Can an Implant Help You Lose Weight? RealSelf Doctors Say This About the Latest Obesity Treatment

Jager Weatherby on 3 Feb 2015 at 5:00pm

Maestro ImplantThe FDA Approves the First Surgical Implant to Suppress Appetite
The US Food and Drug Administration recently signed off on a first-of-its-kind medical implant known as the Maestro Rechargeable System, and it’s pretty high-tech: The device is surgically implanted into the abdomen, where it sends intermittent electrical pulses to the vagus nerve. (Don’t worry. We’ve never heard of it either.) These pulses reduce hunger by controlling the signals sent from the stomach to the brain telling it you’re full. While the system will never deliver the kind of drastic results we see with popular bariatric treatments sleeve gastrectomy (RealSelf Worth It Rating: 100%) and gastric bypass (96%), it could be an appealing option for those who are hesitant to undergo a more invasive procedure or don’t have quite as much weight to lose.

RELATED: Top 10 Tips Before and After Gastric Bypass Surgery

How Effective Is This New “Pacemaker For the Stomach”?
Though the FDA supports the device’s ability to aid in sustained weight loss, the outcome of the clinical study wasn’t quite as encouraging as originally expected: “[The] experimental group lost 8.5% more of its excess weight than the [participants who received a sham implant],” the FDA reveals. The problem? They were aiming for 10%, if not more. As part of Maestro’s approval, the manufacturer must conduct a five-year post-approval study to collect additional data on safety and effectiveness.

What Do RealSelf Doctors Have to Say About Maestro?
“The procedure is ‘less invasive’ in the sense that it doesn’t require stapling of the stomach or altering the gastrointestinal anatomy,” says Texas bariatric surgeon Dr. Lloyd Stegemann. “The procedure still requires an operating room, several incisions, and having a device underneath the skin, but since there’s no stapling involved, we shouldn’t see problems with leaks, ulcers, and strictures. Another benefit is that it’s easily removed if needed. Having this procedure doesn’t preclude a patient from having a different bariatric surgery down the road if needed.”

That said, the system isn’t without its drawbacks. Not only is weight loss expected to be just 10-15% of body weight, but there still many questions left unanswered. “How long can it be left in? Does it become less effective over time? What are the maintenance costs associated with it?” Dr. Stegemann lists. “The reason gastric bypass and sleeve gastrectomy are so effective is the hormonal changes that occur in the body due to the surgery. These same hormonal changes are not seen with the new device.”

Dr. Mark Pleatman of Michigan echoes this opinion: “As far as I’m concerned, this is still an experimental procedure. It may appeal to patients who want the ‘latest and greatest’ operation, but not for patients who want something that’s known to work. It’s a tricky procedure, and the battery will need to be replaced every five years. For me, it’s a no-go.”


Yet Dr. Stegemann doesn’t discount the device just yet, and fully intends to include the Maestro System in his practice. “It’s my personal belief that bariatric surgeons should be able to offer all types of procedures, as there’s not one ‘perfect’ operation for everybody,” he says. “I think that if it gets approval to be placed in patients with BMIs between 30-35 (the system is currently only approved for use in those between 35-45), it will be a valuable tool. It may also be helpful in patients with very high BMIs, as it might help them lose weight before they do a more definitive procedure.”

What Do Real People Think About Maestro?
Perhaps an even bigger issue is the emotional aspect of obesity that can’t be addressed with a simple device. “I will always have psychological issues with food,” says Kirsty, a RealSelf community manager who underwent sleeve gastrectomy to lose 230 pounds. “I was an emotional eater. Food was attached to so many things in my life. If I was celebrating, we’d go out for a meal. If I was sad, I’d eat cake. The Maestro System seems great for people who have the self-control to say, ‘Okay, I’m full. I’m going to stop eating.’ But I didn’t have that self-control. For me personally, I needed a surgery that was permanent and was going to have a negative effect on me if I continued to eat incorrectly. Now, on the rare occasions when I do overeat, I get sick and throw up. I needed something to force me to change my habits.”

When Can You Get It and How Much Does It Cost?
If the Maestro System sounds like something that might be a suitable option, you can expect it become available later this year. However, our doctors warn that you should be prepared to pay a pretty penny. While the device doesn’t yet have a definitive price tag, doctors estimate it could cost anywhere between $10,000-$30,000, which may have to come out of pocket. At this point, most insurance companies aren’t likely to cover the procedure.