In recent days, the European Center for Disease Prevention and Control (ECDC) has reported 67 cases of botulism (debilitating disease caused by the bacterium Clostridium botulinum) in patients undergoing botulinum toxin injections in Turkey , a treatment advertised for weight loss that is not approved by Western drug agencies. The procedure, which promises to make you lose weight with a much less invasive procedure than bariatric surgery, has been dubbed “gastric botox.” Botulinum toxin is injected into the stomach through the mouth with an endoscope. The drug immobilizes the muscles of the stomach wall, preventing them from contracting. This keeps food in the stomach longer, slows down digestion and makes you feel full for longer. It is an experimental treatment, totally off-label, that is, outside the recommendations for the use of botulinum toxin, widely used in the aesthetic field.
symptoms
The cases of botulinum poisoning were almost all registered in Turkey, a dozen in Germany, one in Austria and another in Switzerland. All the patients had turned to two clinics in Istanbul or Izmir between February 22 and March 1 to undergo gastric botox. No deaths have been reported at the moment, but many patients have complained of weakness, fatigue, swallowing and breathing difficulties, double vision, slurred speech, nausea and diarrhea. Some people were hospitalized, others in intensive care, and given antibodies to neutralize the toxin. Statistically, death from botulinum toxin poisoning occurs in 15-20% of cases. Those who have suffered the effects of the crippling toxin can take months to fully recover. When dealing with one of the world’s deadliest toxins, absolute safety is difficult to guarantee and there is not much leeway in calculating a safe and effective dose at which one nanogram of toxin per kilogram of mass is considered lethal.
What does science say about the process
There is no scientific evidence that stomach botox is really effective for weight loss. Studies with small patient numbers conducted in Turkey and Egypt concluded that the treatment could result in 10-15% body weight loss with minimal side effects and a minimally invasive and inexpensive procedure. Even a team of researchers from Malaga had already concluded a review in 2017 that botulinum toxin could be effective in reducing weight by up to 5% compared to the placebo drug against obesity. However, the same researchers have shown that the quality of the papers was poor, the studies were not randomized and double-blind, and the samples were very limited, necessitating more structured experimentation. The same Malaga team recently published another study signaling that the weight loss was short term. Another study conducted by researchers from Qatar came to the same conclusion: There is no evidence that gastric botox leads to permanent and noticeable weight loss. The effect of the injection is indeed temporary, lasting about three months, and the procedure should definitely be repeated every month, with a number of possible side effects, including unknown ones.
The investigations
What actually happened in the two clinics in Turkey is not yet clear. The botulinum toxin was indeed an approved type (although used off-label in this case) and authorities are investigating whether there was a problem with the route of administration or dosage, however ECDC is urging European citizens not to travel to Turkey undergoes gastric botox, a procedure not approved in Europe and the West: the risk of botulism is indeed high.