Treatment Options

Gastric Electrical Stimulation for Treatment of Obesity

Possible Harm/No Value

GES is being investigated as a treatment of obesity.  The GES device consists of a battery-powered implantable pulse generator, a 15-inch lead wire with two electrodes, and an external programmer.  The pulse generator is implanted in a subcutaneous abdominal pocket between the rib cage and belt line.  The implanted lead and electrodes are attached to the stomach muscles with permanent stitches.  The external programmer is a computer that is used noninvasively to give instructions to the implantable pulse generator.  The implantable pulse generator then delivers electrical pulses to the stomach muscles.  The primary factor in the physics of electric stimulation is the frequency of pulse bursts (every five seconds).  Other factors include the duration of the pulse burst and the frequency of the burst when delivered. Additional parameters include current (five to 10 milliamps) and pulse width (200-500 milliseconds).

It is thought that GES may cause feelings of increased satiety (feeling full) leading to reduced food intake and weight loss.  The exact mechanisms that result in changes in eating and behavior are uncertain. The mechanisms may be related to neuro-hormonal modulation and/or stomach muscle stimulation.

Things to Consider

  • Gastric electrical stimulation (GES) for treatment of obesity is available only through clinical trials in the United States.  
  • More than six in 10 adults in the United States aged 20 years and older are overweight.
  • More than 110,000 deaths per year in the United States are associated with obesity.

Results

Possible Harm/No Value

Will I live longer if I use gastric electrical stimulation for the treatment of obesity?

Scientific evidence is not available to show if GES works for the treatment of obesity.  Weight loss may cause you to live longer.

Will use of gastric electrical stimulation for the treatment of obesity improve my quality of life?

There is no scientific evidence available to show if GES works for the treatment of obesity.  Weight loss may improve your quality of life.

Safety

Possible Harm/No Value

How safe is this for me?

Much more information, including data from more individuals who have had the procedure and longer follow-up, is needed to determine the safety of GES for treatment of obesity. 

Serious potential complications may include: 

  • Pulmonary embolism
  • Perforation of the stomach
  • Dislodgement of the device lead
  • Complications associated with the use of anesthesia

Comparison

Possible Harm/No Value

Alternative treatments include:

  • Good nutrition (balanced healthy eating plan or lower calorie balanced eating plan)
  • Regular physical activity
  • Behavioral management
  • Pharmacological treatment 
  • Surgery (bariatric surgery in carefully selected morbidly obese individuals)

Treatment for obesity requires a team approach.  You should consult your health care provider if you are considering any of these options.  Scientific studies that compare gastric electrical stimulation with the alternative treatments for obesity listed above are not available.

Cost

Possible Harm/No Value

The cost of gastric electrical stimulation for treatment of obesity may range from $45,000 to $65,000 or more.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

Institute for Clinical Systems Improvement. (2013, May). Health care guideline.  Prevention and management of obesity (mature adolescents and adults). Retrieved August 12, 2013 from https://www.icsi.org/_asset/s935hy/Obesity-Interactive0411.pdf. .

OHTAC Recommendation. (2006, August). Gastric electrical stimulation. Retrieved August 12, 2013 from http://www.health.gov.on.ca/english/providers/program/ohtac/tech/recommend/rec_ges_081806.pdf.

Next Review Date

8/22/2014

This document has been classified as public information.

Table of Findings

results:  possible harm / no value

safety:  possible harm / no value

comparison:  possible harm / no value

cost: possible harm / no value


total: possible harm / no value

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Page modified:November 9, 2012