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Research

The Institute of Weight Control is committed to continuing to develop a strong research base for its clinical practice. Good research leads to excellent clinical practice, which translates to excellent care for our patients. The team at IWC have been at the forefront of developments in bariatric surgery, including new devices and new surgical procedures, and continues to take a leadership role in the delivery of programmes to achieve lasting weight reduction.

Research Studies

The Institute of Weight Control (IWC) has been researching the benefits of gastric banding in the morbidly obese for over a decade. We have studied the harmful effects of obesity, the health benefits of weight loss and the optimal care of the patient undertaking gastric band surgery. We have developed a wealth of knowledge regarding the best techniques for placement of the band and follow up care of patients after surgery.  We have now treated more than 3,500 patients during the last 10 years and have published many articles on the results of our studies into the outcomes of this surgery.

The Institute of Weight Control is also at the forefront of developing new surgical techniques.  We are offering two alternate weight loss procedures, called the gastric sleeve resection and the gastric plication and researching their weight loss benefits.

We are also at the forefront of researching new and innovative surgical weight loss devices; 1) the revolutionary neuro-blocking therapy called VBLOC therapy which reduces hunger sensations and controls obesity,  and 2) the para gastric implant in which a removable “kidney” shaped implant is placed on top of the stomach preventing the stomach from expanding and limiting the amount of food you can eat.

We have learned much from the studies conducted at the Institute of Weight control including the following:

Adjustable Gastric Bands

Since the introduction of the gastric band back in 2002, over 3500 patients have had effective treatment for their obesity using this device here at the Institute of Weight Control. Studies have shown:

  • Gastric banding is a safe procedure
  • On average gastric banding leads to between 40 to 60% of excess  weight loss
  • Weight loss following gastric banding leads to remission and/or improvement in most of the problems caused by obesity
  • Weight loss following gastric banding leads to improvement in quality of life

Type 2 Diabetes

Weight loss using the adjustable gastric band leads to better control of diabetes, reduced medication and in some instances abolishes the need for medication. Ongoing studies are looking at the role of adjustable gastric bands versus the gastric sleeve and gastric plication and their effectiveness.

Pressure Adjustments of Gastric Bands

Currently all gastric bands are adjusted using saline. The optimal fill volume allows the patient to eat as little as possible as they are no longer hungry. In future it may be possible to adjust bands by recording the pressure within the band as opposed to the volume much like filling your car tyre at a certain pressure. Measuring "pressure" may be more physiological and meaningful.

The Self Adjusting Gastric Band

The Attune tubing accessory is an attachment to the gastric band which is being currently tested at the Institute of Weight Control. The Attune tubing has pods or reservoirs which contain extra saline, which is thought may allow the band to be more distensible. Too little inflation of the band can result in the feeling of hunger and lack of weight loss, whilst too much inflation of the band can cause too much restriction, increasing the risk of heart burn and vomiting. Even when the band is optimally adjusted, patients may experience regurgitation or vomiting if they eat too quickly as some nutritious foods tend to be more fibrous and chewy.  It is hoped that the Attune tubing may make band adjustments easier, less frequent and reduce regurgitation and/or vomiting.

New Technologies : The Maestro VBLOC System

The Institute of Weight Control has been working with Enteromedics in the development of a vagal blocking system (VBLOC)  for the past 6 years.  The innovative neuro-blocking therapy results in increased satiety, reduces hunger and hence is effective in weight reduction and in treating type 2 diabetes and hypertension. VBLOC Therapy delivers low energy electrical impulses via a pacemaker like device that blocks signals in the vagus nerve, thereby reducing appetite. The new technology will become commercially available soon and heralds the next major development in the treatment of obesity and the diseases associate with obesity.

New Devices: The Para gastric implant

The para gastric implant is a kidney shaped inflatable  balloon that is inserted using key hole surgery and  sits on top of the stomach preventing it from expanding when we eat.  The implant was designed to occupy the space that the stomach would normally occupy when we eat thereby limiting your capacity to eat. The implant does not involve any cutting, stapling or removal of any organs. Also, vomiting does not see to be a problem and patients an tolerate a better range of foods unlike gastric banding. The para gastric implant is under clinical investigation.

New Procedures:  Gastric Plication as an alternative to Sleeve Gastrectomy

Although the sleeve gastrectomy results in weight loss of over 50% of excess weight, it is not without risk.  There have been a number of reports of gastric leaks with a risk of about 1%.  The gastric plication operation involves invaginating the stomach onto itself without the need to surgically remove it. It is under clinical trial investigation.

Dietary requirements before and after surgery

Food products have been developed which are nutritionally sound and achieve satiety with minimal calories. These are taken prior to surgery in order to address the problems with fatty livers and then after the surgery during the healing and transition to normal diet phases. The food comes under the name of Fulfil and is recommend for all IWC patients.

Ethical Approval

All the projects the Institute is involved in have the approval of an ethics committee e.g. the Bellberry Human Research Ethics Committee.

Our extensive database enables us to track a patient’s clinical assessment and progress. It also enables us to conduct research on how effective the procedure has been in terms of individual progress as well as being able to examine what the average weight loss is at any given point in time for all patients.

It must be stated that when patients information is used for research that it is "de-identified", which means that no identifying markers will be used and patients will only be identified by their file number and initials.

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