Can brain surgery fight obesity?

Monday, 29 November 2010 13:16

A team of neurosurgeons from West Virginia University Health Sciences Center are investigating a new type of surgery that could help people lose weight: a form of brain surgery.

The experimental procedure, known as deep brain stimulation, is designed for obese individuals who have not had success with other weight-loss methods, including bariatric surgery. Doctors use needles to deliver electricity into different parts of the brain that are believed to control feelings of hunger and satisfaction.

An FDA-approved study is currently underway for the treatment, which has already been used to treat neurological conditions such as Parkinson's disease and epilepsy, as well as behavioral problems such as obsessive-compulsive disorder and depression.

The treatment is not for overweight patients, but only for morbidly obese patients whose weight puts their lives at risk. All patients considered for the study must undergo a details psychiatric evaluation.

"I believe that many people have done everything they can," said Dr. Julian Bailes, chairman of West Virginia University's department of neurosurgery. "And maybe there's some predisposition. Maybe there's some effect that the brain cannot control exactly what we consume."

Risks associated with the procedure include infection and bleeding. There is less than one percent chance of paralysis or death.

During the surgery, needles are inserted about 10 centimeters into each side of the brain, through tissue that does not affect other function. When the needles reach a point in the hypothalamus that controls the stomach, surgeons insert a small wire that carries an electrical impulse. Doctors can then alter the level of electricity that is naturally generated by that region of the brain, making patients feel like they are full.
Because there are no pain receptors in the brain, patients remain awake during the procedure. This allows surgeons to speak to the patients and adjust the electrical current until they receive the desired response from the patient. Pacemaker devices are then implanted into the patient's chest, and the electricity pulses are gradually increased over the course of several months.

After the surgery, it may be several months before the patient loses a significant amount of weight. Study participants are required to keep a meticulous food journal. If initial results are positive, surgeons believe the procedure could eventual become widely available.