Intragastric botulinum toxin injection: a promising alternative for obesity treatment?

Introduction: Over the past 50 years, the rise in obesity has prompted a search for new treatments. Intragastric injections of botulinum toxin A (BT-A), a safer alternative to surgery, show promise in reducing weight and caloric intake by inducing early satiety. This study examines their efficacy for weight loss.

Material and methods: From 2021 to 2023, we conducted a retrospective analysis of patients who underwent intragastric BT-A injections in a general surgery endoscopy unit. The inclusion criteria were being aged 18-65 and having a body mass index (BMI) over 25 kg/m². Patients with specific medical conditions or incomplete records were excluded. We monitored patient weight and BMI values before the procedure and at monthly intervals, with further assessments conducted in the sixth month, including appetite and patient satisfaction.

Results: Our study on 67 patients, predominantly female (82.1%), aged 35.5 ±9.0 years with a mean BMI of 33.5 ±3.3 kg/m², examined BT-A injections' effectiveness. 58.2% received injections in both gastric antrum and fundus regions, showing greater weight loss (mean: 10.7 ±7.0 kg) than those treated in the antrum alone. Side effects occurred in 16.4%, with various symptoms. High dietary compliance (80.6%) correlated with weight loss, especially among those reporting intense satiety. Patient satisfaction positively correlated with weight loss, highlighting treatment efficacy and patient response to dual-region injections.

Conclusions: Our study suggested that intragastric BT-A injections in the antrum and fundus are effective and safe for satiety and weight loss, with few side effects. Individual responses vary, and diet adherence is crucial. More studies are needed to assess the treatment's efficacy in obesity.