title: Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression.
abstract: BACKGROUND
  Controversies persist regarding the effect of intragastric injection of botulinum toxin A for the treatment of obesity.
  
  
  OBJECTIVE
  To assess the efficacy of intragastric botulinum toxin injection for the treatment of obesity.
  
  
  METHODS
  A systematic literature review was conducted by using the core databases. Pre- and posttreatment body weight data were extracted and analyzed by using Hedges' g. A random-effects model was applied. The methodological quality of the enrolled studies was assessed by the risk of bias table and Newcastle-Ottawa Scale. Publication bias was evaluated via the funnel plot, trim and fill method, Egger's test, and rank correlation test.
  
  
  METHODS
  Meta-analysis of 8 studies.
  
  
  METHODS
  A total of 115 patients (79 treated vs 36 placebo).
  
  
  METHODS
  Intragastric botulinum toxin A injection.
  
  
  METHODS
  Hedges' g, calculated from pre- and posttreatment body weight data and comparison of body weight changes between treatment and placebo group.
  
  
  RESULTS
  The treatment group was associated with weight loss in a pre/post comparative approach and compared with the placebo group (Hedges' g: -0.443; 95% confidence interval, -0.845 to -0.040; P = .031; and Hedges' g: -0.521; 95% confidence interval, -0.956 to -0.085; P = .019). Wide area injection including the fundus or body rather than the antrum only was associated with weight loss. Multiple injections (>10) were associated with weight loss. However, a large amount of botulinum toxin A (500 IU) was not associated with weight loss. Sensitivity analyses showed consistent results. Meta-regression for the botulinum toxin A dose and number of injections showed consistent results. Publication bias was not detected.
  
  
  CONCLUSIONS
  In this analysis, intragastric injection of botulinum toxin A is effective for the treatment of obesity.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Chang Seok
authors.initials: CS
authors.lastname: Bang
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.affiliation: College of Education, Jeonju University, Jeonju, South Korea.
authors.forename: In Soo
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Jin Bong
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Jai Hoon
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D001835:Body Weight / Q000187:drug effects*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D006801:Humans; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D009765:Obesity / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A