Loss Pills That Expand in the Stomach

Early Results Arrive on Weight-Loss Pills That Expand in the Stomach
By ANDREW POLLACK
JUNE 23, 2014
http://www.nytimes.com/2014/06/23/business/early-results-arrive-on-weight-loss-pills-that-expand-in-the-stomach.html

It is a tantalizingly simple idea for losing weight: Before meals, swallow a capsule that temporarily swells up in the stomach, making you feel full.

Now, some early results for such a pill are in. And they are only partly fulfilling.

People who took the capsule lost 6.1 percent of their weight after 12 weeks, compared with 4.1 percent for those taking a placebo, according to results presented Sunday at an endocrinology meeting in Chicago.

Gelesis, the company developing the capsule, declared the results a triumph and said it would start a larger study next year aimed at winning approval for the product, called Gelesis100.

“I’m definitely impressed, absolutely,” Dr. Arne V. Astrup, head of the department of nutrition, exercise and sports at the University of Copenhagen in Denmark and the lead investigator in the study, said in an interview. He said the physical mode of action could make the product safer than many existing diet drugs, which act chemically on the brain to influence appetite.

But Dr. Daniel H. Bessesen, an endocrinologist at the University of Colorado who was not involved in the study, said weight loss of 2 percent beyond that provided by a placebo was “very modest.”

“It doesn’t look like a game changer,” he said.

Gelesis, a privately held company based in Boston, is one of many trying to come up with a product that can provide significant weight loss without bariatric surgery.

Two new drugs — Qsymia from Vivus, and Belviq from Arena Pharmaceuticals and Eisai — have had disappointing sales since their approvals in 2012. Reasons include modest effectiveness, safety concerns, lack of insurance reimbursement and a belief among some doctors and overweight people that obesity is not a disease.

Two other companies, Orexigen Therapeutics and Novo Nordisk, hope to win approval for their obesity drugs this year.

Last week, investors clamored to buy shares in the initial public offering of Zafgen, whose obesity drug beloranib produced an average weight loss at least 5 percentage points greater than placebo in a 12-week clinical trial. Patients who took the highest dose for all 12 weeks lost 10.3 percentage points more than those on placebo, though most people on that dose quit early because of side effects.

Also last week, an advisory committee to the Food and Drug Administration endorsed, though somewhat weakly, a device developed by EnteroMedics that is surgically implanted and delivers electric pulses to a nerve that helps control hunger and digestion.

Gelesis100, which is considered a medical device rather than a drug, consists of tiny particles made of two substances already used in food. The company has not identified those substances.

The particles absorb the water and swell to 100 times their original size in the stomach, mixing with food to create greater volume. After the particles travel through the small intestine, enzymes in the large intestine degrade them, and they release the water and are excreted.

The study involved 128 overweight or obese Europeans who swallowed a capsule before lunch and dinner along with half a liter, or about 17 fluid ounces, of water. They were also put on a reduced-calorie diet.

The 6.1 percent weight loss occurred in the patients who took the lower-dose pill. Those who got a higher dose lost an average of 4.5 percent of their weight, basically the same as the placebo group.

Gelesis executives said that was probably because 24 percent of patients on the higher dose stopped taking the capsules, which could cause bloating, flatulence, abdominal pain and diarrhea. Only 5 percent of patients on the lower dose dropped out, none because of side effects.

Yishai Zohar, chief executive of Gelesis, said weight loss was continuing and would have been greater if the trial had been longer. He added that the placebo might have helped people lose weight because it was made of cellulose, which is already used as a fat substitute in foods.

He also noted that the weight loss was much greater in people with higher blood sugar levels and that the capsule helped lower blood sugar.

Gelesis100 is similar in concept to balloons that are inserted through the mouth into the stomach and then inflated. These are not approved in the United States because of issues of safety with an older model.

A company called ReShape Medical plans to apply this year to the F.D.A. for approval of a balloon it says solves some of the earlier problems. It could become the first nonsurgical weight-loss device to win approval in decades.

The advantage of a capsule like Gelesis100 is that the stomach filling occurs only at mealtimes, while the balloon stays in place round the clock, though it should be taken out after six months. But that could also be its disadvantage. Someone anticipating a sumptuous feast could simply not take their Gelesis capsule. And over time, people tend to stop taking diet pills altogether.

“With the balloon process, the patient makes a commitment up front,” said Richard Thompson, chief executive of ReShape. “The balloon is in.”

Replies

  • kmm0034
    kmm0034 Posts: 46 Member
    I see. Mmmhmmmm. Well. Who funded the study, what university did the scientists graduate from, can I see papers? I would like to know their techniques, to ensure there was no contamination of data. Could they please explain the chemistry behind how a pill expands in the stomach, further, would they please and thank you very much explain to my the physics behind the expansion, and an estimation of how much of the stomach is blocked. Further, what is the molecular structure, and is it similar to anything potentially dangerous, if so how so, if not how not.

    Hocky science is hocky, and this sounds hocky.
  • Meerataila
    Meerataila Posts: 1,885 Member
    Probably wood pulp is one of the ingredients, they've got something similar in the UK and it's already in our food. Could work for some people, I suppose, except it strikes me as familiar. Wasn't this the trend in the diet industry a decade or so back? Maybe two decades? Take this pill before meals, it swells in your belly, you eat less? If it had worked, there wouldn't be any fat people left, would there?
  • MelodyandBarbells
    MelodyandBarbells Posts: 7,724 Member
    Like one of those lactose intolerance pills lol. I have to say I'm a bit intrigued. My beef with weight loss pills at least partially has to do with interfering with heart rate and other body chemistry, they just seem shady and dangerous to me. This absorbs water kind of like fiber. Curious to see if it takes off
  • _EndGame_
    _EndGame_ Posts: 770 Member
    You know, here in the UK, there is a pill named "Orlistat" also called "Xenical" and the over the counter, less effective version is called "Alli" and I find it great! Loads of people complained about "oily leakage" and their stomachs being upset, but I found they have really helped. Been taking them on and off for a year now (only take them when I have something with more than 15 grams of fat in, not including good fats)

    I actually think I'm the only person I know who has taken this pill that has good things to say about it.
  • rowlandsw
    rowlandsw Posts: 1,166 Member
    Couldn't you just eat a bunch of fiber and drink some water to get full before a meal?
  • MelodyandBarbells
    MelodyandBarbells Posts: 7,724 Member
    Couldn't you just eat a bunch of fiber and drink some water to get full before a meal?

    Eating before eating?
  • TechLady11412
    TechLady11412 Posts: 35 Member
    you could also supplement with beef gelatin powder. add to protein shakes, it adds an extra dose of protein (9g per tablespoon). It's rich in collagen, which supports skin, hair and nails. kind of like treating wrinkles and the joints from the inside out. it also expands in the stomach, making you feel fuller. it has no taste and it's reasonably priced.
  • Meerataila
    Meerataila Posts: 1,885 Member
    you could also supplement with beef gelatin powder. add to protein shakes, it adds an extra dose of protein (9g per tablespoon). It's rich in collagen, which supports skin, hair and nails. kind of like treating wrinkles and the joints from the inside out. it also expands in the stomach, making you feel fuller. it has no taste and it's reasonably priced.

    Well then, it might be the second ingredient. Yummy, splinters and boiled bones!
  • rowlandsw
    rowlandsw Posts: 1,166 Member
    Couldn't you just eat a bunch of fiber and drink some water to get full before a meal?

    Eating before eating?

    Yeah i worded that wrong lol. I was thinking more of a fiber powder. Not too much because of the issues fiber can cause but enough to help fill you up.