Can gastric botulinum toxin A injection be used as minimally invasive procedure in the short-term treatment of obesity?

Abstract

Background/Aim: Gastric botulinum toxin A (BTX-A) injection is a type of endoscopic obesity treatment option that delays gastric emptying. However, there is little and contradictory information concerning the treatment efficacy of BTX-A injection. This study evaluated the treatment efficacy of BTX-A injection in the treatment of obesity. Materials and Methods: This was an open-label, prospective study of obese individuals with a body mass index >30 kg/m 2 admitted to our clinic. The sample consisted of 72 consecutive treatment-naive patients with obesity divided into age-sex-matched three groups: gastric BTX-A injection (study group), calorie-restricted (15-20 Kcal/kg) diet (control) and bariatric surgery (BS) (control) groups. In the study group, 200 IU BTX-A was injected to the antrum and corpus endoscopically. The study and control groups were compared for their total body weight loss (TBWL) and excess body weight loss (EBWL) at the 6 th month. Results: Gastric BTX-A injection therapy was applied to 24 patients. The mean age was 39.1 ± 9.1/years. 54.1% of the patients (n = 13) was female. At the 6 th month, the mean TBWL and EBWL of patients were; 10% ±4.1 and 37.2% ±13.9 for gastric BTXA injection group, 5% ±2.3 and 20.2% ±9.3 for diet group, 30.7% ±5.3 and 66.9% ±14.4 for BS group. Patients who underwent gastric BTX-A injection lost weight more effectively than patients who were on diet alone, while BS patients lost weight more effectively than those who had gastric BTX-A injection (P < 0.001). In the gastric BXT-A injection group, the first 3-month delta EBWL and TBWL (change of EBWL and TBWL percentages) were found significantly higher than the 3-6 th month and 6-12 th month (P = 0.001 and P < 0.001). Conclusion: Gastric BTX-A injection is a minimally invasive and short-term effective method that can be used in the treatment of obesity.