A capsule tricks your stomach into feeling full; could it treat obesity?

A new capsule was recently cleared by the government to help adults who are overweight or obese shed some pounds when used along with diet and exercise, according to the  biotech company which developed the product.

The company announced government clearance this month and noted that the product, called Plenity, is the only prescription weight management product cleared for use by overweight adults with a body mass index of 25 or higher.

Body Mass Insex or BMI, is a person's weight in kilograms divided by the square of their height in meters, and the measurement is used to screen for obesity. A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or greater is considered obese.

 

Nearly 40% of people 20 and older in the United States are living with obesity.

 

The company said Plenity will be broadly available by prescription in the United States in 2020. No cost for the product has been announced.

How it works

Even though it looks like a pill, Plenity is considered a medical device.

 

The hydrogel capsule can be taken with water before lunch and dinner. In the stomach, the capsule releases thousands of particles that absorb water and swell to create small individual gel pieces. 

 

Those gel pieces increase the volume and elasticity of the stomach and small intestine, helping to make you feel full, which then could lead to weight loss.

 

Once in the large intestine, the hydrogel is partially broken down by enzymes, loses its three-dimensional structure, releases the water that was absorbed and then gets expelled in feces.

 

"The most compelling aspects of this approach are its effectiveness, novel mechanism of action and impressive safety data," said a weight loss expert.

"This approach creates another arm in the treatment algorithm of weight management and could be used by an overwhelming majority of people struggling with weight issues," he said.

Data from a study on Plenity,  in February, found that the treatment resulted in 6.4% weight loss in a group of 223 patients using the product compared with 4.4% in 213 patients using a placebo.

The device should be used with caution in patients with gastrointestinal conditions, such as gastroesophageal reflux disease, ulcers or heartburn, according to the researchers. The most common adverse events relating to the treatment are gastrointestinal disorders, including gastrointestinal discomfort.

Plenity isn't the only weight loss aid that has emerged in recent years; several interventions are on the market.

 

Yet "for the first time in a long time, it's a new treatment for obesity that doesn't affect the central nervous system," said a Dr. 

 

"So most of the drugs on the market that are appetite suppressants or work on the appetite regulatory system have some kind of central nervous system side effect, because any time you affect any neurotransmitter in the brain regarding appetite, there's always going to be another systemic effect of some system, whether it's moodiness or it can affect depression or it can affect headaches," said the Dr., who has no relation to Plenity but is board-certified in both pediatrics and obesity medicine.

 

"This is really, clearly just focused on the physicality of being more full," she said. "Your stomach is going to be more full, and it's excreted, and it's really not affecting your central nervous system in that sense."

'The wave of the future'

In general, a medication can be considered effective for weight management if, after one year of treatment, at least 35% of those in the drug group (and about double the proportion of people of the placebo group) lose at least 5% of their weight in a study or trial.

Weight loss drugs approved for long-term use include orlistat (brand name Xenical), lorcaserin (Belviq) and liraglutide (Saxenda) as well as the combination drugs naltrexone-bupropion (Contrave) and phentermine-topiramate (Qsymia).

 

In one recent study, these drugs helped overweight or obese people lost at least 5% of their body weight  at the end of a year -- that's at least 10 pounds if you weigh 200 -- compared with a placebo. 

 

Qsymia and Saxenda were associated with the highest odds of achieving that amount of weight loss.

For many, losing 5% to 10% of your body weight is associated with improved blood pressure, triglycerides and blood sugar, factors that lower the risk for heart disease and diabetes.

The Dr. called weight loss interventions like Plenity "the wave of the future," and she hopes the product soon might be approved for use in children.

"I see so many obese patients, and I really don't have options for them," she said. "And then we have something like this, which is literally just a cellulose that you swallow and you excrete. I think the biggest problem for me in pediatrics is going to be able to get the younger kids to be able to swallow the pills."

 

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New swallowable sensors to monitor human gut health

Scientists have successfully completed the first human trials of an ingestible capsule that can monitor gases in the gut in real time, potentially revolutionising the way stomach and colon disorders are diagnosed.

The capsule can uncover mechanisms in the body that have never been seen before, including a potentially new immune system, researchers said.

The new technology is a game-changer for the one-in-five people worldwide who will suffer from a gastrointestinal disorder in their lifetime. They could also lead to fewer invasive procedures like colonoscopies, they said.

The ingestible capsule developed by researchers detects and measures gut gases — hydrogen, carbon dioxides and oxygen — in real time. This data can be sent to a mobile phone.

“We found that the stomach releases oxidising chemicals to break down and beat foreign compounds that are staying in the stomach for longer than usual,” said a Dr.

“This could represent a gastric protection system against foreign bodies. Such an immune mechanism has never been reported before,” said the co-inventor of the capsule.

Another never before seen observation from the trial was that the colon may contain oxygen.

“Trials showed the presence of high concentrations of oxygen in the colon under an extremely high-fibre diet,” the Dr. said.

“This contradicts the old belief that the colon is always oxygen free. This new information could help us better understand how debilitating diseases like colon cancer occur,” he said.

The trials were conducted on seven healthy individuals on low- and high-fibre diets.

Results showed that the capsule accurately shows the onset of food fermentation, highlighting their potential to clinically monitor digestion and normal gut health.

The trials also demonstrated that the capsule could offer a much more effective way of measuring microbiome activities in the stomach, a critical way of determining gut health.

“Previously, we have had to rely on faecal samples or surgery to sample and analyse microbes in the gut,” the Dr. said.

“But this meant measuring them when they are not a true reflection of the gut microbiota at that time. Our capsule will offer a non-invasive method to measure microbiome activity,” he said. 

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Peppermint Oil and Cinnamon Heal Persistent Wounds

Infectious colonies of bacteria called biofilms that develop on chronic wounds and medical devices can cause serious health problems and are tough to treat. But now scientists have found a way to package antimicrobial compounds from peppermint and cinnamon in tiny capsules that can both kill biofilms and actively promote healing. The researchers say the new material, reported in the journal ACS Nano, could be used as a topical antibacterial treatment and disinfectant.

Many bacteria clump together in sticky plaques in a way that makes them difficult to eliminate with traditional antibiotics. Doctors sometimes recommend cutting out infected tissues. This approach is costly, however, and because it’s invasive, many patients opt out of treatment altogether. Essential oils and other natural compounds have emerged recently as alternative substances that can get rid of pathogenic bacteria, but researchers have had a hard time translating their antibacterial activity into treatments. Vincent M. Rotello and colleagues wanted to address this challenge.

The researchers packaged peppermint oil and cinnamaldehyde, the compound in cinnamon responsible for its flavor and aroma, into silica nanoparticles. The microcapsule treatment was effective against four different types of bacteria, including one antibiotic-resistant strain. It also promoted the growth of fibroblasts, a cell type that is important in wound healing.

The authors acknowledge funding from Firmenich, the National Institutes of Health, and the National Science Foundation.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.






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