The latest advance in extreme weight-loss management isn’t a pill or new surgical procedure. It’s a pacemaker-like device that tricks people into thinking they’re not hungry.
The Maestro System, which was recently approved by the FDA, is implanted around the vagus nerves that connect the brain with the stomach. By sending out high-frequency pulses, it interrupts the normal “I need to eat” messages that cause people to, well, eat.
“It gives patients a way to control their feelings of hunger and fullness without anatomy-altering surgery or drastic or difficult lifestyle and food choice changes,” says Mark Knudson, CEO of Minnesota-based EnteroMedics, the company behind the technology.
The Maestro is about three-quarters the size of an iPhone 5 and is implanted in a patient’s side. Electrodes extending from the unit are placed around the vagus at the point where the esophagus meets the stomach. The device has its own battery (which is why it’s quite big) and its own clock. When doctors turn it on, they can program it to work around someone’s daily routine. It turns off when people are sleeping.
It’s not meant for people just a little overweight. Under FDA rules, a potential patient needs to have a Body Mass Index of at least 40 (25 is the threshold for being “overweight”). Or, they need to have a BMI of 35 plus another condition like high blood pressure or cholesterol. Patients also need to go through a supervised weight-loss program before they can get a Maestro.
The device went through a randomized clinical trial where some participants wore sham devices and some wore no devices at all. After 12 months, those implanted with the Maestro cut their excess weight (above BMI 25) by 25%. It should be available later this year.
You might say weight-loss tech creates a perverse incentive for people to eat more and exercise less, as they know there’s always a device waiting should they need it. But the Maestro at least seems to allow people to lose weight more naturally. The implant is reversible (you can switch it off if need be) and you can continue eating foods you’re used to (just less of them).
“When the nutritionist says ‘this is what you should eat and how you should eat it and this is when you should eat it’, the patient can actually go out and comfortably change their lifestyle without being driven crazy by hunger,” Knudson says. “If you eat an ethnic style of food, it might be incompatible with those other types of surgeries.”