a revolutionary weight loss device Stacy Bartlett Amanda Doodlesack

Obesity more than 1/3 of the U.S population (35.7%) is obese W.H.O: Body Mass Index over 30 is considered obese, over 40 is morbidly obese more than 1/3 of the U.S population (35.7%) is obese 2008 obesity-related medical costs were ~$147 billion obesity increases risk of other diseases including: coronary heart disease, stroke, high blood pressure type 2 diabetes cancers (endometrial, breast, colon) high total cholesterol, high levels of triglycerides liver and gallbladder disease sleep apnea, respiratory problems osteoarthritis reproductive health complications (i.e. infertility) mental health conditions (i.e. depression)

Before considering this device patient has tried diet and exercise to lose weight patient may have tried prescription weight loss drugs patient must be obese and have a BMI between 35 and 55 for a 5'4" female, weight between 205lbs and 320lbs for a 5'10" male, weight between 245lbs and 385lbs

Overview Abiliti - developed by Intrapace, a California based company lead connects to stomach in two places: food detection sensor on upper portion of stomach stimulating electrode that sends electrical impulses to stomach to make person feel full device is based on technology developed by Medtronic for cardiac pacemakers battery powered stimulator device implanted in abdomen

Abiliti vs. other bariatric surgery options Lapband o minimially invasive, safe, low rate of complications as shown by safety and efficacy studies done so far o no drastic altering of the anatomy (less invasive than other procedures) o reversible o holistic approach- changes eating habits and control of hunger rather than just physically altering the stomach o other tools (food tracking, exercise logging, social networking) help lead to a healthy lifestyle, more permanent results Gastric Bypass

Cost device still in trials and development stage company refused to offer pricetag, but expected it to cost similar amount to other bariatric surgeries ~$25,000 current bariatric surgeries are covered by insurance, so hopefully this will be too device is currently only available in Europe, so its hard to extrapolate to US health insurance coverage

Therapeutic procedures - protocol 3-4 small incisions in abdomen for probes diagnostic electrode attached to stomach and then brought through abdominal cavity diagnostic electrode connected to gastric stimulator gastric stimulator implanted probes removed and incisions closed entire procedure < 1 hour

Recovery protocols - overnight hospital stay - follow-up appointments with physician every 6-8 weeks in the year following surgery - my.abiliti® system monitors food consumption and activity levels - allows physician and patient to monitor and adjust settings - provides online tools and support system for patients

Improvements controls appetite so patient feels full sooner patient loses weight (~22% body weight) reduced risk for obesity-related complications physician monitoring + online support system change diet and eating habits improve overall health

Complications - virtually none of the nausea or other side effects that come with other procedures - potential complications are similar to those of any implanted device -rejection -fibrosis -inflammation -biofilms -pain at implant site - battery lifetime: 2-5 years; device lifetime: ~5 years

Future Directions - currently performed in 38 hospitals and clinics in Europe - currently enrolling patients in study that will be completed in 2015 - company hopes to receive FDA approval after the completion of the study

References Slide 2: http://www.cdc.gov/chronicdisease/resources/publications/aag/obesity.htm Slide 3: http://www.abiliti.com/en/about_obesity Slide 4: http://www.abiliti.com/en/about_abiliti Slide 5: http://www.abiliti.com/en/abiliti_product_overview Slide 6: http://www.boston.com/businessupdates/2012/09/12/lose-weight-forever-with-abiliti-implant-obesity-cure/UrEjnC54qEBpRFnWYNiK7I/story.html Slide 7: http://www.nuffieldhealth.com/treatments/abiliti Slide 8: http://foregutsurgeon.com/stomach-pacemaker-for-obesity-abiliti1 Slide 9: http://www.fastcompany.com/1734252/obesity-shocker-pacemaker-zaps-stomach-internally-prevent- overindulging Slide 10: http://www.wlshelp.com/news/abiliti-system-for-weight-loss-receives-ce-mark-approval/ Photo credits: http://www.abiliti.com/en/ http://www.implantable-device.com/2011/12/22/intrapace-abiliti-gastric-stimulator-for-the-treatment-of-obesity/ http://www.trendbird.biz/entry/Trendbird-A-Social-Networking-Implant-for-Weight-Loss-Abiliti http://www.oliakcenter.com/lap-band/surgery/ http://www.citelighter.com/science/surgery/knowledgecards/gastric-bypass http://www.youtube.com/watch?v=K99qqNI_9JY http://prometheus.matse.illinois.edu/glossary/biofilms/