ingestible capsule

Could a vibrating, ingestible capsule help treat obesity?

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Researchers have developed a vibrating ingestible capsule that may help treat obesity. DKart/Getty Images

  • Obesity is a known risk factor for a number of health concerns and diseases.
  • Current noninvasive and invasive treatments for obesity have risks and barriers people may need to overcome.
  • The newest treatment for obesity comes from researchers at MIT, who developed an ingestible capsule that vibrates within the stomach.
  • The way this capsule works is by tricking the brain into thinking it is full.

As of 2020, about 38% of the world’s population is considered to have obesity or overweight, with that percentage expected to jump to 42% by 2025.

Obesity is a known risk factor for a variety of health concerns, including high blood pressureTrusted Source, high cholesterolTrusted Source, sleep apneaTrusted Source, and depression.

Additionally, obesity may increase a person’s chance of developing diseases such as cardiovascular diseaseTrusted Source, type 2 diabetesTrusted Source, osteoarthritisTrusted Source, dementiaTrusted Source, and even certain cancersTrusted Source.

Although there are treatments available for obesity, some interventions, such as making dietary changesTrusted Source can be difficult for a person to stick with for a long time, and others, such as weight loss surgeryTrusted Source also have barriers that may keep a person from that treatment.

To help provide a new option for noninvasive obesity treatment, researchers from the Massachusetts Institute of Technology (MIT) have developed an ingestible capsule that vibrates within the stomach, tricking the brain into thinking it is full.

Information on this new research was recently published in the journal Science Advances.

Finding new noninvasive treatments for obesity

Dr. Shriya Srinivasan, a former MIT graduate student and postdoc who is now an assistant professor of bioengineering at Harvard University, and the lead author of this study, told Medical News Today that the development of new noninvasive methods for treating obesity is of importance in confronting the multifaceted challenges posed by this global health crisis.

“Traditional interventions, such as invasive surgeries, can be associated with significant risks, costs, and lifestyle modifications, limiting their applicability and effectiveness,” Dr. Srinivasan continued. “Noninvasive methods for treating obesity offer alternatives to invasive procedures, reducing associated risks and costs while improving accessibility for a broader population.”

In developing the ingestible capsule, she explained they wanted to develop a method that relied on the body’s natural signaling mechanisms in a closed-loop fashion.

“We believe that relying on these mechanisms will minimize side effects. Relying on mechanostimulationTrusted Source has not yet been explored in this application and may offer a new modality that could lead to increased efficacy, overcoming the limitations of current methods. (And) a capsule-based solution offers scalability and minimization of costs, making this accessible to global populations,” she added.

40% less food intake with the capsule

According to researchers, the ingestible pill is about the size of a multivitamin and is powered by a small silver oxide battery.

Dr. Srinivasan said the ingestible capsule is swallowed about 20 minutes prior to a meal.

“It turns on when it makes contact with gastric fluid in the stomach. It then vibrates and activates the stretch receptorsTrusted Source to signal that the stomach is distended or full. This will then make the subject less hungry, limiting intake,” she explained.

“We feel satiated, or full, primarily when stretch receptors in the stomach indicate that the stomach is ‘full’ of food. We can activate these stretch receptors with just vibration — even in an empty stomach — thereby ‘tricking’ the stomach into feeling full.”
— Dr. Shriya Srinivasan

Dr. Srinivasan and her team conducted research on how well the ingestible capsule might work via an animal model. They found animals given the pill 20 minutes before eating reduced their food intake by about 40%.

“Given the neurophysiology and metabolic results in the study, we expected the [vibrations] to indeed decrease intake, consistent with the mechanism and physiological principles governing hunger and feeding,” Dr. Srinivasan said.

“However, we were impressed by the level to which it was effective, especially in the swine model as these animals normally have a large appetite. It was a very consistent effect, which supports our hypotheses about the working mechanism,” she said.

An alternative to GLP-1 medications like Ozempic

In addition to the reduced food intake, researchers also found the animals in the study gained weight more slowly during periods when they were treated with the vibrating pill.

“We know that consistent limited intake leads to decreased weight gain,” Dr. Srinivasan said. “Since the [vibrations from the capsule] leads to decreased intake, this tool may be useful to people seeking to minimize their weight gain.”

While GLP-1 receptor agonists have recently become very popular as a way to potentially lose weight, the scientists noted there are some potential barriers to these medications, including cost, availability, and the need for them to be self-injected.

“For a lot of populations, some of the more effective therapies for obesity are very costly,” Dr. Srinivasan said.

“At scale, our device could be manufactured at a pretty cost-effective price point. I’d love to see how this would transform care and therapy for people in global health settings who may not have access to some of the more sophisticated or expensive options that are available today,” she added.

Natural ways to feel “full” 

MNT also spoke with Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this new research.

While Dr. Ali said this is an interesting noninvasive concept, he mentioned some potential hurdles.

“First, the stomach empties within an hour, so the longest this thing would give you that effect would be like an hour,” he detailed. “You can’t keep swallowing one of these every hour, so they have to figure out a way for it to last longer in the stomach. If that’s possible, then that can be an alternative.”

“The other issue is it has batteries and batteries are notorious for causing lots of problems in the GI tract. In fact, when a child swallows a battery, like one of those little button batteries, it’s a surgical emergency. So a patient purposely swallowing batteries is not usually a good idea,” Dr. Ali continued.

He said it is important for researchers to develop new noninvasive obesity treatments because although weight loss surgery has been around for many years and is still the most effective treatment, a lot of patients are apprehensive about it.

“In fact, of the patients that qualify for weight loss surgery, only about 2% or so actually end up having surgery because there’s a lot of fear and misconceptions about surgery, insurance issues, psychosocial issues, and other hurdles to achieving surgery,” he explained.

Dr. Ali also said there are ways people can naturally “trick” their stomach and brain into feeling full to help them lose weight.

“Things that are more dense in calories like proteins will typically make the patient feel full for longer. So we emphasize to the patient to eat more protein and vegetables. Things like carbohydrates and sugars are digested more rapidly, so they typically feel full for a shorter period of time,” he said.

This vibrating, ingestible capsule might help treat obesity

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technology in a translucent capsule

MIT engineers designed an ingestible capsule that vibrates within the stomach. These vibrations activate the same stretch receptors that sense when the stomach is distended, creating an illusory sense of fullness and reducing appetite. Such a pill could offer a minimally invasive, cost-effective way to treat obesity.

Swallowing the device before a meal could create a sense of fullness, tricking the brain into thinking it’s time to stop eating, the developers propose.

When you eat a large meal, your stomach sends signals to your brain that create a feeling of fullness, which helps you realize it’s time to stop eating. A stomach full of liquid can also send these messages, which is why dieters are often advised to drink a glass of water before eating. Engineers at the Massachusetts Institute of Technology (MIT) have now come up with a new way to take advantage of that phenomenon, using an ingestible capsule that vibrates within the stomach. These vibrations activate the same stretch receptors that sense when the stomach is distended, creating an illusory sense of fullness. 

In animals who were given this pill 20 minutes before eating, the researchers found that this treatment not only stimulated the release of hormones that signal satiety, but also reduced the animals’ food intake by about 40%. Scientists have much more to learn about the mechanisms that influence human body weight, but if further research suggests this technology could be safely used in humans, such a pill might offer a minimally invasive way to treat obesity, the researchers say. “For somebody who wants to lose weight or control their appetite, it could be taken before each meal,” says Shriya Srinivasan PhD ’20, a former MIT graduate student and postdoc who is now an assistant professor of bioengineering at Harvard University. “This could be really interesting in that it would provide an option that could minimize the side effects that we see with the other pharmacological treatments out there.” 

Srinivasan is the lead author of the new study, which appears in Science Advances. Giovanni Traverso, an associate professor of mechanical engineering at MIT and a gastroenterologist at Brigham and Women’s Hospital, is the senior author of the paper.

The behavioral change is profound, and that’s using the endogenous system rather than any exogenous therapeuticGiovanni Traverso

When the stomach becomes distended, specialized cells called mechanoreceptors sense that stretching and send signals to the brain via the vagus nerve. As a result, the brain stimulates production of insulin, as well as hormones such as C-peptide, Pyy, and GLP-1. All of these hormones work together to help people digest their food, feel full, and stop eating. At the same time, levels of ghrelin, a hunger-promoting hormone, go down. 

While a graduate student at MIT, Srinivasan became interested in the idea of controlling this process by artificially stretching the mechanoreceptors that line the stomach, through vibration. Previous research had shown that vibration applied to a muscle can induce a sense that the muscle has stretched farther than it actually has. “I wondered if we could activate stretch receptors in the stomach by vibrating them and having them perceive that the entire stomach has been expanded, to create an illusory sense of distension that could modulate hormones and eating patterns,” Srinivasan says. 

As a postdoc in MIT’s Koch Institute for Integrative Cancer Research, Srinivasan worked closely with Traverso’s lab, which has developed many novel approaches to oral delivery of drugs and electronic devices. For this study, Srinivasan, Traverso, and a team of researchers designed a capsule about the size of a multivitamin, that includes a vibrating element. When the pill, which is powered by a small silver oxide battery, reaches the stomach, acidic gastric fluids dissolve a gelatinous membrane that covers the capsule, completing the electronic circuit that activates the vibrating motor. In a study in animals, the researchers showed that once the pill begins vibrating, it activates mechanoreceptors, which send signals to the brain through stimulation of the vagus nerve. The researchers tracked hormone levels during the periods when the device was vibrating and found that they mirrored the hormone release patterns seen following a meal, even when the animals had fasted. 

The researchers then tested the effects of this stimulation on the animals’ appetite. They found that when the pill was activated for about 20 minutes, before the animals were offered food, they consumed 40% less, on average, than they did when the pill was not activated. The animals also gained weight more slowly during periods when they were treated with the vibrating pill. “The behavioral change is profound, and that’s using the endogenous system rather than any exogenous therapeutic. We have the potential to overcome some of the challenges and costs associated with delivery of biologic drugs by modulating the enteric nervous system,” Traverso says.

The idea that it might be possible to be overweight or obese but not at increased risk of heart disease, otherwise known as the “obesity paradox”, has been challenged by a study of nearly 300,000 people published in in the European Heart Journal.

The current version of the pill is designed to vibrate for about 30 minutes after arriving in the stomach, but the researchers plan to explore the possibility of adapting it to remain in the stomach for longer periods of time, where it could be turned on and off wirelessly as needed. In the animal studies, the pills passed through the digestive tract within four or five days. The study also found that the animals did not show any signs of obstruction, perforation, or other negative impacts while the pill was in their digestive tract. 

This type of pill could offer an alternative to the current approaches to treating obesity, the researchers say. Nonmedical interventions such as diet exercise don’t always work, and many of the existing medical interventions are fairly invasive. These include gastric bypass surgery, as well as gastric balloons, which are no longer used widely in the United States due to safety concerns. 

Drugs such as GLP-1 agonists can also aid weight loss, but most of them have to be injected, and they are unaffordable for many people. According to Srinivasan, the MIT capsules could be manufactured at a cost that would make them available to people who don’t have access to more expensive treatment options. “For a lot of populations, some of the more effective therapies for obesity are very costly. At scale, our device could be manufactured at a pretty cost-effective price point,” she says. “I’d love to see how this would transform care and therapy for people in global health settings who may not have access to some of the more sophisticated or expensive options that are available today.” 

The researchers now plan to explore ways to scale up the manufacturing of the capsules, which could enable clinical trials in humans. Such studies would be important to learn more about the devices’ safety, as well as determine the best time to swallow the capsule before to a meal and how often it would need to be administered. 

Other authors of the paper include Amro Alshareef, Alexandria Hwang, Ceara Byrne, Johannes Kuosmann, Keiko Ishida, Joshua Jenkins, Sabrina Liu, Wiam Abdalla Mohammed Madani, Alison Hayward, and Niora Fabian. The research was funded by the National Institutes of Health, Novo Nordisk, the Department of Mechanical Engineering at MIT, a Schmidt Science Fellowship, and the National Science Foundation. 

Source: Massachusetts Institute of Technology; written by Anne Trafton, MIT News Office