Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 28, 2008; 14(12): 1805-1809
Published online Mar 28, 2008. doi: 10.3748/wjg.14.1805
Intragastric injection of botulinum toxin for the treatment of obesity. Where are we?
Diego Garcia-Compean, Hector Maldonado Garza
Diego Garcia-Compean, Hector Maldonado Garza, Department of Gastroenterology, Faculty of Medicine, University Hospital. Ave Madero y Gonzalitos, Col Mitras Centro, Monterrey 64700, Mexico
Author contributions: Jaquez Quintana JO and Reyes Cabello E contributed equally to this work.
Correspondence to: Diego Garcia-Compean, Department of Gastroenterology, Faculty of Medicine, University Hospital, Ave Madero y Gonzalitos, Col Mitras Centro, Monterrey 64700, Mexico. digarciacompean@prodigy.net.mx
Telephone: +52-81-83487315
Fax: +52-81-89891381
Received: January 4, 2008
Revised: January 29, 2008
Published online: March 28, 2008

Obesity has reached epidemic proportions particularly in western countries. Most non-surgical treatments of this condition are disappointing. Since 2005, several studies evaluating the effect of Botulinum Toxin type A (BT-A) in gastric antrum by means of endoscopy for the treatment of obesity have been published. This treatment modality was based on the observation that gastric injection of BT-A in laparatomized rats induced a significant reduction of food intake and body weight. Nowadays, 6 studies have been published yielding conflicting results. Differences in selection of patients, doses of BT-A, method of administration of the toxin and instruments of evaluation of some parameters among these studies may be the cause of divergent results. We discuss herein some important features of these studies pointing out on differences among them. At the same time, based on the knowledge of physiological characteristics of normal and abnormal gastric function related with feeding, we discuss the probable causes of failure observed in these trials. Finally, we give some guidelines concerning the way that future research in this field may follow, not without calling attention to disadvantages of this treatment.

Keywords: Botulinum toxin, Obesity, Gastric emptying, Gastric motility, Gastroparesis