Effect of Intragastric Botulinum Type A Injection Combined with a Low-Calorie High-Protein Diet in Adults with Overweight or Obesity

Abstract

(1) Background/aims: Intragastric botulinum toxin A injection (IGBI) combined with diet control is a new and effective weight loss method for grade 2 obese patients. However, the application of IGIB on overweight or obese adults still needs further research to confirm its efficacy. (2) Methods: We retrospectively collected medical data from 1 July 2021 to 1 January 2022 from a total of 71 patients without diabetes who participated in the bariatric clinic with a body mass index (BMI) > 25 kg/m2. Forty-nine participants opted for intragastric botulinum injection (IGBI) using 300 units of botulinum injected into the antrum, body, and fundus, followed with a low-calorie high-protein diet course. Another 22 people participated only in the low-calorie high-protein diet course as a placebo group. This study analyzes the weight loss percentage of the two groups. Adverse events after IGBI are also reported in a safety assessment. (3) Results: In terms of the characteristics of the two groups, the mean BMI was 29.3 kg/m2 in the IGBI group and 28.0 kg/m in the placebo group (p = 0.63 without significant difference). Comparing the percent weight loss from baseline in the two groups after 12 weeks, the IGBI group lost 11.5% of their body weight and the placebo group lost 1.8%. In terms of group analysis, the percentages of participants with a weight reduction of at least 5% for the IGBI and placebo groups were 95% and 4%, respectively. For weight reduction of at least 10%, these values for the IGBI and placebo groups were 63% and 4%, respectively. In terms of adverse events after IGBI for 12 weeks, 12 participants (24.4%) had constipation, which was the main side effect. No serious adverse events were observed during the study period. (4) Conclusion: The combination of a low-calorie high-protein diet and IGBI is an effective and safe procedure in overweight or obese adults for weight reduction, but further larger studies are needed.

Outbreaks of iatrogenic botulism in Europe: Combating off-label medical use of Botulinum Neurotoxin (BoNT) in bariatric procedures

“…Another retrospective study reported significant reduction in weight loss when injecting BTA in combination with liraglutide (a glucagon-like peptide-1 agonist used to treat diabetes and chronic obesity) than BTA alone [ 13 ]. Multiple other studies have reported on the benefits of combining BTA intragastric injections with low-calorie diet [ [14] , [15] , [16] ]. In a study from Jordon, the authors noted that although BTA injections are associated with lesser weight loss in comparison with gastric balloons, shorter procedure duration and fewer postoperative complications may make BTA injections a favourable treatment modality [ 17 ].…”

Retraction: Comparing the controlled attenuation parameter using FibroScan and attenuation imaging with ultrasound as a novel measurement for liver steatosis

“…The ethics approval number (210202) in [ 1 ] is also reported in several articles by some of the same authors, including [ 3 – 7 ], which describe studies and patient cohorts different to those reported in [ 1 ]. Additionally, discrepancies were identified between the description of the study design in [ 1 ] and the ethics approval documentation provided during discussions.…”

“…Hence, the article does not adhere to the journal's second publication criterion or PLOS' Editorial policies pertaining to text reuse and publication of related studies, and concerns remain regarding partial redundancy of the two articles [1,2].The ethics approval number (210202) in [1] is also reported in several articles by some of the same authors, including [3-7], which describe studies and patient cohorts different to those reported in [1]. Additionally, discrepancies were identified between the description of the study design in [1] and the ethics approval documentation provided during discussions.The first author stated that the same approval number (210202) was obtained for multiple different studies [1,[3][4][5][6][7] as the applications for approval for all the studies were made to the IRB together. They also acknowledged that the study described in [1] was retrospective, which conflicts with the description of the study design in [1].…”

“…The first author stated that the same approval number (210202) was obtained for multiple different studies [1,[3][4][5][6][7] as the applications for approval for all the studies were made to the IRB together. They also acknowledged that the study described in [1] was retrospective, which conflicts with the description of the study design in [1].…”