Propantheline as an adjuvant to weight loss after vertical gastroplasty

Weight loss after gastroplasty surgery is sometimes unsatisfactory despite normal surgical anatomy and no evidence of deliberate dietary indiscretion.

Two morbidly obese female patients were treated with a modified Long vertical gastroplasty following failed attempts at weight loss using nonsurgical means. One of these (109 kg) complained of a lack of satiety soon after the surgery and her weight loss was unsatisfactory at 11 kg after 90 days. The other patient (128 kg) lost weight as expected but at 3 months leveled off her weight at 93 kg also with an associated loss of satiety. Both patients noted an increased capacity for food and ease of eating solids including red meat. Gastroscopy revealed normal gastric anatomy in both and the patients were prescribed oral propantheline.

There was an immediate subjective improvement in satiety, a reduction in capacity for food and an increase in difficulty with eating some solids. There was a resumption of weight loss that has been sustained down to healthy weight range.

In two patients with unsatisfactory weight loss after gastroplasty but no demonstrable surgical defect, adjuvant propantheline appeared to induce an excellent further weight loss.