Vagotomy: Is cutting the vagus nerve the answer to weight loss?

Las Vegas, NV

Last year, 200,000 Americans had weight loss surgery and while gastric bypass surgery can significantly reduce weight, the surgery comes with risks.

Now a procedure that was once commonly used to treat ulcers is being tested as a safe alternative to weight loss surgery.

Action News reporter Kimberly Tere has the details.

The vagus nerve controls your feeling of hunger.

Some even say every single thing the vagus nerve does is designed to make you gain weight.

That is why San Francisco Doctor Robert Lustig is testing laparoscopic vagotomy, a surgery in which the vagus nerve is cut.

Cutting the vagus nerve can reduce the amount of fat stored in the body and can increase energy levels.

"Every patient in the study said their hunger was gone, just gone. One comment I got from one patient was this is the first time in her life that she was not a prisoner to food," said Dr. Lustig.

It worked for Garth Michaels who after years of standing out, ballooned up to 340 pounds.

"I was eating the wrong stuff. I was eating too much of it. I was eating too fast and I was not exercising," said Garth.

Garth decided to stand up and wage a battle against the bulge.

"Moving would hurt, it just hurt and my ankles could not take my weight," explained Garth.

After 20 years of battling the physical and mental strains of obesity, Garth had a vagotomy done.

With the help of the procedure and exercise, Garth lost more than 100 pounds.

"When I started exercising all of a sudden, you know I was doing it three or four times a week and the switch turned on," said Garth.

Now a study is underway to find out whether it is a viable alternative to the traditional gastric bypass.

15 patients have had vagotomies done at University of California at San Francisco Medical Center.

One of the main differences is a vagotomy only takes 20 minutes under conscious sedation with a breathing mask or under general anesthesia.

It is also an outpatient procedure.

On the other hand, gastric bypass generally takes four hours to perform and requires a hospital stay of at least three days.

Now two years after having the vagotomy done and after a lifetime of hiding under big clothes, Garth is finally comfortable in his own skin.

"I would say I look in the mirror right now and feel 75% better than when I looked in the mirror before," said Garth.

The majority of the patients who underwent vagotomy lost weight and were able to keep it off.

But for others, there was little or no effect.

While hunger was curbed, Dr. Lustig says they kept eating out of stress or habit.

"This is not a procedure for the reward pathway or for the stress pathway. It seems to be a procedure strictly related to hunger," said Dr Lustig.

Patients in the study did lose an average of 20% of their weight.

For Garth it was a life altering surgery that gave him the push he needed to win the battle on weight for good.

The vagotomy is still experimental when it comes to being used for weight loss.

Dr. Lustig says more research needs to be done before it is ready for widespread use.

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Vagotomy: Doctors studying safer alternative to gastric bypass surgery

Seattle, WA

More than 177,000 Americans had weight loss surgery in 2006. This can mean massive weight loss, but the surgery doesn't come without risks. Now, there's an investigational approach that's helping patients shed pounds a whole lot safer.

Losing weight was never easy for Garth Michaels.

"I've felt fat all my life, really," he said.

Michaels reached 320 pounds.

"I really was just up against a wall," he said. "I was praying daily. I didn't know where to turn."

Then, he found Dr. Robert Lustig, an endocrinologist at the University of California-San Francisco.

"Everyone in the world seems to think that obesity is just one problem," said Lustig. "You eat too much, exercise too little and it couldn't be further from the truth."

Lustig says the vagus nerve plays a big role in obesity.

"Every single thing the vagus nerve does is designed to get energy into your fat cells," said Lustig.

He's testing a new surgery called laparoscopic vagotomy, where he actually cuts the vagus nerve.

"The severe hunger that many obese patients report seems to be just completely obviated. It goes away completely," said Lustig.

So far, the 20 minute procedure is resulting in an average 18 percent excess weight lost.

"The weight loss that the patients have achieved appears to be durable and we're very happy about that," said Lustig.

Michaels has lost more than 100 pounds since having the procedure nearly two years ago.

"Definitely life-saving," said Michaels. "I think I added at least 10 to 20 years to my life… It's a whole new life, a whole new lease on life and at age 56. That's pretty good."

And after a lifetime of big clothes, Michaels is proud to finally shed that image.

Compared to gastric bypass surgery, this procedure is about one-fifth the cost, has fewer side effects, but patients will not lose as much weight. This technique is still being studied and not yet widely available.

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Laparoscopic vagatomy: Gastric bypass surgery alternative

Rochester, NY

Thousands of people have weight loss surgery each year. This can mean massive weight loss, but the surgery doesn't come without risks. News 10NBC has the latest on an investigational approach that's helping patients shed pounds a whole lot safer.

Losing weight was never easy for Garth Michaels. “I've felt fat all my life, really,” he said. He topped out at 320 pounds.

“I really was just up against a wall. I was praying daily. I didn't know where to turn,” Garth said. Then, he found Doctor Robert Lustig.

“Everyone in the world seems to think that obesity is just one problem, you know, you eat too much, exercise too little and it couldn't be further from the truth,” Dr. Lustig said.

Lustig says the vagus nerve, which tells the brain when the body's full, plays a big part in obesity.

“Every single thing the vagus nerve does is designed to get energy into your fat cells,” Dr. Lustig said.

He's testing an easy-on-the patient surgery called a laparoscopic vagotomy where he actually cuts the vagus nerve.

“The severe hunger that many obese patients report seems to be just completely obviated. It goes away completely,” said Dr. Lustig.

An early study shows the 20-minute procedure led to an average 18 percent excess weight lost. More >>

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Stanford in study on vagal nerve blocking, gastric bypass surgery alternative

San Francisco, CA

Stanford researchers are participating in a national study to test a new weight-loss therapy that blocks the nerves that tell people when they're hungry and control how the body stores fat.

The treatment is considered a less invasive alternative to bariatric surgeries, which typically involve shrinking the stomach by wrapping a tight band around it or bypassing large sections of it and going straight to the rest of the digestive tract.

In the new treatment, which has been tested overseas, a device inserted just beneath the skin emits electronic impulses that confuse signals sent on the vagal nerves from the brain to the stomach. In early studies, the impulses made people feel full and satisfied when they'd otherwise be hungry.

"It starts in the brain, and works down to the stomach. We're not cutting or sewing or rerouting the anatomy here," said Dr. John Morton, a bariatric surgeon leading the study at Stanford. "It has a lot of potential to help patients lose weight."

The treatment is called VBLOC therapy, for vagal blocking. Stanford is one of 13 sites around the country participating in the study, being funded by medical device company EnteroMedics. Researchers hope to sign up 250 to 300 volunteers, about 50 of them in the Bay Area, and study them for five years.

It is a blind study - all volunteers will have the device implanted, but it will be turned on in only two-thirds of them, and neither researchers nor patients will know whether it is on or off. After the first year, the device will be turned on in all patients. More >>

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Vagotomy: Gastric bypass surgery alternative?

Orlando, FL

Weight loss surgery is becoming a more popular choice for obese Americans. There were nearly 10 times as many weight loss procedures performed in 2005 as 1998. Gastric bypass surgery is a real option for patients, but it also comes with real risks. Nutritional deficiencies occur in more than 30 percent of patients and nausea and vomiting after eating occurs in up to 15 percent of patients. Other major risks include ulcers, hernias and even death.

SAFER APPROACH: A procedure that was once commonly used to treat ulcers, called a vagotomy, is now being tested as a safe weight loss surgery. Robert Lustig, M.D., from the University of California, San Francisco Medical Center, says, "[Vagotomy] was actually the most common procedure done in this country between 1944 and 1978." But the way the procedure was performed back then for ulcers caused lot of undesirable side effects. Even so, doctors noticed that people who had the procedure for ulcers also lost weight. Because it was invasive and had bad side effects, the procedure fell to the wayside, especially as newer drugs and treatments for ulcers emerged and, of course, so did gastric bypass surgery for obesity. Doctors are now revisiting vagotomies as a way to lose weight. They have modified the procedure so that it is safe and side effects are minimal -- and they've also made it a laparoscopic procedure. For weight loss, the procedure can be done non-invasively with five small incisions in about 20 minutes.

WHAT IS IT? During a laparoscopic vagotomy, doctors actually go in and cut the vagus nerve in the esophagus. Dr. Lustig says, "The vagus nerve is the energy storage nerve. That's its job. That's part of why you get hunger is the vagus nerve from the stomach to the brain tells you, the stomach is empty, you need to eat." By cutting the nerve, Dr. Lustig can eliminate the severe hunger that many obese patients report. Their hunger just simply goes away. Dr. Lustig says, "The majority of the weight loss that's achieved is primarily in the first six months, nine months and then it definitely slows down. But they're not regaining it. They are actually keeping their weight down." More >>

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