Comparison of botulinum toxin applications in the treatment of obesity

Obesity is a global health problem, however, there is no consensus on the treatment for patients with a BMI between 30 and 35. Intragastric botulinum toxin injection (IGBT) has been proposed as a new endoscopic treatment for obesity, with the potential to delay gastric emptying and increase satiety by temporarily paralyzing the injected area. A retrospective study was conducted on 157 patients who received antral or fundus dominant IGBT and were followed up for 6 months with a diet program from January 2020 to December 2022. The patients were divided into three groups: Group 1 consisted of patients who received more injections in the fundus during IGBT, group 2 consisted of patients who received more injections in the antrum during IGBT, and group 3 consisted of patients who were only followed up with a diet program. Group 1 patients received 10 fundus and 10 antrum injections, while group 2 patients received 18 antrum and 2 fundus injections. Group 3 patients were only followed up with a diet program. Both antral and fundus dominant IGBT were effective in reducing body weight, and there was a significant difference between the two groups in terms of weight loss. Both groups 1 and 2 had significantly greater weight loss than group 3 (p<0.001). Antral and fundus dominant IGBT can be considered as a potential treatment option for obese patients with a BMI between 30 and 35 who do not meet the criteria for bariatric surgery.