Can Botox injections in the stomach help you lose weight?

(Text/Dr. Wu Yuanhui, Department of Emergency Medicine, Far Eastern Memorial Hospital)

Botulinum toxin is a protein produced by Clostridium botulinum. It is extremely neurotoxic and can paralyze muscles, stop breathing, and cause death. However, in recent years, botulinum toxin has been used more and more in medical applications. Doctors use extremely low doses of botulinum toxin for local injection to temporarily paralyze muscles as a medical treatment.

People often hear that botulinum toxin is injected into the face to eliminate facial wrinkles and achieve beauty goals. In addition, some doctors have tried injecting botulinum toxin into the stomach, hoping to increase the sense of fullness and achieve weight loss by partially paralyzing the contraction of gastric smooth muscles.

In February 2013, the journal Clinical Gastroenterology and Hepatology published a double-blind randomized study report from the Mayo Clinic in Minnesota, USA. The researchers recruited 60 patients with moderate to severe obesity and divided them into four groups. They received 100 units, 300 units, 500 units of botulinum toxin type A and a saline placebo, respectively, which were injected into the gastric antrum under the guidance of gastroscopy and endoscopic ultrasound.

Two weeks after the injection, scintigraphic examination was used to measure the average time it took for half of the solid food to be emptied from the stomach. The results showed that botulinum toxin injection can indeed prolong the gastric emptying time. The best result was achieved by injecting 300 units, with the average time for half of the gastric emptying increasing by 24 minutes. On the contrary, the gastric emptying time was not extended that much by injecting 500 units.

Weight changes were tracked for 16 weeks after the injection, and the average weight of the four groups decreased slightly, but there was no statistically significant difference. There was no difference in satiety or changes in eating habits.

Although there have been sporadic small-scale studies in the past reporting successful weight loss cases of 6 to 11 kg with similar treatments, this study from the Mayo Clinic shows that although injecting botulinum toxin into the gastric antrum can prolong gastric emptying time, it has no significant effect on the ultimate goal of "weight loss."

In this study, even patients who received a placebo had an average weight loss of 2.2 kg after 16 weeks, which was comparable to patients who received 300 units of botulinum toxin. Patients who lost more weight did not have a longer gastric emptying time. It can be seen that there are many other factors that affect the success of weight loss, such as exercise volume, lifestyle, and even psychological motivation.

The research and development of various interventional weight loss medical methods are constantly innovating, but the effects may vary from person to person. People who want to lose weight can consult experts from multiple sources, refer to scientific evidence, rationally judge the risks and benefits, and find the most suitable weight loss method for themselves.

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