Study: Stimulating the brain to fight obesity
Courtesy of Allegheny Health Network
Dr. Don Whiting is regarded as one of the nation’s foremost experts in the use of deep brain stimulation to treat patients with Parkinson’s Disease and other movement disorders.
Courtesy of Allegheny Health Network
Researchers with Allegheny Health Network are studying how well brain stimulation techniques can help people lose weight.
Courtesy of Allegheny Health Network
Devices like this one are being implanted into people’s brains and helping patients with all types of medical issues.
Finding the best way to fight obesity has been an issue that has baffled doctors, scientists and many others as the public health issues has become more widespread across the United States over the past 20 years.
Statistics from the U.S. Centers for Disease Control & Prevention (CDC) show from 2000 to 2018, U.S. obesity prevalence increased from 30.5% to 42.4%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%. Obesity increases the risk of heart disease, stroke, Type 2 diabetes and certain types of cancer and generates medical costs of more than $147 billion each year, according to the CDC.
One approach to fighting the obesity epidemic centers on controlling hunger cravings by stimulating certain areas of the brain. Researchers at Allegheny Health Network (AHN) have been studying this theory and did initial trials nearly a decade ago.
Now, researchers have gotten U.S. Food and Drug Administration (FDA) approval to begin the next phase of clinical trials for deep-brain stimulation.
The team of researchers is led by neurosurgeon Dr. Don Whiting, Allegheny Health Network’s chief medical officer and Allegheny Clinic president. Whiting is regarded as one of the nation’s foremost experts in the use of deep brain stimulation to control the debilitating tremors of patients with Parkinson’s disease and other movement disorders.
Now, Whiting is working to focus those techniques on other areas of the brain to help battle conditions such as obsessive-compulsive disorder, epilepsy, depression and even addiction.
Deep brain stimulation uses electrodes surgically implanted in the reward center of the brain to reprogram it, suppressing its insatiable craving for food. The first phase of the trial took place in 2013 with one of the participants from Morgantown, W.Va., losing more than half her body weight. She has sustained that weight loss ever since.
Whiting said the second phase of trials will modify the procedure somewhat and expand to more patients with a body mass index (BMI) above 35 who have tried other weight loss measures, not had success with gastric bypass surgery and are still more than 50% above their ideal weight.
“Fifty-two percent of people that are in the obese category have Type 2 diabetes,” Whiting said. “You have a 21% higher chance of having coronary artery disease with those categories and between an eight and 42% increased chance of breast cancer and gastrointestinal cancer.”
How does the brain stimulation work?
Whiting said the key is stimulating an area rather than targeting something patients want to destroy.
“It’s not destructible and it’s adaptable,” he said. “With a stimulator there are probably 4,000 different settings and it creates sort of an electrical field that you can shape to be like an oval or circle or hourglass. You can preferentially stimulate or regulate structures that may not be functioning the right way to coordinate the brain functions.”
Whiting said his work using the technique to treat Parkinson’s disease then created the opportunity to go to other areas in the brain such as those that relay signals for cravings and rewards.
“We started looking at new areas like addictions, obsessive compulsive disorder (OCD), depression, epilepsy – those are all different areas with different targets in the brain,” Whiting said. “There are circuits in the brain that control different parts of functions and when the signals aren’t matching up for those circuits at the relay center, we can go in and put an electrode in and change the activity of that relay center to artificially make things function more smoothly.”
Whiting said he uses a device he describes as a sort of pacemaker in the brain consisting of tiny electrodes about a millimeter and a half in diameter connected to a wire that tunnels under the skin behind the ear to connect to the neurotransmitter at the collarbone. That gives doctors access to the transmitter and the ability to turn it on and off and to make adjustments.
Whiting’s team works on areas of the brain responsible for hunger and satiation.
“There have been tons of experiments over the years on animals that prove if you lessen the feeding center, you get a very anorexic animal and if you lessen the other one, it gets very, very fat and won’t stop eating,” Whiting said. “That’s the homeostasis theory… that you’re kind of born with a weight setpoint that is protected by a hormonal and neural network between the gut and the brain to really keep you around that setpoint.”
The theory is that high calorie, high fat diets and sedentary lifestyles start to override that system. Whiting hopes his research will someday lead to treatments possibly along the lines of how insulin pumps help to measure and control dosage for diabetics.
Whiting said his work with Parkinson’s tremors and deep brain stimulation gave him the idea to expand on how the technology can be used and what medical issues it can treat.
“Look, this is cool technology, so what are problems that we haven’t been able to address and how can we do that with this,” he added. “Probably the number two overall health care expense is obesity and it’s been increasing year over year worldwide but also in younger and younger age groups. We were truly the first ones in the world to do it by a number of years and one of the really cool things was we could prove we could change metabolic rate in people with electricity.”