Obesity is a widespread health concern, and effective, safe, and tolerable weight management solutions are needed. Superabsorbent hydrogels represent a promising avenue in this area, offering a nonsystemic approach to weight loss and management. This article explores the science behind hydrogels, various applications, and their potential to reshape the landscape of obesity treatment.
Understanding Superabsorbent Hydrogels
Superabsorbent hydrogels are materials that can absorb and retain extremely large amounts of liquid relative to their own mass. In their dry state, they appear as fine, white powder or tiny granules. When hydrated, they transform into three-dimensional structures filled with water. This unique property makes them useful for various applications, including weight management.
Oral Superabsorbent Hydrogels (OSH): A Novel Approach
One innovative application of hydrogels in weight management involves oral superabsorbent hydrogels (OSH). These hydrogels are created from naturally derived building blocks found in foods, such as cellulose. Each OSH capsule contains thousands of dry particles, approximately the size of a grain of salt. The particles are composed of carboxymethylcellulose (a cellulose derivative) cross-linked with citric acid.
How OSH Works
When ingested, the OSH capsules disintegrate in the stomach, releasing the hydrogel particles. These particles respond to changes in gastrointestinal pH and absorb water, expanding in volume. This expansion increases the volume, viscosity, and firmness of the meal without adding calories. The resulting mixture of food and hydrated hydrogel beads creates a feeling of fullness and satiety, potentially leading to reduced food intake and weight loss.
OSH vs. Dietary Fibers
Unlike dietary fibers, which have a linear, non-cross-linked structure, OSH particles are cross-linked polymers that trap water in a three-dimensional matrix. This structure allows OSH to absorb significantly more fluid than dietary fibers, resulting in more rigid, elastic gel particles. In terms of mechanical properties, OSH more closely resembles fiber-rich vegetables like cucumber and mixed green salad than processed functional fibers.
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Clinical Evidence: The GLOW Study
The effectiveness, safety, and tolerability of OSH for weight loss have been demonstrated in the Gelesis Loss of Weight (GLOW) study, a multicenter, randomized, double-blind, placebo-controlled trial. In this study, participants with excess weight (overweight or obese) were given OSH capsules twice daily before lunch and dinner.
The results showed that approximately 6 out of 10 patients taking OSH achieved significant weight loss (5% or more of their body weight), and 27% lost 10% or more of their total body weight. In comparison, 42% and 15% of patients on placebo achieved ≥5% and ≥10% weight loss, respectively. Additionally, early weight loss (3% or more at 8 weeks) was predictive of long-term effectiveness of OSH.
Safety and Tolerability
The GLOW study also found that the overall incidence of adverse events was similar between the OSH and placebo groups. The most common treatment-related adverse events reported in patients taking OSH were gastrointestinal-related, such as diarrhea, abdominal distension, infrequent bowel movements, and flatulence.
Plenity: An FDA-Cleared OSH Product
Plenity is a unique nonsurgical device for weight management in overweight and obese adults (BMI of 27 to 40 kg/m2) in conjunction with diet and exercise. It is available in capsule form and contains cellulose and citric acid that absorb water in the stomach and small intestine, expanding significantly in size to create increased bulk and signal satiety. The particles break down in the colon and are excreted in the stool without being absorbed.
Plenity is taken as three capsules with 500 mL of water 20 minutes before lunch and dinner. Patients self-administer Plenity after completing an online form about their medical history. In a clinical trial, patients treated with Plenity had a mean average weight loss of 6.4% compared with 4.4% in those receiving placebo. Significantly more patients treated with Plenity (59% vs. 42% with placebo) achieved a weight loss of at least 5%, and 27% (vs. 15% with placebo) lost at least 10% of their body weight.
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Other Superabsorbent Hydrogel Approaches
In addition to OSH, other superabsorbent hydrogel technologies are being developed to support intragastric balloon-like structures, occupying space in the stomach and displacing the meal. These approaches include:
Pufferfish-Inspired Device
This device utilizes superabsorbent hydrogel particles encapsulated in a protective layer. Upon ingestion, the particles swell to form a large sphere, large enough to remain in the stomach. If necessary, the sphere can be rapidly deflated using a calcium chloride solution.
Light-Degradable Hydrogel
This approach involves a biocompatible, light-degradable hydrogel used to seal a gastric balloon. The hydrogel can be triggered to degrade using an LED light source, causing the balloon to deflate.
Epitomee Device (ED)
The Epitomee device is a self-expanding hydrogel film made from pharmaceutical-grade polymers. It unfolds and self-expands in the stomach, absorbing up to 100 times its dry weight. The ED resides in the stomach for a limited time, after which it collapses and degrades in the small intestine.
Intestinal Mechanisms and Metabolic Health
Beyond the satiety mechanism of OSH, preclinical studies have suggested that OSH technology may have broader applicability on metabolic health via intestinal mechanisms. However, clinical data are needed to validate these findings.
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Sirona: A Dual-Polymer Hydrogel Pill
Oxford Medical Products (OMP) is developing Sirona, a dual-polymer hydrogel pill that expands in the stomach, making patients feel full faster. In a clinical trial, participants lost up to 13.5% of their body weight in just six months and ate on average 400 fewer calories per day compared to those taking a placebo. Sirona has demonstrated amazing results during testing with UK hospitals, which have now been externally peer-reviewed. Sirona is designed to help those who are overweight (with a BMI between 25-30) and want to stop their weight from progressing into obesity.
The Future of Hydrogels in Weight Management
Superabsorbent hydrogel technology offers a wide range of clinical applicability and the potential to broaden the treatment landscape for patients with overweight, obesity, or obesity-related metabolic diseases. While current interventions for weight management are limited by variable safety, tolerability, efficacy profiles, and patient adherence, hydrogels provide a nonsystemic treatment option that may be effective and safe for promoting weight loss and/or preventing further weight gain.
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