The Surgery-Free Gastric Band That Could Beat Type 2 Diabetes

Obesity is a growing epidemic in the Western world (no pun intended). In the US, 74% of men and 64% of women are either overweight or obese, with 36% of men and women clinically obese. In the UK, 20% of adults are overweight, and one in fifteen are clinically obese, with levels of obesity predicted to skyrocket by 73% in 20 years to 26 million people (or just less than half of the UK population).

Obesity puts a terrible strain on our bodies, increasing the risk of health conditions such as: heart disease, cancer, and Type 2 Diabetes.

How is Obesity linked to Type 2 Diabetes?

In short, no-one's one-hundred percent sure.

What is known is that being obese gives you an 80-85% greater chance of developing Type 2 Diabetes.

But why?

The biggest risk seems to be if you carry a lot of your weight around your abdomen. It's thought that this triggers a "pro-inflammatory" response, which makes your fat cells less sensitive to your body's own insulin. Excess fatty tissue is also thought to release fat molecules into the blood, making you less sensitive to your own insulin. 

It has also been suggested that obesity causes prediabetes, a metabolic condition that almost always leads to diabetes.  

But, your doctor has probably told you all that.

What if I told you there was a new, surgery-free gastric band that helped you lose weight, and helped your diabetes.

Well, that's why I'm here. But I don't believe it.

The treatment, currently being piloted in three centres in the UK, and available in many counties (although is limited to investigational use only in the USA at this current time), is called the EndoBarrier.

What is it?

A thin plastic sleeve constructed from Teflon-like material, which lines the first 60cm (two feet) of the small intestine, causing food to be absorbed further down the intestine. This alters the way food is absorbed, and may reduce your appetite by tricking your appetite hormones into telling your body that you feel full.

There's no incision. The tube is inserted orally, while the patient is under general anaesthesia. It is then passed through your stomach and fixed into place with a sprung metal anchor that prevents it slipping out.

READ Vitamin D Deficiency: Really Guilty of Causing Obesity?

How does it work?

The EndoBarrier prevents the body digesting food in the upper small intestine. This changes how your body reacts to food. It takes less food to feel full. They also affect your taste-buds, so you prefer savoury food to sweet. Finally, the EndoBarrier helps you manage blood glucose levels; many patients find they quickly return to a healthy range.

So it's like a gastric bypass?

Having an EndoBarrier fitted is similar to a gastric bypass, but is a much more viable option for many patients.  It does not involve invasive surgery; it's safer (a conventional gastric bypass has a 30-day mortality rate of up to 1.1%). It can also be reversed at any time and is less expensive.

More About the EndoBarrier

Does it Work?

Results show that 83% of patients with Type 2 Diabetes showed a decrease in their HbA1c (glycated haemoglobin - your blood glucose levels over two to three months) of 7.0% or lower.  

3 out of 4 patients with Type 2 Diabetes reported a resolution of their Type 2 Diabetes, a development which enabled them to stop taking their anti-diabetes medication altogether.

After 12 weeks with the EndoBarrier, all patients had achieved excess weight loss of 11.9-22%.

Who is the EndoBarrier Suitable for?

The EndoBarrier is for people who:

• Have Type 2 Diabetes
• Are aged over 18
• Who have struggled to lose weight by other methods
• Do not want bariatric surgery (like a gastric bypass)

That's me! So, can I have it?

Do you have £7,000 and live in the UK, Australia, Austria, the Czech Republic, France, Germany, Israel, Italy, the Netherlands, Spain, or Switzerland?

If you don't have the money and you live in the UK, your only other hope is to schmooze your way onto the Imperial College London EndoBarrier Clinical Trial (see Links). But, be aware that, unless you're randomised into the EndoBarrier group, you'll be following a diet and exercise programme for a year (and, if you get into the EndoBarrier group, be aware that it gets taken out after a year).

What? I thought this was the new miracle cure!

The outlook is very promising. But it's still being tested and is not widely available yet.

So, what else do you have to tell me?

Even if you meet the criteria, the EndoBarrier may not be suitable for you.

These common conditions will prevent you having an EndoBarrier:

• A peptic (stomach) ulcer
• Bleeding disorder (such as haemophilia)
• A history of digestive surgery

Are there any potential side-effects?

Side-effects are rare. But they do happen.

• Abdominal pain on the right side.
• Bloating
• Nausea/vomiting
• Rarely, the EndoBarrier may become dislodged and has to be removed (though the anchor has recently been improved)

READ Will a Tax on High-Fat Foods Rescue Americans from the Obesity Pandemic?

So, is the EndoBarrier a good idea or isn't it?

Some are very optimistic about the potential for the EndoBarrier to improve Type 2 Diabetes, support medically-beneficial weight loss and boost our general health.

Dr Aruchuna Mohanaruban, of St. Mary's Hospital London, is very enthusiastic about its potential, saying: "The EndoBarrier could be a powerful weapon in the fight against obesity."

Chair of the National Obesity Forum, Professor David Haslam, is tentative but  upbeat, saying: "It’s very promising but we have to wait for the trial results."

Not everyone is greeting the new surgery-free gastric band with such enthusiasm, though. Diabetes expert, Mike Lean, Professor of human nutrition at Glasgow University, accused the EndoBarrier of a "veterinary approach" and said it "cannot have long-term benefits."

So, what is the answer?

Perhaps we should give the last word to Dr Emily Burns, from charity Diabetes UK, who says: "While weight loss surgery for type 2 diabetes is an important treatment option, it should not be seen as a way to fix the type 2 and the obesity epidemic on its own"

Good advice.

So, whether the EndoBarrier is right for you, remember: no medical procedure invented is a substitute for a healthy, balanced diet and exercise that you enjoy.