Our representatives are available to schedule your appointment Monday through Friday from 9am to 5pm.
For a Northwell ambulance, call
(833) 259-2367.
Insights
Could vagus nerve stimulation become weight-loss medication alternative?
How vagus nerve stimulation could offer a drug-free option for treating obesity
Imagine using a small, implanted device to shed pounds. The reality is closer than you think thanks to advances in the use of vagus nerve stimulation. Even better: this type of treatment doesn’t carry side effects associated with new weight-loss drugs such as Wegovy or Ozempic, which is intended for people with diabetes, but is often used off-label for weight loss.
If you’re curious about how stimulating a nerve could help you shed pounds, you’ll want to hear more about the field of bioelectronic medicine.
Weight-loss medication vs vagus nerve stimulation
Traditional medicine typically relies on a systemic response. In other words, you take medication for a particular condition, and even though it may help cure or control the problem, the entire body is affected, quite often in a negative way. Think about all the commercials you hear listing to a litany of side effects that can accompany these types of drugs.
Bioelectronic medicine is different.
Instead of relying on systemic drugs, the goal of bioelectronic medicine is to allow your body to address problems more naturally by using electronic stimulation of your nervous system.
Think of a pacemaker that delivers a mild electrical shock to reset a person’s erratic heartbeat: In this case, it’s the nervous system that’s being reset — particularly the vagus nerve.
Made up of more than 100,000 individual nerve fibers, the vagus nerve extends from the base of the brain to every major organ and system in your body. Not only does it help regulate things like your breathing, digestion and heart rate, but it also keeps your immune response under control by regulating inflammation.
Sometimes, however, the vagus nerve can malfunction and inflammation can become chronic. Prolonged inflammation can lead to the development of autoimmune diseases such as lupus or rheumatoid arthritis, and potentially exacerbating conditions like high blood pressure, anxiety, depression and even obesity.
But by stimulating the vagus nerve, communication between the brain and the nervous system can be reset, and the inflammatory response can be normalized.
Kevin J. Tracey, MD, explains what the vagus nerve is and how stimulating it can lead to innovative approaches to a long list of chronic conditions, like obesity.
Lab research has shown that implants and other vagus nerve stimulation techniques could treat chronic diseases linked to inflammation — including obesity.
Another appealing aspect of working with the vagus nerve is that side effects are practically non-existent, unlike the current slate of medications used for weight loss.
Researchers note, however, that although some patients may be able to use bioelectronic medicine instead of drugs, techniques such as vagus nerve stimulation will often complement a drug regimen, depending on the patient’s individual needs.
Weight-loss medication drawbacks
Though drugs containing semaglutides (like Ozempic) were initially developed to treat diabetes, the accompanying weight loss led to the development of weight-loss versions, such as Wegovy and Zepbound.
Global sales of obesity drugs topped $4.5 billion last year and are expected to reach nearly $38 billion in less than a decade — a staggering 741% increase. Despite their popularity, it's important to note that these drugs can carry serious side effects and the long-term impact on patients is still unknown. The cost can be prohibitive as well, with prescriptions running as high as $1,400 a month.
One recent study uncovered other drawbacks: Nearly half of patients who use weight loss drugs like Wegovy or Zepbound reported nausea, one in three experienced diarrhea and nearly one in four suffered vomiting and constipation. Other findings suggest the active ingredient in these medications, known as GLP-1, is linked to bowel obstructions and pancreatitis, among other conditions.
These are some of the reasons most people who try these drugs stop using them. One analysis found that nearly 70% of people who took semaglutide stopped after one year. Another study suggested that once patients stop using it on a weekly basis, most regained two-thirds of the weight they’d lost while taking it.
That has scientists at Northwell Health exploring drug-free alternatives, and studies increasingly show that vagus nerve stimulation could be a viable option.
Vagus nerve stimulation for weight loss: Evidence it could work
“We’ve seen clinical evidence that vagus nerve stimulation can not only suppress appetite, but reduce blood glucose levels and improve insulin sensitivity in patients with diabetes,” said Kevin J. Tracey, MD, PhD, president and CEO of the Feinstein Institutes for Medical Research at Northwell.
In fact, an analysis of more than a dozen trials found that 62% of patients being treated for epilepsy using vagus nerve stimulation also lost about 10% of their total weight, and the results were similar for patients being treated with VNS for depression. The higher the electrical current of the stimulator, the greater the weight loss.
Another study found that patients who used vagus nerve stimulation were not only able to lose weight, but maintained healthy blood sugar levels, known as glycemic control, for 2 years, without any other types of medications.
“There are many examples of these types of clinical trials that are either complete or in progress, and they point to a future when these conditions and many others will be treated in an entirely different way,” says Dr. Tracey.
Can inflammation cause weight gain?
Obesity and diabetes have long been linked, and they also share something that makes both susceptible to vagus nerve stimulation — inflammation. Here’s how inflammation plays a role in appetite, weight gain and obesity.
Normally after you eat, your body releases leptin, a hormone from fat cells that signals to the brain that you are full. This process helps control your appetite and regulate your metabolism.
However, inflammation can suppress the normal function of leptin by deadening its sensitivity by interfering with leptin receptors. Your brain doesn’t get the message that you’re full, so it slows the metabolism of the food you’ve already eaten and increases your appetite for more.
Inflammation can also play a role in upsetting insulin levels in your body. Whenever you eat, your body turns food into glucose, or sugar that’s used for energy. Whatever you don’t use immediately is stored as fat and in your liver for later use as needed.
Not just a buzzword, "Ozempic face" represents a real concern for some. A bariatric surgeon shares the causes, solutions and expert advice everyone should know.
Read more
Insulin is the hormone that regulates blood sugar processing; with inflammation come high levels of pro-inflammatory cytokines, and these can scramble insulin signals.
The result is that the cells in your muscles, fat and liver can become insulin-resistant. When those cells no longer absorb sugar properly, excess amounts of glucose remain in your blood, leading to a variety of health complications, including obesity and diabetes.
Focused ultrasound, implants and the vagus nerve
All the signaling from the brain to the body related to food intake, appetite and blood sugar takes place via the vagus nerve, and research has shown that stimulating it reduces inflammation and improves symptoms.
“We can achieve that either by implanting stimulators directly on the vagus nerve, or by using focused ultrasound through the skin directed at certain body parts, much like it’s used every day to look for kidney stones, or to show expectant mothers images of their baby in the womb,” Dr. Tracey says.
In this case, the ultrasound would be focused on an area of the vagus nerve near the liver to regulate the digestive process. Unlike medications currently used to treat obesity and diabetes, focused ultrasound is non-invasive and the risk of side effects on patients is minimal.
While many studies have shown promise in tapping into the vagus nerve to treat a wide variety of conditions, the research still has a ways to go in terms of treating obesity.
The FDA has approved vagus nerve stimulation for use in patients with depression, epilepsy and stroke rehabilitation, but that’s just scratching the surface of its potential.
Dr. Tracey and his colleagues at The Feinstein Institutes for Medical Research are in the midst of a three-year project to create the first anatomical map of the vagus nerve, which is supported by nearly $7 million in federal grants.
“The arrangement of sensory and motor fibers inside the vagus nerve — and their pathways to different organs — are essentially unknown,” said Stavros Zanos, MD, PhD, associate professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes. “Once we have a detailed map of how each fiber affects different systems in the body, we will be able to fine tune our techniques to only stimulate the fibers involved with certain conditions or diseases, without impacting other fibers.”
Ultimately, therapies will be more targeted, more efficient and even more effective.
“My colleagues and I have shown that focused ultrasound can be used to treat obese animals and cause weight loss,” says Dr. Tracey. “Imagine a time when a small device the size of a hockey puck could deliver ultrasound signals to the vagus nerve in your liver and help you lose weight while you went about your normal daily activities.”
Related news
While influencers are obsessed with the health benefits of stimulating the vagus nerve, Kevin Tracey, MD, explains, we should be wary of their claims.
Kevin Tracey, MD, explains the structure and work of the Feinstein Institutes in a LEADERS Magazine interview.
This year's advancements will help patients with cancer and paralysis, among other conditions.