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Intestinal tube prototype aims to become a permanent answer to obesity

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September 10, 2013

Students of the Biodesign program design MetaboShield to fight obesity and reverse type 2 ...

Students of the Biodesign program design MetaboShield to fight obesity and reverse type 2 diabetes (Photo: Hebrew University of Jerusalem)

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MetaboShield, is an innovative intestinal sleeve that can be lodged permanently in the small intestine via the throat in an anesthesia-free procedure. Though it is still a prototype, when developed the sleeve could help people shed unwanted pounds and potentially help reverse type 2 diabetes.

Developed by students at the the Hebrew University of Jerusalem’s Biodesign program along with team members at the Hadassah Medical Center in Israel, MetaboShield could offer patients a non-invasive way to handle obesity, a problem that has reached alarming proportions in recent times. Currently the Centers for Disease Control and Prevention considers 35.7 percent of US adults to be clinically obese. That figure is on the rise and a recent report by the research firm GlobalData expects 113 million people in the US to be obese by the year 2022.

The need for a non-invasive and inexpensive risk-free answer to the problem led the Israeli team to design MetaboShield. The semi-flexible intestinal sleeve is placed at the end of the stomach, right at the start of the small intestine (in the duodenum), via the throat.

A closer look at MetaboShield (Photo: Hebrew University of Jerusalem)
A closer look at MetaboShield (Photo: Hebrew University of Jerusalem)

"It does not effect appetite and satiety, rather it prevents absorption of the food in the most crucial area – the beginning of the small intestine," Dr. Ishay Benuri-Silbiger, a pediatric gastroenterologist at Hadassah Medical Center, tells Gizmag."This is a great advantage, because the patient can eat regularly with no constraints and changes in habits, contrary to gastric devices."

The idea of placing an intestinal sleeve to limit food absorption isn't new. GI Dynamic's EndoBarrier uses the same principle and promises both weight loss and diabetic control. In a clinical trial, about 59 percent of 22 patients implanted with the device were able to carry it for a year and lost on average 35.3 percent of excess body weight. Other participants in the trial needed to have it removed before the year end due to the device migrating, abdominal pain, nausea and other issues. Having to remove the Endobarrier at the end of a year's time still remains a hurdle for those undergoing the procedure.

Designed to stay in the body indefinitely, MetaboShield's apparent strength is in its design. It has a shape that closely resembles the curved part of the upper small intestine, and the natural C-shape anatomy of that area effectively secures the device, the team claims. "We're different in the anchoring mechanism," Benuri-Silbiger tells Gizmag. "We're using geometric principles to hold the sleeve in place." In theory, there is no constant pressure on the walls of the small intestine and the sleeve's flexibility also helps it absorb pressure from the intestine. It's claimed to help block the amount of calories absorbed without causing intestinal damage.

Researchers claim MetaboShield has an even more dramatic impact on type 2 diabetic patients, helping to reverse the condition. However the reasons why any intestinal sleeve proves effective are unclear.

"There are several theories that try to explain how bypassing such a small portion of the small intestine (10 percent) have such a substantial effect on obesity and diabetes," explains Benuri-Silbiger. "When there are several theories that try to explain a phenomenon it usually means that we haven’t yet reached the accurate explanation. It might be, for example, due to hormonal changes in response to exclusion of food from the most sensitive part of the small intestine. It might be because of introduction of less processed food to an area of the intestine that is accustomed usually to meet food that is more refined."

It's important to note that MetaboShield has yet to prove itself as a permanent and safe solution through clinical trials and FDA testing. Benuri-Silbiger says that they are currently negotiating with incubators to develop the sleeve further and expects it to be out in the market in a several years time.

You can see a video illustrating the design below.

Source: The Hebrew University of Jerusalem

About the Author
Lakshmi Sandhana When Lakshmi first encountered pig's wings in a petri dish, she realized that writing about scientists and imagineers was the perfect way to live in an expanding mind bubble. Articles for Wired, BBC Online, New Scientist, The Economist and Fast Company soon followed. She's currently pursuing her dream of traveling from country to country to not only ferret out cool stories but also indulge outrageously in local street foods. When not working, you'll find her either buried nose deep in a fantasy novel or trying her hand at improvisational comedy.   All articles by Lakshmi Sandhana
9 Comments

They think they're going to shove this thing down your throat, with no anesthetic! Ha ha ha!

Eddie
10th September, 2013 @ 08:41 am PDT

Sorry, but there is no way this will ever work. Not only is it not "risk free" but it looks like a liability nightmare. GERD and intestinal blockages WILL occur. Plus, it's not anchored, so "device migrating, abdominal pain, nausea and other issues" are just the beginning.

Dax Wagner
10th September, 2013 @ 08:43 am PDT

I think this sounds really good. While I would not mind trying it, I would definitely have something to keep me from gagging on it as it is placed in the small intestine.

I think it should be used in addition to a diet/lower calorie meal plan. I think it would make it more effective.

BigGoofyGuy
10th September, 2013 @ 11:21 am PDT

Or, you know, maybe, just maybe... we could all eat in moderation or at least work out after stuffing ourselves? Or don't stuff ourselves?

Crazy idea, isn't it?

Richard J. Auchus
10th September, 2013 @ 11:27 am PDT

That's Brilliant! its like shade cloth for your intestines.

Luke McNeilage
10th September, 2013 @ 07:02 pm PDT

We seem to be approaching obesity from the wrong angle. It can't simply be a case of people being plain gluttonous because I'm not sure that explains how so many people from so many countries can suddenly become pigs.

So surely it has more to do with what we eat and the way we eat it. Instead of shoving something in our guts to stop us absorbing nutrition perhaps we could eat better nutrition to start with. IE: food that has a higher nutrient to calorie ratio; in other words "real food". You know the food that grows in the ground, swims in the sea and runs around in the paddock? Try to find someone who eats real food who is clinically obese and I'll give you an award.

Scion
10th September, 2013 @ 09:19 pm PDT

Until they figure out why some people overeat and others don't, why some people eat anything they want including going weeks eating nothing but Twinkies and Coca-cola without gaining excess weight and others eat one piece of candy and gain kilos all they are doing is treating the symptoms.

Slowburn
11th September, 2013 @ 09:52 am PDT

Scion, it's not a nutrient blocker. The reason devices such as this and the endobarrier only block the first couple of feet of intestine is because that part of the intestine absorbs mostly fat and sugar, while lower parts of the intestine absorbs most of the nutrients.

This theory has been successfully tested by the makers of the endobarrier for many years now and has been on the market in several countries for a couple of years already. Simply put, it works.

Richard, screw that!!! Moderation sucks. We want to have our cake (or steak, in my case) and eat it too.

Dave Andrews
11th September, 2013 @ 09:54 am PDT

The problem with this device (and with gastric bypass surgery) is that the "problem" is wrongly defined. The process of digestion needs to viewed from the beginning, that is when the carrot is still in the ground, before it is harvested, peeled, trimmed, chopped, cooked and mushed up. It is wrong to describe a carrot in this state as just "food". It is actually partially pre-digested food quite ready to go straight into the duodenum. Give back to your mouth and stomach the work of chopping and mushing the food and obesity disappears.

Doug MacLeod
11th September, 2013 @ 06:28 pm PDT
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