A Nerve-Racking Approach to Treating Obesity

Different types of surgical intervention have recently become a popular approach to treating overweight and obesity that is sweeping the industrialized world. Most kinds of weight loss surgery require invasive procedures, such as suturing together the stomach walls or installing into the digestive tract balloons or other objects to prevent patients from consuming large quantities of food. A recent invention in the fields of weight loss surgery requires cutting, or otherwise disrupting the vagus nerve, which carries biochemical signals between the brain and the gut and which is responsible for triggering hunger and stimulating appetite and the release of digestive juices.

The vagus nerve is an important part of the peripheral nervous system. It is not only engaged in the stomach activity, but also controls the muscles involved in swallowing and speaking. Its motor fibres reach not only various parts of the digestive tract, but also extend as far as the muscles of the respiratory system and heart. The vagus nerve, therefore, carries all-important information and chemical signals between the central nervous system and the stomach, lungs, heart and surrounding muscles. In addition, it is responsible for our sensations of muscular mobility in the areas of the mouth and throat.

Cutting the vagus nerve, or blocking its signals by other means, such as by implanting into the patient’s tissue an electronic device that upsets correct communication between the brain and stomach, leads to “effective and continuous” weight loss, researchers say. Gastrointestinal surgeons also claim that such type of weight loss surgery is completely safe for the patient. However, many patients are only given a part of the real after-surgery picture. Yes, cutting the vagus nerve will diminish appetite, but it will also disrupt other important physiological processes that regulate the entire metabolism of the person – his intake of vital nutrients, work of the muscles of mastication (chewing), secretion of stomach enzymes and juices that are responsible for a proper digestion of food, etc.

Current clinical research is focused on two basic methods of the vagus nerve surgery – vagatomy (permanent disabling of the nerve by simply cutting it) and vagal nerve disruption that is achieved by the use of an electric current coming from an implanted apparatus. The device is designed to prevent the vagus nerve from transmitting biochemical signals. According to preliminary results, both methods are effective in reducing patients’ weight by up to 20 percent within half-a-year from the beginning of this drastic therapy.

Some researchers believe that we gain weight because our vagus nerve transmits excessive signals of hunger, but not because we choose to eat processed foods and lead a sedentary lifestyle. Involved surgeons also think that the solution to obesity is simply to cut this important nerve so that overweight people do not experience hunger anymore! However, they disregard the fact that the vagus nerve function is an important part of our homeostasis, which insures our long-term survival and disease-free life. The vagus nerve does not just send the signals of hunger; it is directly involved in the process of effective digestion, absorption of nutrients, and passage of food throughout the entire digestive tract. When the vagus nerve signals are disrupted, the entire gastrointestinal system runs out of order, which can also severely affect other systems and organs of the body. Cutting the vagus nerve can induce some weight loss, but will it indeed be beneficial for the organism? And what would be long-term consequences of such surgical intervention?

Dr. Robert Lustig from San Francisco, who has been involved in recent vagatomy research in relation to weight loss, points out that the vagus nerve is also responsible for the release of insulin in response to eating carbohydrate-rich meals and for secreting hormones that store carb-derived triglycerides in adipose tissue. Without these important physiological mechanisms, foods will not be digested, neither the nutrients will be extracted for numerous body uses and the energy production. Can, therefore, vagatomy be a “safe” procedure, especially if to take into consideration that a proper diet and increased physical activity are much better, safer, and physiologically wiser methods of shedding unwanted pounds?

Since early 1940s, vagatomy has been applied to reduce excessive stomach acidity, with weight loss, malnutrition and eventual vitamin, mineral and nutrient deficiencies leading to degenerative diseases being side effects of the procedure. Many patients also experienced post-operative symptoms of severe indigestion, such as diarrhea, gas, intestinal pains, dizziness and vomiting. Dr. Lustig claims, however, that modern vagatomy uses more advanced methods, is much safer for the patient and has milder side effects.

Complete vagatomy is irreversible; however, vagal nerve blocking is a less intrusive procedure that leaves the patient an opportunity to restore a complete function of the vagus nerve after removing of the implanted electronic device. This procedure was developed by the company EnteroMedics and is now tested in clinical conditions at several research centers of the US. The drawbacks of the operation, in addition to malabsorption of nutrients, are potential infections caused by the presence of a foreign object in the patient’s body.

Both operations are performed by means of the laparoscopic technique and are currently performed only in clinical studies. If they are approved, overweight and obese individuals will be given another surgical option to fix their weight problems. Just like a historical application of lobotomy that was proven for a while as an “effective” procedure for treating patients suffering from mental diseases, vagatomy may become a preferred medical method of treating obesity. Beware of!

Terry Smith

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