Gastric Pacemaker

Is this the obesity solution?

This DailyMail article really got my internal debate going, and I thought I'd open the debate up to you.

The technology is capitalizing on what is naturally there, a pathway that passes satiety signals between the stomach and the brain. Only in this case they implant a small 'pacemaker' device and an electrode to stimulate the nerve that releases the hormones which signal to the brain "I'm full."

In trials done here in Europe people with the device ate 45% less at meals. 45% less is definitely significant in terms of weight loss.

The article points out that it could be used for obesity prevention to save money in the long term. The device does cost £10,000, but that's nothing compared to the lifelong costs of treating obesity and its sequela (diabetes, hypertension, heart disease).

Source: http://www.dailymail.co.uk/health/article-2058208/Obesity-Could-gastric-pacemaker-retrain-overweight-eat-healthily.html?ito=feeds-newsxml

So, is this the solution? I don't think so. Sure it might work in the few people who can afford the technology, but there are more than a few people who are overweight or obese.
 
The scary fact is that we've gotten to this point. We've gotten to the point that people can no longer self-regulate food intake and we are exploring such options as a gastric pacemaker. This should spark a deeper converstaion. This is a band-aid not a solution. The real question should be: what is causing us to overeat and be unable to regulate our food intake in the first place?

I have a few theories, as does recent science.

For one, social norms do not support a healthy lifestyle. Its perfectly acceptable to eat whatever you want, whenever you want. While I support healthy, purposeful snacking, I do not support mindless munching on potato chips. Making matters worse, physical activity is pathetic for most of us. Many people have long commutes in the car, and TV, video games and computers keep us glued to chairs and couches.

But I think another big player could be food addiction.

Human beings evolved in an environment where food scarcity was the biggest nutritional threat; where an innate drive to eat energy-dense, fatty, salty and sweet foods increased chances of survival. These highly palatable foods activate the hedonic pathway, the part of the brain that responds to pleasurable stimuli.The same part of the brain is activated in the drive for sex and recreational drugs.

And a growing body of evidence shows that in much the same way that drugs are addictive, salty, sugary, fatty foods may also be addictive. Granted, most of this research has been done in lab animals, but some of it is very compelling. Rats, for instance, were recently shown to prefer sugary drinks to cocaine. Perhaps this is why people have such a hard time kicking their soda habit (or french fries, or milkshakes, or whatever food it may be).


V and I had a quick debate the other night about how the morbidly obese can lose weight. I was arguing that once morbidly obese (with limited mobility and whacked out insulin/other hormones) it is very hard for that person to lose weight without some kind of help or intervention. He argued that they should just eat less.


A lot of the commenters on this gastric pacemaker article seem to side with V's argument: obesity is your fault and you alone can fix it. While I do not take personal responsibility out of play -- what you eat is ultimately your decision and you can change it -- I know that obesity is far more complex than this simple explanation.

That being said, however, when I first read the article I had the same knee jerk reaction as most of the commenters. One woman wrote in saying "Come on!!! Why not eat your 5 a day do a bit of exercise, do it the old fashioned way....Its willpower you need not a pacemaker."

My first thoughts exactly. And its the same line of argument I use against diet pills. But willpower is such an intangible thing for many of us. We know what we should eat and what we shouldn't, and yet we don't do it.

We've gotten to the point in this obesity epidemic where we can't sit back and let willpower take its natural course. Our food and lifestyle environments (junk food on every corner, cities that are built for cars, 60 minute commutes, etc) are working against our 'willpower' and sense. Yes, it can still be done -- I am not by any means saying that it can't be done -- but it is in many ways swimming upstream.

Percent of Adults who are Obese by year. By CDC. Animation: Nevit Dilmen (http://www.cdc.gov/obesity/data/trends.html) [Public domain], via Wikimedia Commons

It will take many many changes, both in personal actions and in social/environmental realms to turn around the tide of the obesity epidemic. Could a gastric pacemaker help? For the morbidly obese, I can see it having a place. It is not the solution, but it could potentially help to reduce the extraordinary costs of treating morbid obesity.


What do you think? Would you like a little help in the eating department with a gastric pacemaker? Weigh in! (pun intended)

I'll leave you with this quote that I love from the US Institute of Medicine:

"It is unreasonable to expect that people will change their behavior easily
when so many forces in the social, cultural, and physical environment conspire
against such change."