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Abu Dhabi, UAEFriday 14 December 2018

A stomach implant, a sensor and a smartphone - can obesity be cured via an app? 

As far as weight-loss solutions go, the available options have long been fairly limited: steadfast willpower, or resort to surgery.

Anything further is generally reserved for the realms of sci-fi or wishful daydreaming.

Well, the future is here, and in the wise words of Apple: there's (potentially going to be) an app for that.

Intrapace, a medical technologies company founded by serial entrepreneur Mir Imran, has developed a 'gastric pacemaker' that relies on a stomach sensor and a smartphone app to help people lose weight.

In an exclusive interview with The National, Mr Imran revealed his plans for the technology in the Middle East, after meetings with potential investors and distribution partners in Abu Dhabi. Mr Imran has held the reins at more than 22 companies, and holds more than 2,000 patents.

According to the World Obesity Federation, more than 40 per cent of the population in the Middle East is obese.

"All of these kids are going to have life-long problems with diabetes and the likes," Mr Imran says.

Experimental weight loss treatments aren't exactly a new idea to the region.

Months ago Semaglutide - a developmental drug used to control diabetes - was being touted as a possible solution. Canteen menu nutritional guidelines were updated to ban unhealthy foods early last year. Meanwhile, a task force set about reducing the average body mass index of children by 15 per cent whilst increasing physical activity by the same amount by 2020 - even mulling a ban on fast food outlets near schools.

This year, the futuristic Bodyo pod, another app-based obesity therapy which tracks your blood pressure and fat mass, among myriad other things, will be introduced across the country.

So what makes Mr Imran's idea special?

Mir Imran, holding the "gastric pacemaker" he believes will help cure obesity. Courtesy Intrapace
Mir Imran, holding the "gastric pacemaker" he believes will help cure obesity. Courtesy Intrapace

The technology

Intrapace's "gastric pacemaker" is a stomach implant containing a sensor, which alerts the brain every time food passes into it. During an "allowed" meal time, it stimulates the wall of the stomach, where the gastric branch of the vagus nerve picks up stimulation signals and alerts the brain. Or, in layman's terms: the sensor sends a signal to the brain indicating it's full so you consume less food.

If you are eating during a "disallowed time” the sensor sends signals to the brain to put you off your food.

"We have found that a certain pattern of stimulation induces a feeling of satiety and a different pattern of stimulation induces a feeling of mild nausea," Mr Imran says.

There are no food restrictions, and all timings can be set via an app.

That app stores all your information; your eating patterns, exercise regime and sleep patterns, and will send the data to your smartphone, and your physician.

If a user experiences pangs of hunger during the day, a push of a button satiates the craving with a "virtual meal" that tells your brain via the pacemaker that you are full.

The app has been in development for about a decade but has yet to break into mainstream use.

The pacemaker was originally touted as the next big thing in 2011, but was met with criticism at being a single arm study. In response, the team began randomized trials in 2012 and stopped all commercial activity. In the years since, three clinical trials have been completed in Europe - with 300 people currently going about their days with the implants.

The next step is raising capital to start the US trial, and to start the commercialisation process in Europe, where it has achieved the CE Mark.

Following initial meetings in Abu Dhabi, Mr Imran hoped to build his app in Arabic, and some "significantly interested" officials from the UAE would be visiting him in California in the coming weeks.

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Read more:

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The concept has the same success rate as lap band surgery of 40 per cent excess weight loss in the first year. The procedure costs more than $20,000, which is slightly more expensive than a standard gastric bypass.

However, it's less invasive (a 30 to 45-minute laparoscopic procedure), and you can be discharged on the same day.

While gastric bypass and lap band surgeries work by restricting food consumption, Mr Imran insists his technology is the "most advanced obesity therapy", as it does not anatomically change your body.

The implants are designed to be used for about four years, at which point patients should have "permanently changed their eating behaviour".

International Federation for the Surgery of Obesity and Metabolic Disorders board of trustees president Dr Antonio Torres, who has 20 years of experience in bariatric surgery, has implanted the device in 25 patients.

"The major benefit with the Intrapace gastric pacemaker is that there are drastically fewer adverse events and we have real-time information about patient behaviour; crucial to help the obese population," he said.

However, Dr Ahmed Marzouk, consultant laparascopic and bariatric surgery at NMC Abu Dhabi, remains sketpical.

He said while such radical treatments were useful to treat critically overweight patients, for whom exercising and eating healthy wouldn't be viable solutions, enforcing lifestyle change was the more important.

"Surgery will help 50 or 60 per cent but the rest is your life you have to change."

He had observed an increasing amount of experimental or radical treatments in popular demand - such as botox injections to the stomach and gastric plication, which shrinks the size of the stomach.

Both worked on manipulating the feeling of fullness, but there had been no long-term studies to prove their success rates, Dr Marzouk said.

Mir Imran in his earlier years. Photo Courtesy: Mir Imran
Mir Imran in his earlier years. Photo Courtesy: Mir Imran

Who is Mir Imran?

Born in 1956 Hyderabad, India, Mir Imran was a "destructive kid" from a young age - always breaking "anything in sight" to understand how it was made.

As the years wore on, the breaking stopped and the building started.

What began as a hobby fixing and building toys for friends grew to taking on clients and night courses. By age 15, Mr Imran was building and selling small radios.

"I could repair anything. People would bring their radios, gramophones, wrist watches, sewing machines - I knew everything at the time. And as time went on I got better."

At age 17, with just 30,000 rupees he borrowed from his father's friend, Mr Imran bought a plane ticket to New Jersey to study at Rutgers University.

Poverty rather than academic excellence forced him to complete a four-year undergraduate degree in two years. He completed all the work for a mechanical engineering degree, but lacked the money to graduate with an official qualification.

"I was dirt poor. It was a struggle as it is for most immigrants who don't have family or a support system. I had no choice. I worked day and night," he says.

Mir Imran in his earlier years. Photo Courtesy: Mir Imran
Mir Imran in his earlier years. Photo Courtesy: Mir Imran

His first foray into the world of entrepreneurship came in graduate school when him and a friend maxed out a $500 limit on his credit card and set about building security systems for homes and businesses. The operation collapsed early on.

A year later, another friend suggested they start another company but that too failed.

It was then that he took on medical school.

During this tenure, a cardiologist from John Hopkins needed help developing a defibrillator to save those suffering deadly cardiac arrhythmia.

Aged 24, Mr Imran developed the implantable cardioverter-defibrillator (ICD) - a veritable game-changer for cardiology.

The start-up that developed the ICD was acquired for $120 million in 1985. Twenty years later, it was sold to a bigger company as a standalone entity for $27.5 billion.

"I had never even heard the term 'entrepreneurship'," he says.

"But I knew I had to take my inventions and turn them into real products."

And that soon became second nature.

After 9/11, he developed new airport security scanners.

But what is his greatest achievement? Improving the lives of millions of people worldwide? Contributing invaluable research to the medical world?

The truth is, he can't answer that.

"The problem in medicine is you don't know which solutions are going to be lasting solutions. Each one of these inventions have to withstand the test of time. Only decades later can you can sit back and say 'wow, that was a great invention'.

"Fail. Keep failing. Because I often say that failure is a constant companion and success an occasional visitor."