In July 2011, the Australian Therapeutic Goods Administration (TGA
) approved the EndoBarrier® Gastrointestinal Liner (the EndoBarrier) for inclusion on the Australian Register of Therapeutic Goods. The TGA has approved the use of the EndoBarrier for up to 12 months for the treatment of type 2 diabetes and obesity.
It is an interesting approach that is designed to mimic the effects of gastric bypass surgery without the risks of surgery. It looks like a clear plastic sock, open at both ends (see image). It is inserted into the top part of the small intestine just after the stomach. The barrier is placed endoscopically, via the mouth, with imaging assistance so that the doctor can position it precisely. The device works by simply stopping food from making contact with the lining of the small intestine where so much absorption takes place: the duodenum and jejunum. As the food exits the device, absorption begins so some food is digested through the rest of the small intestine.
As is often the case, with less risk, there is slightly less power when compared with surgery, in bringing about weight loss. The Endobarrier brings about 19% average excess weight loss (compared to around 50% for banding and other forms of surgery) and is more geared towards improving diabetes. Most of the diabetic patients in the clinical trials have shown improvement in the disease.
My primary concern with gastric banding is that it ???trains people up??? to eat a poorer diet as the foods that most readily pass through the band are processed foods e.g. ice cream, chocolate, milkshakes, mashed potato and baked goods like biscuits. Moreover, vegetables and lean protein can be a problem with a band. Bypass surgery allows people to continue to eat healthy foods without this ???training up???, but surgical risks are greater.
The Endobarrier has received approval in Europe and is commercially available in Chile, Germany, the United Kingdom and the Netherlands. Further trials are beginning to gain approval in the USA. Trials to date have included 500 people and I will be watching with interest our local experience here in Australia. For more information go to the manufacturer’s website: www.gidynamics.com
Hi Dr George,
I always smile when I see that a new email from you has arrived! I thought you would be interested in hearing that I recently tried hypnosis to become a “healthy and nutritious” eater. I had a session about a month ago, and I think it has helped. I know full well that it is a life long attitude so am happy to accept a gradual weight loss. Combining that with your wise words from the book, well success is almost guaranteed!! Anyway, I will look forward to hearing from you again, and that time can give an update on my journey.
best regards from Claire.