An innovative weight loss procedure uses thermal energy to reduce hunger.
Blasting a patch of patients’ stomach lining with thermal energy decreased hunger and led to weight loss, according to a small pilot study to be presented at the annual Digestive Disease Week meeting on May 19 in Washington, D.C.
This procedure, called gastric fundus mucosal ablation, employs an endoscope—a thin tube threaded down the throat. The process takes less than an hour and does not require hospitalization. “The advantage of this is that it’s a relatively straightforward procedure,” says Cleveland Clinic surgical endoscopist Matthew Kroh, who was not involved in the study. Side effects were minimal, including mild nausea and cramping, as noted by one study author at a news conference on May 8.
This approach differs significantly from bariatric surgery, the gold standard treatment for obesity, which often involves significant recovery time and hospitalization. Obese individuals frequently avoid bariatric surgery due to the invasive nature of the procedures, says Kroh.
If larger studies confirm the findings, this new procedure could offer an easier alternative. “There’s potential,” Kroh says, “but I think we have to be cautious.”
The trial included 10 women, placing the method at the proof-of-concept stage. Over six months, participants lost nearly 8 percent of their body weight, approximately 19 pounds. This is less than what is typically achieved with bariatric surgery or anti-obesity drugs like Wegovy (SN 12/13/23).
Margaret Keane, a bariatric endoscopist at Johns Hopkins Hospital who was not part of the study, says the weight loss achieved is still significant. Even at this level, individuals can see improvements in obesity-related conditions such as high blood pressure, high cholesterol, and diabetes.
The study’s authors attribute the weight loss to a reduction in the hunger hormone ghrelin, which signals the brain that it’s time to eat. Lower ghrelin levels mean fewer hunger pangs. While no drug currently lowers ghrelin levels, doctors can target the tissue that produces it. The upper stomach lining produces most of the hormone, and burning these cells should promote weight loss, explained study coauthor Christopher McGowan, a gastroenterologist at True You Weight Loss in Cary, N.C.
This concept is not entirely new. Bariatric surgeries that remove or bypass this stomach portion also reduce ghrelin. In the new study, participants’ ghrelin levels dropped by about 45 percent, from around 460 picograms per milliliter to about 250 at six months post-procedure, likely due to having fewer ghrelin-producing cells, McGowan noted at the news conference.
The study only followed patients for six months, so the duration of the procedure’s effects and whether ghrelin-producing cells will regenerate remain uncertain. However, McGowan pointed out another potential effect: the formation of scar tissue, which makes the treated stomach area “less stretchy, less expandable, and stiffer,” leading to a feeling of fullness with less food.
McGowan envisions this technique as a potential standalone treatment for obesity and suggests it could help patients transitioning off medications like Wegovy, who often regain weight.
Keane is particularly enthusiastic about combining the ablation treatment with procedures like endoscopic sleeve gastroplasty, which reduces stomach size by stitching its walls together. Both methods are nonsurgical and use an endoscope.
It’s too early to draw definitive conclusions, Keane says, but such a combined treatment could potentially achieve “surgical levels of weight loss without the longer recovery time.”
