A new non-surgical weight-loss procedure has shown promising results, says a gastroenterologist from the US, who is due to present the results of the study at the Digestive Disease Week in Washington on Sunday. This can potentially broaden people's <a href="https://www.thenationalnews.com/lifestyle/wellbeing/2024/04/10/weight-loss-ozempic-versus-oatzempic/" target="_blank">weight-loss options</a>. Dr Christopher McGowan says the human-trialed endoscopic mucosal ablation is a procedure that specifically targets <a href="https://www.thenationalnews.com/lifestyle/wellbeing/does-the-one-meal-a-day-diet-work-experts-outline-the-pros-and-cons-1.1126922" target="_blank">ghrelin</a>, also known as the hunger hormone. This directly <a href="https://www.thenationalnews.com/lifestyle/wellbeing/2023/12/26/intermittent-energy-restriction-diet-for-weight-loss/" target="_blank">controls appetite</a> – the higher your levels of ghrelin, the hungrier you get. The hormone is primarily produced in the stomach, and the procedure ablates, or burns, the gastric lining to reduce its production. The six-month trial was conducted on 10 female patients with obesity, and results were generally positive, with the participants losing 7.7 per cent of their <a href="https://www.thenationalnews.com/lifestyle/wellbeing/2024/04/25/weighing-yourself-daily-fitness/" target="_blank">body weight </a>on average. One woman, for example, lost 11.7kg. The participants said their hunger leve ls decreased by more than a third, owing to a reduction of about 40 per cent in fasting ghrelin levels. Researchers also noted a 42 per cent reduction in stomach capacity after the procedure. McGowan, who is a gastroenterologist and medical director of True You Weight Loss clinic, said obesity affects “overall health and quality of life” and, given massive global healthcare costs, “we need as many treatment options as possible”. Perceived efficacy aside, the procedure is being touted as a less strenuous alternative to invasive weight loss treatments. The procedure starts with an endoscopist introducing fluid to protect stomach tissue. A tiny device is then used to burn the mucosal lining of the upper portion of the stomach, where feelings of hunger originate. This ablation reduces the number of ghrelin-producing cells. “This relatively brief, outpatient, non-surgical procedure can significantly curb hunger, and could be an additional option for patients who don’t want or aren’t eligible for anti-obesity medications, such as Wegovy and Ozempic, or bariatric surgery,” said McGowan. Before this trial, surgically removing or bypassing the gastric fundus was the only proven method to target ghrelin production. But such procedures are considered major medical treatments, with higher risks and longer operating and recovery times. Ablation takes about 55 minutes to complete and patients are asked to avoid strenuous activities for three to five days. By comparison, a gastric bypass takes up to three hours with a recovery period of two to four weeks. Further, no drug currently exists to reduce ghrelin. “Obesity and weight are very complex and regulated by multiple hormone pathways. This procedure alters one of these many pathways that make it difficult for people to lose weight and maintain weight loss,” said McGowan. He added longer trials are needed, involving more participants, to fully determine the procedure's potential. “This is just the beginning. The first question was whether we can endoscopically reduce hunger and ghrelin. The answer is – yes, we can.”