"Previous attempts to induce and sustain weight loss solely by decreasing a person's capacity to consume large quantities have failed," says Smith. Right now, the gold standard in weight loss surgery is the gastric bypass, which works by three different mechanisms.
First, the small pouch created during the procedure limits the food a patient can eat at one sitting. Second, calories are not well absorbed because food never passes through portions of the small intestine. And third, patient who eat too much will experience dumping -- the rapid and unpleasant elimination of excess, indigestible foods. "So with gastric bypass, there's a restrictive, a malabsorptive, and a strong behavior component," he says.
And there is 14-year follow-up data showing that "90% of gastric bypass patients lost 50%-75% of their excess weight and kept it off," says Smith. "I think we still have a long ways to go with the gastric pacing data. It's far too early to recommend its application."
Cigaina cautions that gastric pacing is not a 'cure' for obesity. "You have to have the pacemaker all your life," he says, "because even though you are lean, you are still an obese person. Without the pacemaker, you will regain the weight."
Technology is continuing to improve, but for now, the cost of the unit is quite high, and batteries must be replaced every four years or so.
Still, Cigaina tells WebMD, receiving the gastric pacemaker is a much less invasive procedure for treating obesity than is the increasingly popular gastric bypass surgery. "In terms of quality of life, there's no comparison," he says.
In Europe, the device should be on the market by September of this year, says Cigaina. In the U.S., however, the rigorous FDA approval process will likely delay availability for at least a few more years.