There is not just one eating disorder. This month, February, is eating disorders awareness month. In this spirit, we wanted to highlight some of the eating disorders that are currently being addressed by developments in neurotechnology.
Obesity and other eating disorders might not be categorized as neurological disorders or disease, but they are conditions by which there are significant developments of technologies for the treatment of these conditions. More specifically, we focus on technologies that interact with the human nervous system. We have seen technology developments mainly in two areas: obesity and gastroparesis. Other eating disorders are also being explore in scientific research.
Obesity affects 66 million people in the U.S. to the point where medical intervention is necessary. Morbid obesity, defined as obesity that threatens vital organs, afflicts 14 million in the U.S. Obesity has become an epidemic with a significant unmet medical need. People suffering from obesity are at increased risk for a number of serious health conditions such as diabetes, coronary heart disease, and hypertension. By actively treating obesity, there is an opportunity to limit the burden on the healthcare system and significantly improve patient lives. Whereas, gastroparesis is a debilitating condition with no known cure in which the stomach muscles work poorly or not at all. It has many possible causes and is of particular concern to the increasing U.S. diabetes population, as it is estimated to affect about five percent of people with diabetes.
Reshape Life Sciences (previously EnteroMedics) received both CE Mark and FDA approval for the VBLOC therapy delivered via the Maestro system for the treatment of obesity. The Maestro system is the first to treat obesity using neuroblocking technology and represents a less invasive alternative to existing surgical weight loss procedures, which alter digestive system anatomy, lifestyle, and food choices and may present significant risks. The company has made a business decision to sell the device outside the U.S. for now.
Neurovalens Ltd., a neurotech startup based in Northern Ireland, has developed a noninvasive vestibular nerve stimulation system that the company intends to market to consumers to help them lose weight.
For the treatment of gastroparesis, Medtronic’s Enterra II therapy consists of a small neurostimulator, which is implanted under the skin, usually in the lower abdominal region. Two leads are implanted in the stomach wall muscle and then connected to the neurostimulator, which delivers mild electrical pulses through the leads to stimulate the smooth muscles of the lower stomach. After the device is implanted, the doctor uses a handheld, external programmer to noninvasively adjust the neurostimulator and customize the stimulation to each patient’s needs.
Stimulating the brain to alter its intrinsic reward system shows promise in the treatment of obesity and possibly other eating disorders. Some results were presented in Barcelona at the European Society of Endocrinology annual meeting, ECE 2018. The technique has yielded positive results after just a single treatment session, revealing its potential to become a safer alternative to treat obesity, avoiding invasive surgery and drug side effects. It has been reported that, in some obesity cases, the reward system in the brain may be altered, causing a greater reward response to food than in normal weight individuals. This can make people more vulnerable to craving, and can lead to weight gain. This dysfunction in the reward system can also be seen in cases of addiction to substances, e.g. drugs or alcohol, or behaviors, e.g. gambling. Deep transcranial magnetic stimulation has been used to treat depression and addictive behaviors, and previous studies have suggested that dTMS could be a good option to reduce drug and food cravings.
Other avenues of research for obesity include exoskeleton robotics and vagus nerve stimulation. As with brain stimulation systems, these are still under investigation.
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