He reported that by year 4, there was a dampening of the weight loss effect, but patients still were 55 pounds (25 kg) reduced from their baseline weight.
"Aspiration therapy results in substantial and durable weight reduction," he said. "Aspiration therapy also results in substantial improvement in cardiometabolic parameters."
He said patients in the post-marketing study were able to achieve statistically significant reductions in HbA1C (in both diabetic and non-diabetic patients), in systolic and diastolic blood pressure, and in triglycerides.
Machytka said the AspireAssist system gives obese patients – the baseline body mass index in the study group was 44.3 kg/m2 – an option between conservative diet and exercise and medical therapy or radical gastric bypass procedures. He said that for patients whose insurance won't cover surgery, AspireAssist could offer a less expensive option as well.
Under "twilight sedation" doctors place a tube into the stomach that connects to a button on the surface of the abdomen. After each meal, the device enables the individual to empty up to 30% of a meal into the toilet through this tube by connecting a small, handheld device to the button. The device is about the size of a smartphone, and stores away in a small case afterwards.

The aspiration process is performed about 20 to 30 minutes after the entire meal is consumed and takes 5 to 10 minutes to complete in the privacy of the restroom. Because aspiration only removes a third of the food, the body still receives the calories it needs to function.
Machytka said there was no emergence of aberrant eating habits or disorders among the patients.
This therapy is used in conjunction with lifestyle counseling, Machytka said. "In theory there is no reason someone could not use the system for as long as they want," he said, "but people will likely stop using it when they achieve a satisfactory weight."
"This system does work, and for a small proportion of people who are obese there is a market for this device," said Eric Ravussin, PhD, associate executive director for clinical science at Pennington Biomedical Research Center at Louisiana State University in Baton Rouge.
Ravussin told MedPage Today that while the system may seem intrusive, "many obese people are desperate to lose weight and this can be one application that helps them reach that goal."

The patients for the study were enrolled between 2012 and 2016, Machytka said. Of the 132 patients who had completed one year of treatment at the time the study was presented, measurements had been completed in 117 of those individuals. Overall, at the end of year one, they had as a group achieved a mean 19% reduction in body weight.
In 57 patients tested, HbA1c decreased from 5.9% at baseline to 5.5% at one year, a change that was statistically significant (P<0.0001).
Among 13 patients diagnosed with diabetes, HbA1c declined from 7.8% to 6.8% (P<0.0001).
In 58 patients tested, glucose levels decreased from an average of 110 mg/dl to 102 mg/dl (P=0.002).
In 63 patients tested, systolic blood pressure declined from 141 mmHg to 129 mmHg (P<0.0001).
In 63 patients tested, diastolic blood pressure declined from 88 mmHg to 82 mmHg (P=0.001).
In 53 patients tested, triglycerides declined from 133 mg/dl to 107 mg/dl (P<0.0001).
Machytka said the treatment was well tolerated; complications were few and minor, and resolved with conservative treatment.

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