title: Aspiration therapy leads to weight loss in obese subjects: a pilot study.
abstract: OBJECTIVE
  Obese patients rarely achieve long-term weight loss with only lifestyle interventions. We evaluated the use of endoscopic aspiration therapy for obesity. Aspiration therapy involves endoscopic placement of a gastrostomy tube (A-Tube) and the AspireAssist siphon assembly (Aspire Bariatrics, King of Prussia, PA) to aspirate gastric contents 20 minutes after meal consumption.
  
  
  METHODS
  We performed a pilot study of 18 obese subjects who were randomly assigned (2:1) to groups that underwent aspiration therapy for 1 year plus lifestyle therapy (n = 11; mean body mass index, 42.6 ± 1.4 kg/m(2)) or lifestyle therapy only (n = 7; mean body mass index, 43.4 ± 2.0 kg/m(2)). Lifestyle intervention comprised a 15-session diet and behavioral education program.
  
  
  RESULTS
  Ten of the 11 subjects who underwent aspiration therapy and 4 of the 7 subjects who underwent lifestyle therapy completed the first year of the study. After 1 year, subjects in the aspiration therapy group lost 18.6% ± 2.3% of their body weight (49.0% ± 7.7% of excess weight loss [EWL]) and those in the lifestyle therapy group lost 5.9% ± 5.0% (14.9% ± 12.2% of EWL) (P < .04). Seven of the 10 subjects in the aspiration therapy group completed an additional year of therapy and maintained a 20.1% ± 3.5% body weight loss (54.6% ± 12.0% of EWL). There were no adverse effects of aspiration therapy on eating behavior and no evidence of compensation for aspirated calories with increased food intake. No episodes of binge eating in the aspiration therapy group or serious adverse were reported.
  
  
  CONCLUSIONS
  In a pilot study, aspiration therapy appears to be a safe and effective long-term weight loss therapy for obesity.
authors.affiliation: Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri. Electronic address: ssulliva@dom.wustl.edu.
authors.forename: Shelby
authors.initials: S
authors.lastname: Sullivan
authors.forename: Richard
authors.initials: R
authors.lastname: Stein
authors.forename: Sreenivasa
authors.initials: S
authors.lastname: Jonnalagadda
authors.forename: Daniel
authors.initials: D
authors.lastname: Mullady
authors.forename: Steven
authors.initials: S
authors.lastname: Edmundowicz
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D013396:Suction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
keywords: ALT; AT; BDI-II; BMI; Beck Depression Inventory; EDE; EWL; Eating Disorder Examination; Endoscopic Bariatric Therapy; LT; Obesity; Overweight; PEG; Percutaneous Endoscopic Gastrostomy; RCT; alanine aminotransferase; aspiration therapy plus lifestyle therapy; body mass index; excess weight loss; lifestyle therapy only; percutaneous endoscopic gastrostomy; randomized controlled trial