Brooke Nelson's story highlights a new frontier in weight loss procedures. Struggling with being over 200 pounds, Nelson participated in a clinical trial for a minimally invasive weight loss procedure. Within six months, she experienced a significant transformation, losing over 20 pounds and altering her relationship with food.
Endoscopic Ablation: A New Hope?
The procedure Nelson underwent is called endoscopic ablation. According to Dr. Christopher McGowan, founder of True You Weight Loss in Cory, North Carolina, this procedure is not yet available to the general public but is undergoing testing. During the experimental operation, doctors insert a camera into the patient’s stomach while administering fluids to protect the stomach tissue. A small device then ablates, or burns, the lining of the upper portion of the stomach that makes ghrelin, a hormone that tells your brain you are hungry and which also inhibits insulin secretion and helps your body store fat.
Nelson noted a significant decrease in food cravings after the procedure. "The constant just wanting of food has drastically decreased," Nelson told "Good Morning America." "There's still moments where I want a chocolate chip cookie, but there's a lot more moments when I find myself wanting something like greens."
Dr. McGowan plans to present the results from the trial at a medical conference in Washington, D.C.
The Science Behind Endoscopic Ablation
Endoscopic ablation targets ghrelin, often referred to as the "hunger hormone." By ablating the ghrelin-producing cells in the stomach lining, the procedure aims to reduce appetite and promote weight loss. It also inhibits insulin secretion and helps your body store fat.
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Potential Benefits and Risks
Dr. McGowan suggests that endoscopic ablation may be a more acceptable option for patients who are afraid of surgery. Risks of the procedure include ulcers and bleeding, according to McGowan. "Risks of this technology could include things like ulcers, bleeding, somehow injuring the stomach. These were things we were really careful about," he said. "In this case, everything was mild and that was the cramping and gas and nausea, things you'd expect when you'd perform a procedure on the stomach.
Obesity in America: A Growing Concern
A little more than 42% of people in the US are obese, Healthline reported. According to the Centers for Disease Control and Prevention, obesity has been associated with conditions including stroke and heart disease, hypertension and breathing problems such as sleep apnea. As it stands, patients who are severely obese, meaning that they have a body mass index of 40 or higher, are eligible for surgical intervention such as gastric bypass surgery according to Penn Medicine.
The Rise of GLP-1s and the Shifting Weight Management Landscape
The weight management industry has seen a significant shift with the rise of GLP-1 injectables. Long Island residents are seeing results from using GLP-1 injectables, even as the drugs face concerns over affordability, insurance coverage and potential side effects. The weight management industry has shifted significantly toward GLP-1 drugs, leading to the decline of traditional programs like WeightWatchers and Jenny Craig.
GLP-1 agonists are medicines that help regulate blood sugar levels, reduce appetite, and encourage increased feelings of fullness after eating by slowing down digestion. The drugs were originally prescribed to treat diabetes but have been proven to be highly effective for weight loss. Nearly 4 in 10 people surveyed in a May 2024 poll by nonprofit health policy research organization KFF said they’ve taken a GLP-1 solely for weight loss. Some once-a-week injectables have even been approved specifically for weight loss by the Food and Drug Administration.
Long Island residents interviewed by Newsday said they've had success with GLP-1s. They also shared a common sentiment: the injectables are just one tool in a longer journey to look and feel better. Still, despite their effectiveness and market success, patients can have a difficult - or impossible - time getting insurance providers to cover prescriptions, often paying out-of-pocket or turning to telehealth services.
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Concerns also persist about long-term side effects, with a recent lawsuit filed by Long Island residents contending that semaglutide and tirzepatide - the active ingredients in these drugs - cause vision loss. Proved side effects include constipation and nausea. But there's currently no scientific evidence linking the drug to blindness, said nurse practitioner Angela Godwin Beoku-Betts.
The Importance of a Holistic Approach
Weight loss experts emphasize the need for a holistic approach combining medication with lifestyle changes for effective weight loss.
Lyndsay Johnson, said she has had success combining weight loss drugs with lifestyle changes. It was at the center that she learned just how important a holistic approach is to losing weight. She walks daily with a coworker, takes spin classes and plays soccer with her sons.
Dr. Michael Kaplan, the chief medical officer of the private medical practice Long Island Weight Loss Institute, said that lifestyle changes are part of all his patients’ treatment plans. He emphasized that people who use GLP-1s should include physical activity, dietary modifications and mental health support as part of their weight loss strategy.
Affordability and Accessibility Concerns
To qualify for GLP-1 weight loss treatment, patients need a Body Mass Index of 27 if they have a comorbidity - one or more medical conditions that co-exist alongside a primary diagnosis and can worsen people's health, like hypertension or diabetes - or a BMI of 30 without one. Yet most insurance plans won’t cover the drugs for weight loss.
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Bunnii Buglione, 35, of Aquebogue, turned to telehealth provider Ro in December 2024 when her insurance declined coverage.
Brooke Nelson, 46, of Southold, found herself struggling to lose weight after undergoing treatment for breast cancer. Nelson’s treatment triggered early menopause, which caused the former dancer to gain weight and struggle to lose it. After multiple failed appeals to her insurance company, Nelson turned to Eli Lilly, which manufactures the FDA-approved Zepbound and sells direct-to-consumer. She said she pays $300 out of pocket for the drug monthly.
The Future of Weight Loss
The weight management industry reached a major inflection point in 2022, when millions began taking GLP-1s instead of using traditional weight loss programs, said John LaRosa, owner of market research company Marketdata LLC.
When Novo Nordisk and Eli Lilly began developing semaglutide and tirzepatide for obesity, Morningstar analyst Karen Anderson was skeptical. However, Anderson’s research shows sales have doubled annually for GLP-1s as obesity drugs, reaching $11.77 billion in 2024, up from $4.11 billion in 2023.
The endoscopic ablation procedure will have to go through more testing before it’s available to the public.