A no-fuss, no-muss aid for obesity

A no-fuss, no-muss aid for obesity

Gastric sleeve developed by Jerusalem researchers will help diabetics as well as the dangerously heavy

Dr. Yaakov Nahmias (R), director of the center for bioengineering at the Hebrew University of Jerusalem, and Esther Goldblum, an engineering student at the center. (photo credit: Courtesy)
Dr. Yaakov Nahmias (R), director of the center for bioengineering at the Hebrew University of Jerusalem, and Esther Goldblum, an engineering student at the center. (photo credit: Courtesy)

That obesity has become a major health problem is no secret; according to the World Health Organization, a staggering 35% of the world’s population is clinically obese (body mass index of 30 or more), with the US near the top of the list of obese nations.

For health professionals, it’s a nightmare — but for entrepreneurs who can come up with a way to reduce obesity rates, it’s a major market opportunity.

According to Yaakov Nahmias, the director of The Hebrew University’s Center for Bioengineering, the MetaboShield, a gastric sleeve that is inserted into the intestine endoscopically (via the throat), could be the next big thing in heavy-duty weight loss. Researchers at The Hebrew University of Jerusalem, along with colleagues at Hadassah Hospital, have developed the first system that can dramatically help obese people get the pounds off, and keep them off, without surgery.

The MetaboShield is just one of several projects introduced by Hebrew University and Hadassah in a program called BioDesign, which was established a mere one year ago by Nahmias and Prof. Chaim Lotan, the director of Hadassah Medical Center’s Heart Institute.

BioDesign has produced four projects — including the MetaboShield — all of which have been assigned to the tech transfer companies of Hebrew University and Hadassah for commercialization. The two partnered with Prof. Dan Galai, the former dean of Hebrew University’s business school, and with the help of Dr. Todd Brighton, a Biodesign program director at Stanford University, established Hebrew University’s Biodesign: Medical Innovation program, the first academic medical innovation accelerator in Israel.

Biodesign is a multidisciplinary, team-based approach to medical innovation, said Nahmias. The program takes top medical fellows, bioengineering and business graduate students, and tutors them in the science and practice of bringing a medical innovation to market. The teams receive a list of clinical problems collected from Israeli and American hospitals, and critically evaluate their commercial potential. Once they identify a clinical need with commercial potential, they find an engineering solution that can be protected by a patent application. The students are mentored by some of Israel’s best and brightest academic and industry experts who bring their experience in scientific discovery, clinical applications and business development.

According to Nahmias, “This isn’t a pure academic exercise. We have students and clinicians who are eager to bring innovation to the market. The program generated quite of lot of excitement with the business and academic environment. It is exactly this drive that makes Israel a start-up nation.”

One result of that drive is the MetaboShield, the first alternative to gastric bypass and sleeve surgery for the morbidly obese who would generally be urged to pursue bariatric surgery, which includes gastric bypass or a sleeve gastrectomy. The procedures involve surgically cutting away a large portion of the stomach, shrinking it in order to reduce the amount of food it can hold. With a smaller stomach, patients are fuller faster, and eat less.

But many people balk at the idea, because of the general risks of surgery and specific risks of gastric surgery (leaks from deteriorated sutures, blood clots, infections), and the fact that there is no guarantee that the weight will remain off (although the surgery has been shown to be very helpful for patients with diabetes or other obesity-related medical conditions). Although the surgery is generally reserved for the morbidly obese (BMI 40+), it is also recommended by many medical authorities for individuals with a BMI of 35 and above who suffer from a disease like diabetes. (A six-foot-tall man weighing 260 pounds has a BMI of 35.3.)

The MetaboShield is the solution the obese and their doctors have been waiting for, said Nahmias. The device is a semi-flexible (rigid on the length, flexible on the side) sleeve that is administered via a patient’s throat — no surgery, incisions or even anesthesia required. The sleeve is inserted into the small intestine, and effectively reduces the size of the stomach, as all food passes through the sleeve.

“There is another artificial sleeve on the market, but it requires using a stent, which must be removed annually for cleaning, so it is very unpopular among patients and doctors,” said Nahmias. “The MetaboShield can remain in place indefinitely.”

The MetaboShield’s real secret, said Nahmias, is its shape. “The sleeve follows the shape of the duodenum, the top of the small intestine that is curved. In our clinical trials we have observed that when we insert the MetaboShield into patients with Type II Diabetes their symptoms began to recede after just a few weeks. While the MetaboShield is a breakthrough for the morbidly obese, it will be even more important for those suffering from diabetes,” said Nahmias.

The device is just about ready for the market, although it will have to go through the FDA vetting process before doctors can begin using it. Nevertheless, he said, there has been a great deal of interest from numerous drug and medical device companies, who see the huge potential in the MetaboShield.

“There are many people out there who have avoided gastric surgery because of fears of the risks involved,” said Nahmias. “This is a $140 billion market, and the system we have developed is the only one that does not require surgery.”

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