Weight Doctors® hydroGMA

Why we address hunger

The fact that hunger so often wins when you are losing weight is not a question of willpower but a normal protective reaction of the body: for the body, losing weight means that energy reserves are shrinking, and it responds with signals that increase appetite. The hormone ghrelin plays an important part in this. Most of it is produced by cells in the lining of the upper stomach, the gastric fundus. When its level rises, the brain gets the signal that it is time to eat. During a diet, ghrelin can rise – exactly when perseverance would be particularly important.

Weight Doctors® hydroGMA is a gastric mucosal ablation, that is, a targeted ablation of the stomach lining in this area. It is carried out as part of a stomach examination, without external incisions and usually under sedation or short general anaesthesia. The hybrid APC technique is used with the MOVIVA® system from Erbe Elektromedizin: a jet of water lifts the top layer of the mucous membrane on a saline cushion, and argon plasma ablates it in a controlled way. The water cushion protects the deeper layers of the stomach wall.

No stomach tissue is removed, the structure of the stomach is not changed surgically, and the shape of the stomach stays the same. The treated area heals, ghrelin production can fall and the feeling of hunger can ease; the effect can build up over a few weeks. The aim is that cravings and constant appetite ease and that you feel full sooner. In this way, hydroGMA, similarly to GLP-⁠1 therapy, addresses the feeling of hunger.

Ghrelin is not a simple switch, however: sleep, meals, other hormones, emotions and habits all play a part – more on this in the article Lowering the hunger hormone ghrelin. The procedure is therefore supportive: long-term success requires changes to diet, exercise and, where appropriate, an accompanying programme.

How the procedure works and what the first experiences show is explained by Priv.-Doz. Dr. med. Dörte Wichmann and Dr. med. Oliver Scheffel in the series of conversations on this page.

Which path often suits whom

Many people with excess weight know this cycle: at the start of a change in diet, things go well. But the more weight is lost, the louder the hunger seems to become – portions feel too small, appetite turns into cravings. hydroGMA is intended for them, on its own or combined:

Gently ablated – in three steps

After the procedure: what happens next

The procedure alone is not enough – what comes afterwards is what matters. This is what the path typically looks like; all the details are under Procedure, aftercare & safety:

Treatment at the Weight Doctors® Nationalklinik

We carry out hydroGMA at the Weight Doctors® Nationalklinik in Wertheim, our specialised obesity centre with specialists around the clock. Before every procedure, we check your suitability individually.

If you travel by plane, our patient service will, on request, organise everything around your journey – including a shuttle from Frankfurt Airport.

What hydroGMA can do – put honestly into context

hydroGMA is scientifically tested, but a young procedure. The data so far come mainly from small pilot studies. In a first clinical study, ten women with obesity had lost on average 7.7% of their starting weight six months after treatment; fasting ghrelin fell by more than 40%, and hunger and the desire to eat decreased. For hydroGMA on its own, a loss of up to 15% of starting weight after one year is reported.

In combination with the Weight Doctors SLEEVE®, more tends to be possible because two mechanisms of action come together – more on this under hydroGMA alone or combined. Results vary from person to person and depend significantly on diet and exercise; there is no guarantee.

Important to put into context: in the treatment of obesity, hydroGMA is not yet an established standard procedure. Large long-term studies are still under way. This makes a careful check of suitability and an honest assessment of what is realistically achievable for you all the more important.

hydroGMA, GLP-⁠1, gastric balloon or SLEEVE?

There is no single treatment that suits everyone. hydroGMA adds a hormone-based path to the options – and can be embedded in a larger plan, for example with the Weight Doctors SLEEVE® or with GLP-⁠1 pharmacotherapy for stabilisation. The paths at a glance; the direct comparison of the endoscopic procedures can be found under Procedure, aftercare & safety:

What does hydroGMA cost?

Weight Doctors® hydroGMA is a self-pay service; the German statutory health insurers do not cover it. We will give you the price on request and discuss your budget openly in the consultation.