Effects of Intraparietal Gastric Botulinum Toxin-A Injection on Weight Loss: A Retrospective Study of 500 Patients

Ahmet Bekin,1 Tuncay Sahutoglu,2 Kadri Atay3 1Dr.Nazif Bagricak Kadikoy Hospital, Department of General Surgery, Istanbul, Turkiye; 2Mehmet Akif Inan Research and Training Hospital, Department of Internal Medicine and Nephrology, Sanlıurfa, Turkiye; 3Mardin Research and Training Hospital, Department of Gastroenterology, Mardin, TurkiyeCorrespondence: Kadri Atay, Mardin Research and Training Hospital, Department of Gastroenterology, Mardin, Turkiye, Email [email protected]: Obesity is a serious and widespread health concern, and while there is no universally effective pharmacological treatment, endoscopic applications such as intraparietal gastric botulinum toxin-A injection have shown promise. This study aimed to investigate the effects of intragastric botulinum toxin-A injection on weight loss and to evaluate the ratio of weight loss achieved.Methods: This was a retrospective cohort study conducted between 2020– 2022. 500 patients were included in this study who had undergone gastric botulinum toxin-A application and completed at least 6 months of regular follow-up. Patients were injected intramuscularly with 1000 U of botulinum toxin-A in the antrum and fundus regions of the stomach via endoscopy under sedation anesthesia (midazolam and propofol). Patients were monitored for 2 hours after the procedure and were then discharged. A low-calorie diet and active life support were provided under the guidance of a dietician for 6 months after the procedure.Results: At the end of the third and sixth months, all subjects lost body weight, with mean weight loss of 10.54 ± 3.36 kg (13.9 ± 4.4%) (Group 1), 13.54 ± 4.57 kg (15.1 ± 4.9%) (Group 2), 16.76 ± 3.86 kg (16.0 ± 3.6%) (Group 3), and 20.6 ± 5.33 kg (16.4 ± 4.2%) (Group 4) at the third month; and 14.50 ± 4.95 kg (19.2 ± 6.6%) (Group 1), 18.39 ± 6.49 kg (20.5 ± 7.0%) (Group 2), 23.37 ± 5.51 kg (22.4 ± 5.2%) (Group 3), and 29.17 ± 7.96 kg (23.2 ± 6.3%) (Group 4) at the sixth month, respectively. The differences between the third and sixth months were statistically significant (p < 0.05). The body mass index values of the patients also showed significant reductions at the end of the third and sixth months (p < 0.05). These results were statistically significant and reflect the primary outcome of the study.Conclusion: Intraparietal gastric botulinum toxin-A injection can lead to significant weight loss and may contribute to the development of effective, minimally invasive approaches for the management of obesity. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these findings.Keywords: body mass index, botulinum toxin-A injection, intraparietal gastric botulinum toxin-A, obesity, weight loss