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Small incision, big impact: New weight loss surgery being tested

Cheryl Denby of Oxon Hill, Maryland, walks with her son, Harry. In December, Denby underwent a new minimally invasive surgery at Johns Hopkins, and has since lost more than 40 pounds. "It is not magic, I still have to work at this," she said.

WASHINGTON — Cheryl Denby has an infectious smile and a laugh that can fill a room with joy.

“I’ll never be thin, but I do want to be healthy,” she said, describing her slow but successful journey from obese to overweight, and eventually to average weight.

Denby, who lives in Oxon Hill, Maryland, was one of the first participants in a clinical trial for a new type of minimally invasive weight loss surgery that’s being tested by researchers at Johns Hopkins.

She came to the trial in the most modern of ways: Denby knew she needed to lose weight, but she wasn’t completely sold on traditional bariatric surgery. She periodically browsed clinicaltrials.gov — a website with information for people interested in being what some might call “medical guinea pigs” — and came across a post that piqued her interest.

Dr. Clifford Weiss and his team at Hopkins were looking for obese candidates for a new procedure that involves blocking certain blood vessels at the top of the stomach to cut the production of the appetite hormone, ghrelin.

“I thought, ‘This is neat! This sounds interesting! This actually sounds doable for me,'” she said.

Denby quickly put in an application.

After careful screening, she underwent surgery Dec. 2, 2015 at the age of 48. And while she had to stay in the hospital overnight for monitoring due to previous issues with anesthesia, she was able to return to work a few days later. (Traditional bariatric surgery keeps patients in the hospital for a few days and home from work for two to four weeks, University of Chicago Medicine reports.)

Denby admits now that she was skeptical the procedure would work.  But after the surgery, she began to notice her food cravings fade and her desire to eat diminish. Denby, a working mom who acknowledges her eating habits before the operation were pretty horrible, says these noticeable changes were a big deal for her.

“I would get home late from work and just sit there and proceed to eat dinner all night,” she said about her lifestyle before the surgery. “Sometimes it would be a whole pizza or cartons of Chinese carryout.”

These days, dinner is different. Denby opts for meals such as baked chicken and roasted vegetables. She says she always knew what she should eat, but her appetite got in the way. Once it was under control, she was able to follow a healthy eating plan with guidance from a dietitian who worked with the clinical trial.

As the weight came off, bending to tie her shoes became less of a chore, and long walks evolved into a way to exercise and bond with her 22-year-old son, Harry.

“It is not magic, I still have to work at this,” Denby said.

Her eyes light up at the mention of the doctor who pushed an idea that may ultimately change how weight loss surgery is viewed in the country. Weiss, an interventional radiologist at Johns Hopkins, says some people thought it was crazy to take a technique previously used to stop internal stomach bleeding and transform it into a weight loss tool.

Using a tiny catheter that’s inserted into the wrist or groin, Weiss injects microscopic plastic pellets into the blood stream. The pellets travel through a main artery into the stomach and lodge in small blood vessels in the area where 90 percent of the body’s ghrelin is produced.

“This hormone is the most powerful hunger stimulating hormone we know of,” Weiss said, adding that the cut in blood flow to the specific cells that create ghrelin does not damage the rest of the organ.

Early results on the minimally invasive surgery are excellent, with the procedure passing initial tests for safety required by the Food and Drug Administration.  And participants in that first clinical trial at Johns Hopkins — including Denby — are seeing results.

Weiss says he is very excited about the potential for the procedure, formally known as gastric artery embolization, but admits there is still a long way to go before it is approved for general use — possibly as long as six years.

Weiss describes the procedure as one element in a weight loss tool kit, albeit a very powerful one.  And while he cautions that much more work is needed, he senses the surgery could eventually be a game-changer for the millions of Americans who are considered obese.

It’s already working for Denby, who has shed more than 40 pounds in six months. So far, her weight loss has been steady and healthy, and she has no doubt that another 100 pounds are within her grasp.

“There is a ways to go, but where I am now, I am happy,” she said.

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