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Judith J. Wurtman, PhD

Judith J. Wurtman, PhD

Posted: November 6, 2010 09:49 AM

If you fill your stomach with a gel-like substance that swells so much that very little room is left for food, will you lose weight? Researchers at Gelesis, a Boston-based company, think so. They have been testing a polymer or hydrogel called Attiva. The substance is about the size of a sugar grain, but when the grains are consumed in a capsule along with water, the grains swell into a gel-like substance. As the gel expands in the stomach, little room is left for food. The gel also stretches the stomach walls and stimulates nerve fibers that tell the brain the stomach is too full to receive any more food.

Rats given this gel stopped eating for about 18 hours. Early tests with humans produced a sensation of fullness after meals and a decrease in hunger between meals. But these particles did more than limit food intake. When they finally leave the stomach (by shrinking and going back to their granular form) they enter the small intestine where digested food is absorbed into the bloodstream. Here they swell again and trap digested sugar and fatty acids in their viscous matrix. Think of partially firm Jell-O with bits of fruit floating around in it. The polymer is the Jell-O-like substance that captures bits of sugar and fatty acids. Eventually, as the polymer shrinks again, the sugar and fatty acids are released and slowly trickle into the blood stream. The gel continues on its way through the large intestine, finally disintegrates and passes out of the body.

Might this be the answer to our ever-increasing problem with obesity? The polymer has one major advantage over appetite-suppressant drugs. Since it never enters the blood stream, side effects are probably much less than those associated with weight-loss drugs. Its advantage over surgical methods to reduce the size of the stomach is obvious, as it eliminates the risks of an operation.

But will it really have an impact on obesity? It certainly will stop someone from consuming an excessive amount of food. If the stomach has room for only one small hamburger, rather than a triple cheeseburger with bacon, a large order of fries and a 20-ounce container of soda, many fewer calories will be consumed. People who binge may be particularly receptive to the weight-loss substance, as the tiny stomach capacity will abort quickly any episode of excessive food intake. Of course, unlike the surgical procedures used for stomach size reduction that are in place, Attiva must be swallowed before eating. One can imagine a scenario in which someone goes on a cruise and decides to skip the gel for a week because he wants to get his money's worth from the meals on board. (I've seen this happen with people using the nicotine patch who remove it when they want to smoke.)

Surgical methods to reduce stomach size have been around for decades. Still, it is not understood why many people who have had these procedures rarely attain their weight-loss goals and why others gain back weight despite the tiny size of their stomachs. Some people are so driven to eat that they often risk vomiting or injuring their stomach because they swallow too much food. Obviously, they are not eating because they feel physically hungry. Hunger goes away very quickly after the surgical procedure.

So why are they still eating more than they should? It is likely that the triggers that made them overeat excessively before the surgery are still influencing their food intake. The reasons for their overeating reside in the brain, along with their emotional state, work, social, family situations, hormones and lack of sleep. Can Attiva stop overeating caused by medications such as antidepressants, premenstrual syndrome, overwork or simply boredom? Somehow it seems unlikely that a woman with PMS searching for chocolate will settle for the hydrogel instead. Perhaps the best we can hope for is that gel will allow her to settle for six chocolate kisses rather than a pound of fudge.

 

Follow Judith J. Wurtman, PhD on Twitter: www.twitter.com/stopmed_wt_gain

If you fill your stomach with a gel-like substance that swells so much that very little room is left for food, will you lose weight? Researchers at Gelesis, a Boston-based company, think so. They ha...
If you fill your stomach with a gel-like substance that swells so much that very little room is left for food, will you lose weight? Researchers at Gelesis, a Boston-based company, think so. They ha...
 
 
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HUFFPOST SUPER USER
CocaColaKid
Southern Democrat and Pragmatist
04:40 AM on 11/14/2010
This is new? Sounds like "Chitosan" that GNC has been selling since the 90's.
04:34 PM on 11/16/2010
Just for your information, Chitosan is a fat binder, which is a completely different story. By the way, Chitosan was also not proven clinically (in real studies) and the FDA has issued in 2004 warning letters to few companies that sells them. Gelesis is still not in the market, but hopefully they will have good clinical studies to support their claims. I hope it helps.
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HUFFPOST SUPER USER
CocaColaKid
Southern Democrat and Pragmatist
06:34 PM on 11/16/2010
Thanks for the info. The reason I thought it was the same was due to a friend of mine that took it back in the 90's and the person at GNC had pitched it that way, saying it would gel up, bind the fats...etc.
03:43 PM on 11/08/2010
The description in the first two paragraphs nearly made me lose my lunch. Which, perhaps, is another way the medication works to promote weight loss.
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HUFFPOST COMMUNITY MODERATOR
goosie29
LIVE AND LET DIE
08:09 AM on 11/08/2010
"..........they enter the small intestine where digested food is absorbed into the bloodstream. Here they swell again and trap digested sugar and fatty acids in their viscous matrix...... Eventually, as the polymer shrinks again, the sugar and fatty acids are released and slowly trickle into the blood stream...."
So it doesn't really prevent the body from absorbing these nutrients then? I guess this is good, because I can bet that it doesn't trap ONLY sugar and fat in its "vicious" matrix! lol. On the other hand, if it expands the stomach walls too much, it might result in raving hunger pangs later on, or cause us to eat much more when we don't take the capsule! You can't win!
03:54 PM on 11/07/2010
I would hate to see what the side effects are on this one!
04:15 PM on 11/07/2010
There is much lower risk of side effects here because it is not interacting with the central nervous system in any way (unlike other drug approaches) and it is non-invasive (unlike bariatric surgery). This shouldn't have any more side effects than eating a big bowl of lettuce or soup before your meal.
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01:38 AM on 11/08/2010
The only thing I'm worried about is like with any other weight loss strategy, you must stick with it in order to lose weight. If it works my expanding your stomach and you suddenly stop taking it, do you suddenly have a very empty, enlarged stomach? Does it prevent vital nutrient absorption? Does it affect the absorption of other drugs (such as contraceptives)? It would likely be very expensive to have to pay for a lifetime of this medication.
03:02 PM on 11/07/2010
Using this gel, Attiva, to control eating behavior is pathetic. This is nothing more than treating the symptoms of bad behaviors. In this article, you asked whether this "Might this be the answer to our ever-increasing problem with obesity?"

Of course not, and for the same reason that surgical treatments for obesity fail -- because you don't treat the actual problem, which are the behavioral habits themselves.
03:38 PM on 11/07/2010
Bariatric surgery failed? Sorry, you are wrong. This is the only effective and approved treatment for obesity at this stage. The problem is that it is highly invasive, and therefore cannot be applied in many cases. The nice thing about this pill is that it acts through the same mechanisms, just by a non invasive way. You sound like a thin healthy person who never tried a diet in his life (am I right?)
05:09 PM on 11/07/2010
Hi Mama Nutrition. I am so sorry, I think my comments were misunderstood. Bariatric surgery, whether through banding or Roux-en-Y, is an effective treatment for obesity. You are absolutely correct about this.

My comment was to point out that, in the times when it does fails as a method to sustain weight loss over the long term (as it can almost 20% of the time), the reason is most often because patients haven't changed unhealthy eating behaviors.

As for me, I teach people healthy eating behaviors in corporations, hospitals, and wellness centers. Actually, we just started working with a hospital to work with bariatric, cancer recovery, and mid-life patient populations. So I have some familiarity at least :).

Thank you so much for your comment. I hope that clarified my intent somewhat!
01:58 PM on 11/07/2010
I have been reading about this Attiva, including their publications. This IS food but it has no calories. It is made from food and the food is crosslinked to hold water and then releases the water in the colon when an enzyme degrades the crosslinking. This is incredible cool, elegant science and it's all natural. Also, this was developed in academia, not in a pharma company. To get the same effect from fiber, you would need to eat 100 times the amount of fiber, which is both not feasible and also not safe because fiber doesn't degrade in the colon (like this material does).
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01:40 AM on 11/08/2010
Watch out, you might get confused for being a "big pharma endorser."
08:51 AM on 11/08/2010
Is it like metamucil? Gel fibre?
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HUFFPOST SUPER USER
StAlphonso
"Yes indeed, here we are."
09:59 AM on 11/07/2010
I've been using this stuff for years. It's called beer.
09:42 AM on 11/07/2010
All I can say is that's some darn yummy German food in the picture that made me click of this article!!! Mmmm.. Haxen und knodle mit sose... Und eine grosse Pils, bitte!
09:16 AM on 11/07/2010
P-O-L-Y-M-E-R-S?! That sounds like a really great idea. So now we'll have a boatload of skinny SICK people, because they'll only be able to squeeze on twinkie in their piehole!
08:49 AM on 11/07/2010
What a sick society. 1/2 the world is starving, and we are eating ourselves to death; obsessed with zero calorie this and that, crap that tricks us into feeling full, impulse buy exercise machines...
none of it making a dent in our obesity/diabetes epidemics.
Whatever you do, don't mention mature self discipline to anyone. We truly are a nation of thumb sucking children trying to get our emotional needs met from soft drinks, junk food and a talk show styled culture where endlessly wallowing in your "issues" is a sort of social glue, but ridding one's self of them alienates you from the herd, like a recovered drug addict.
09:00 AM on 11/08/2010
Ahhh, someone who talks sense!
I couldn't agree more... instead of taking personal responsibility, people look to society (doctors, tv shows, etc.) for quick fixes!
Why is it that obesity is only a large scale problem in western cultures, and is growing at an alarming rate where western culture and diet is growing in popularity?
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HUFFPOST SUPER USER
RedBirdy
A right delayed is a right denied
07:20 AM on 11/07/2010
Years ago I considered weight loss surgery. After a full physical I had to visit a shrink. I was told to keep a food diary for 3 months. Returned the diary, was told I was lying and the shrink asked me to have my then husband keep the diary. After 3 months he returned it. I had another physical. No high blood pressure, no diabetes, no heart disease, no high cholesterol etc. I was denied the surgery. He said ''bad news I can't approve you for the surgery, good news is you're a healthy fat person''. I don't over eat, I walk a lot (living in philly, now in nyc, I walk at least 3 miles a day) I exercise, I count calories, I don't eat fried foods. My idea of junk food is a few olives with cheese and grapes. My point is, not all over weight people over eat. I never have. I was raised by a very healthy parent. To this day unsweetened apple sauce and crackers is the only junk food you'll find in her kitchen. Some people are not meant to be thin. Doesn't meant they are unhealthy.
HUFFPOST SUPER USER
Sinestro Jones
I may not have good taste....but I do taste good.
06:06 AM on 11/07/2010
how about to hell with all of this nonsense...eat, excrete, repeat..
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Tunghoy
My other car is a TARDIS
12:55 AM on 11/07/2010
This is what spirulina does. It's been available at health food stores for decades.
04:12 PM on 11/07/2010
no, this is about 100 times stronger than any of those products. The other difference is that it degrades in the colon, to minimize side effects.
jaslyn
don't go away mad, just go away
12:25 AM on 11/07/2010
Seriously? this is what they're working on? How about improving the types of foods on supermarket shelves? Get rid of all the fake, crap that masquerades as food. Get rid of high sugar, fake fat, hydrogenated fat, additives, colors, preservatives, sodas and all the garbage the media has brainwashed this country into eating. They'll find out after a few people die from this 'gel' what a bad idea it was. Disgusting.
HUFFPOST SUPER USER
Brad T Casali
Wissenschaftler
12:42 AM on 11/07/2010
^Agreed.
08:53 AM on 11/07/2010
"Don't put that crap in your mouth" is the only answer. Same as drugs. We all know the risks of both, and make our choices anyway. A food "prohibition" would work just as well as the one on alcohol did.
11:44 PM on 11/06/2010
sounds like the blob, was that not a movie about scary creatures. Frankly, it sounds like something that will clog the drains and create a massive retaliation from nature everytime it rains....