Appetite suppression and weight loss incidental to spinal cord stimulation for pain relief

Spinal cord stimulation (SCS) uses electrical stimulation of the dorsal columns of the spinal cord to prevent the perception of intractable neuropathic pain signals, but its mechanisms and consequences of use are poorly understood. Two overweight female patients who were implanted with SCS systems (Precision; Advanced Bionics/Boston Scientific, Valencia, CA) reported better than 50% relief of their chronic back and leg pain. Unexpectedly, SCS stimulation was also associated with a tingling sensation in the viscera and a reduction in appetite. Both patients were thus able to reduce food intake at mealtimes and had lost about 9 kg in the first 4 months of SCS use, despite denying changes in exercise habits. The mechanism by which SCS can reduce the desire for food is unknown, but this and similar neuromodulation techniques may hold promise for weight loss in patients who fail other treatments or are not healthy enough for surgery.