Implantable gastric stimulation for the treatment of clinically severe obesity: results of the SHAPE trial

{ "0" : "Tufts Medical Center, Boston, Massachusetts" , "1" : "International Diabetes Center at Park Nicollet, Minneapolis, Minnesota" , "2" : "Columbia-Presbyterian Medical Center, New York, New York" , "3" : "George Washington University, Washington, DC" , "4" : "Temple University, Philadelphia, Pennsylvania" , "5" : "University of Florida College of Medicine, Gainesville, Florida" , "6" : "Washington University, St. Louis, Missouri" , "7" : "Northwestern Memorial Hospital, Chicago, Illinois" , "8" : "University of Pennsylvania, Philadelphia, Pennsylvania" , "10" : "Morbid obesity" , "11" : "Severe obesity" , "12" : "Implantable gastric stimulation" , "13" : "Weight loss" , "14" : "Bariatric surgery" , "15" : "Gastric pacing"}
Surgery for Obesity and Related Diseases (Impact Factor: 4.94). 02/2009; 5(1):31-37. DOI: 10.1016/j.soard.2008.09.012

ABSTRACT BackgroundTo compare implantable gastric stimulation therapy with a standard diet and behavioral therapy regimen in a group of carefully selected class 2 and 3 obese subjects by evaluating the difference in the percentage of excess weight loss (EWL) between the control and treatment groups. The primary endpoint was the percentage of EWL from baseline to 12 months after randomization. Implantable gastric stimulation has been proposed as a first-line treatment for severely obese patients; however, previous investigations have reported inconclusive results.MethodsA total of 190 subjects were enrolled in this prospective, randomized, placebo-controlled, double-blind, multicenter study. All patients underwent implantation with the implantable gastric stimulator and were randomized to 1 of 2 treatment groups: the control group (stimulation off) or treatment group (stimulation on). The patients were evaluated on a monthly basis. All individuals who enrolled in this study agreed to consume a diet with a 500-kcal/d deficit and to participate in monthly support group meetings.ResultsThe procedure resulted in no deaths and a low complication rate. The primary endpoint of a difference in weight loss between the treatment and control groups was not met. The control group lost 11.7% ± 16.9% of excess weight and the treatment group lost 11.8% ± 17.6% (P = .717) according to an intent-to-treat analysis.ConclusionImplantable gastric stimulation as a surgical option for the treatment of morbid obesity is a less complex procedure than current bariatric operations. However, the results of the present study do not support its application. Additional research is indicated to understand the physiology and potential benefits of this therapy.

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