Vagotomy as a treatment for morbid obesity.

Based on animal experiments, on the original clinical observations of Dragstedt, and on similarities with appetitive behavior after jejunoileostomy, truncal vagotomy has been attempted as a treatment for morbid obesity in 13 patients with a mean weight of 123 kg. Weight decreases of 20 to 30 kg (range, 2 to 64 kg) have been observed so far. Impaired gastric emptying alone does not seem to account for the decreases. Possibly, improved glucose tolerance with reduction of hyperinsulinemia and other hormonal and/or neural effects are responsible for weight loss and lack of "hunger." The period of observation is short, yet 2 of the 13 patients seem to be failures, of whom one had gastric hyposecretion before operation. It is too early to consider the procedure for general clinical use, which must await further research efforts.