A novel weight-loss procedure is causing patients to lose muscle as well as fat, researchers have warned.
Left gastric artery embolization is being explored as an alternative to the invasive gastric bypass but has an unexpected side-effect.
Obesity is a major health issue worldwide, linked with serious conditions like heart disease, cancer and diabetes. At four, 10 percent of kids are obese, rising to 20 percent by age 10. In adulthood, this rises again to 25 percent.
First-line treatments such as diet and exercise often don’t work, leading many patients to opt for gastric bypass surgery, a successful procedure known to help the morbidly obese lose weight.
Researchers said the loss of muscle mass is concerning and underscores the importance of proper nutritional counselling after the procedure
A gastric bypass involves tying a band around the stomach to make it smaller, but carries with it significant costs and potential complications.
Currently under investigation in clinical trials, embolization only requires reducing blood flow to the upper part of the stomach called the fundus.
People feel hungry when the hormone ghrelin is released by the fundus, so researches thought reducing the blood flow to the stomach would slow the release of ghrelin, therefore lessening hunger.
In the procedure, microscopic beads are injected under imaging guidance into the artery that supplies blood to the stomach.
It has proved to be successful for reducing weight, but an unintended side effect was significant muscle loss.
Researchers said the loss of muscle mass is concerning and underscores the importance of proper nutritional counselling after the procedure.
Lead author Dr Edwin Takahashi, a vascular and interventional radiology fellow at the Mayo Clinic in Rochester, Minnesota, said: ‘There has been lots of research focused on the efficacy of gastric artery embolization for weight loss.
‘However, there has been no data on what is contributing to the weight loss, whether the patients are losing fat, as desired, or muscle mass, or some combination of the two.’
To learn more, Dr Takahashi and his team studied CT scans of 16 overweight or obese patients who had undergone left gastric artery embolization to treat gastrointestinal bleeding.
CT scans, when used in conjunction with special software, allow for measurements of body composition based on the different densities of tissues like fat and muscle.
The scans were done before and approximately one-and-a-half months after the procedure.
The results were compared to those of a control group of 16 outpatients who did not undergo left gastric artery embolization but had CT scans at two different time periods for nonspecific abdominal pain.
All 16 individuals experienced significant weight loss after the embolization procedure, losing an average of 6.4 percent of their body weight over the one-and-a-half months.
Body mass index, a measure of body weight relative to a person’s height, dropped by 6.3 percent.
While the weight loss was not surprising to the researchers, the changes in body composition were.
The skeletal muscle index, a measure of the amount of muscle that connects to the skeleton and helps move the limbs, fell by 6.8 percent.
Skeletal muscle is important to health, and loss of it can impair physical function and metabolism and put a person at higher risk of injury.
Dr Takahashi said: ‘The significant decrease in the amount of skeletal muscle highlights the fact that patients who undergo this procedure are at risk for losing muscle mass and need to be managed accordingly after procedure.
‘We must make sure they receive adequate nutrition to minimise the amount of muscle tissue they lose.’
The patients also lost a significant amount of body fat.
Their overall body fat index dropped by an average of 3.7 percent.
However, much of the fat loss was subcutaneous, or the fat that lies directly under the skin.
Visceral fat, the more dangerous fat surrounding the organs and associated with serious health problems like heart disease and diabetes, did not decrease significantly over the course of follow-up.
The researchers plan to expand their studies in the future to include people who are specifically undergoing embolization as a treatment for obesity.
The study was presented at the annual meeting of the Radiological Society of North America (RSNA) in Chicago.