Weight loss surgery 'in a pill' could address obesity and type 2 diabetes, finds study

A treatment that delivers the weight loss benefits of gastric band or bypass surgery in a pill taken before each meal could help tackle an epidemic of type 2 diabetes and obesity, scientists have said.

Harvard Medical School researchers have developed a gut-coating medication that can prevent sugars and other nutrients in food being absorbed in the intestines.

This could allow the benefits of bariatric weight-loss surgery to be delivered temporarily with lower risk and lower cost, the researchers said.

“What we’ve developed here is essentially ‘surgery in a pill,’” said Dr Yuhan Lee, one of the study’s lead authors and a materials scientist from Brigham and Women’s Hospital at Harvard.

“We’ve used a bioengineering approach to formulate a pill that has good adhesion properties and can attach nicely to the gut in a preclinical model. And, after a couple of hours, its effects dissipate.”

The team have only tested their medication in rats so far and further trials would be needed to show it is safe and effective in human patients.

However, its main component is sucralfate, a substance already approved as safe for use in treating ulcers of the stomach and intestine.

The authors of the study, published in the journal Nature Materials today, said the material can be made into a powder and encased in a pill that they envision a “patient can take before a meal to mimic the effects of surgery”.

In trials in rats the treatment was shown to alter the uptake of nutrients from food. Blood sugar levels in the rodents that received the pill were 47 per cent lower than rats without the treatment, showing calories were not being taken up.

Gastric band procedures constrict the stomach to make recipients feel full quicker, and while they are reversible they still require surgery.

A gastric bypass shrinks the stomach permanently by creating a smaller pouch and reattaching the small intestine higher up.

The procedures are highly effective at delivering weight loss in people who are obese. They also have the benefit of reversing weight-related conditions, such as type 2 diabetes.

“Gastric bypass is one of the best studied surgeries in the world,” said Dr Ali Tavakkoli, a senior author and director of the Centre for Weight Management and Metabolic Surgery.

“We know that it can lead to many benefits including positive effects for blood pressure, sleep apnea and certain forms of cancer, and a remarkably fast and weight-independent improvement in diabetes.

“Having a transient coating that could mimic the effects of surgery would be a tremendous asset for patients and their care providers.”

The head of the NHS in England said last year that obesity is the new smoking and the treatment of diabetes, 90 per cent of which is lifestyle-linked type 2, accounts for about 10 per cent of the NHS annual budget.

Obesity-related admissions to hospital increased 18 per cent last year, official data shows, but budget cuts have meant many areas are denying obese patients non-urgent surgery unless they lose weight.

This is despite official guidelines in 2014 recommending the NHS triples the number of bariatric surgeries, and prioritise the procedure for anyone with a BMI of 30 or more.