Could a hormone jab be the answer to the obesity epidemic?

A new jab which mimics the effects of a gastric bypass with no need for surgery has been developed by British researchers
A new jab which mimics the effects of a gastric bypass with no need for surgery has been developed by British researchers Credit: WillSelarep

According to the NHS, 29 per cent of UK adults are now obese - up three per cent from 2016. Add in those who are overweight as well, and that accounts for two-thirds of the UK adult population. The advice to “eat less, move more” is - to be frank - not cutting it. 

Could a new hormone injection for obesity be the game-changer we need? The therapy - developed by a team at Imperial College London and announced last week - is a combination of three hormones, dispensed for 12 hours a day via an insulin-style infusion pump. This is attached to the stomach with a patch for 16 weeks. The jab mimics the effects of a gastric bypass, with no need for an operation - and whilst it is still in the early stages of testing, the results are very promising. 

“Patients are losing about 4kg in a month, compared to 8kg for someone who has undergone gastric bypass surgery,” says Professor Tricia Tan, a consultant in diabetes, endocrinology and metabolic medicine at Imperial, who helped develop the therapy.

Most people think that obesity surgery aids weight gain because it physically reduces a person’s stomach in size so they feel full more quickly, but the reality is far more complex, she explains. “Surgery seems to affect the whole gut in a more profound way. In particular, it has been observed that it leads to higher levels of the hormones which affect metabolism, hunger and insulin production.”  

In other words, operations such as the gastric bypass or sleeve act on the brain as much as the stomach - altering the signals that control our cravings and feelings of fullness and appetite. Now, researchers and drug companies are racing to develop a drug or jab that reproduces the effect, avoiding the costs and potential complications of surgery which mean that further revisions are needed in around 11 per cent of cases. 

“When we give the hormones they reduce appetite naturally and improve the body’s ability to process sugar, leading to lower blood sugar levels," says Prof Tan.

“This treatment really could be a breakthrough, an added option for diabetes and weight loss treatment for everyone.”

One of the first people to try the new therapy was retired civil servant Alan Palmer, 65, who lives in Bromley, Kent. Palmer joined Prof Tan’s study in late 2017 after learning about it at a support group for people with type 2 diabetes.

“I’d been overweight since my 30s,” he says, “and when I started I was just under 18 stone, the heaviest I’ve been. Now I’m 14 stone at just under six foot tall.”

Palmer is delighted with his weight loss as it has put his type 2 diabetes into remission. He has now been settled on to a healthy eating programme to support his weight loss. 

Hormones are being used in other ways to halt the obesity epidemic. Injections of a compound called liraglutide (Victoza or Saxenda) and, since the start of this year, semaglutide (Ozempic) which mimics the same hormonal action, are already available to treat type 2 diabetes and obesity in conjunction with diet and exercise, though not yet on the NHS.

Another non-invasive weight loss innovation now being offered in the UK is the Elipse balloon. 

The Elipse works by making users feel artificially full - thanks to the insertion of a balloon into their stomachs (swallowed as a capsule). The balloon is then filled with 550ml of fluid (mostly water), via a small tube down the throat in a 20-minute procedure.

The device is thought to retrain appetite both by reducing space in the stomach and thus altering hormones that control hunger and appetite. For four months, the balloon sits in place before a time-activated release valve opens, allowing it to empty and pass naturally through the gastrointestinal tract without the need for a removal procedure. (It can also be punctured via a tiny endoscope should early removal be needed.) 

During that time, users are supported with a health and wellbeing programme which aims to re-educate their heads as their stomachs are retrained by the presence of the balloon. 

Josephine Davies underwent a new weight loss treatment involving swallowing a balloon to create artificial feelings of fullness
Josephine Davies underwent a new weight loss treatment involving swallowing a balloon to create artificial feelings of fullness Credit: Clara Molden for The Telegraph

Josephine Davies, a 52-year-old midwife, who lives in East London with her black cab driver husband Tony, is halfway through her Elipse therapy and has lost one stone and four pounds in two months?

“I’ve spent my life as a yo-yo dieter,” says Davies, “and as a nurse on shifts, have always struggled with hunger. “But the balloon fills you up so you never feel hunger. In fact, if you overeat at all, you get a stomach ache.”

Davies says the device felt odd to begin with: ‘I was very aware of it sloshing around for the first couple of days, but now I never think about it.” Her husband Tony has also had the treatment and lost even more weight: “He had more to lose in the first place but is now five stone down,” she says.

The Elipse balloon - which costs about £4,000, and is available to people over 18 with a body mass index greater than 27 - cannot offer the same significant and rapid weight loss as bariatric surgery, but its manufacturers hope it will be seen as an earlier intervention. Unlike with surgery, this and the new hormone jab can safely be repeated to help users maintain weight-loss long term.

For as every dieter knows, losing the fat is only half the story. For many, the bigger challenge is addressing the underlying feelngs which led to overeating in the first place. 

“Most of my clients over-eat when they are stressed, sad, bored, tired, have a low mood, feel lonely or are anxious,” says psychologist Uxshely Chotai at The Food Psychology Clinic. “A diet or gastric band surgery can offer quick weight loss but it does not equip an individual with an alternative coping mechanism to turn to when they experience these feelings.

“Establishing a healthy relationship with food, where you eat for nourishment and pleasure is key to achieving long-term weight loss.”

But for now, those patients who are morbidly obese find bariatric surgery is still their best option - as treatments like Imperial’s new hormone jab just won’t shed the pounds in the same way, says Professor Francesco Rubino, chair of bariatric surgery at King’s College London.

“Hormone therapy is one of the hopes we have for the future. It is not yet possible to say if it will outperform bariatric surgery but this is progress.”

He adds: “Obesity and type 2 diabetes are a spectrum of diseases with different stages. Using hormones might have an application for some patients, if not all.  

“Surgery changes the signalling to the brain to say how full or hungry you are. But you have to remove or bypass part of stomach or gut to get to that point.”

Having tried dieting in the past, Alan Palmer found the real difference that the hormone infusion made was in terms of appetite. “In the past,” he says, “I’d never really been aware of my body being hungry or full. Really basic stuff.” 

But while the hormone pump has given him a jumpstart, he knows the psychological battle will be with him for life. 

“I sometimes feel smug. But other times I panic because all the reasons I ate badly, the comfort eating and so on - it’s always a choice that I’ve still got. Do I keep going or do I go back to how I was?”

His concerns highlight again that there are no easy solutions which allow weight loss and maintenance without major physical and emotional work.  Prof Tan says: “We have approached obesity wrongly in the past looking for this amazing diet, or this amazing drug. It’s more complex than that. It’s important to treat the patient as a whole person.”

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