"In a bid to increase treatments for the nations  million obese adults the Food and Drug Administration has approved U.S. marketing of an implantable device that stimulates weight loss by manipulating key appetite signals passing between the brain and the gut. The new device is the Maestro Rechargeable System manufactured by EnteroMedics of St. Paul Minn. While the FDA has approved four medications for weight loss in the past   years the Maestro system is the first weight loss device to be approved since . Using electrical leads implanted just above the stomach and a regulator carried under the skin near the ribcage the device suppresses signals carried by the vagus nerve. The device adopts a variant of a neuromodulation technique long used in the treatment of epilepsy by applying intermittent bursts of electrical current to the vagus nerve it disrupts the signals that prompt the stomach to relax expand and prepare for an influx of food. We think it will be a very important tool in the toolbag of surgeons and physicians treating obesity and its comorbidities said Gregory S. Lea senior vice president and chief financial officer of EnteroMedics. When patients leave the diet counseling and drug world and have nothing more they turn to surgical procedures and only  to  of patients who might be eligible for bariatric surgery are getting it. The FDA approved the use of the device in adult patients with a body mass index or BMI between  and  who have at least one other obesityrelated condition such as type  diabetes. Delivered by the Maestro device vagal blocking therapy or VBLOC offers obese patients a weight loss therapy that does not permanently alter the digestive system in the way that gastric bypass surgery does and which may be less expensive said Lea. He added it poses no risk of the malabsorption problems that often come with such surgery. In a month clinical trial considered by the FDA . of subjects who received the active Maestro device lost at least a quarter of their excess weight and . of subjects lost at least  of their excess weight. On average weight loss in those subjects with an active device was about . greater than that seen in subjects who received a Maestro electrical pulse generator that was not activated. The human bodys longest cranial nerve the vagusor wanderingnerve stretches from the lower abdomen up to the brain stem passing through the heart esophagus and lungs. A key node in the bodys involuntary nervous system it carries signals between body and brain that control heart rate digestive processes and respiration. In a  to minute laparoscopic procedure physicians trained to implant the new device will attach its electrical leads to the anterior and posterior trunks of the vagus nerve right at the gastric junction. During a patients waking hours the device is designed to alternate between delivering fiveminute bursts of highfrequency energy and five minutes of inactivity. During sleep the device powers down. By suppressing the exchange of messages that cue hunger and ready the stomach for food the intermittent electrical currents make most feel less hungry feel full sooner and to feel full for longer. Most eat less and lose weight. Researchers testing the device also observed that like bariatric surgery it might have beneficial effects that go beyond weight loss. Suppressing signals between gut and brain on the vagus nerve appeared to improve the metabolic function of obese patients who got the device. You actually see the effect before patients actually have had that much weight loss said Dr. Ken Fujioka a Scripps Institute endocrinologist and weight management expert who conducted some of the studies that led to the EnteroMedics device. That suggests that the device may be especially beneficial for those who have developed obesityrelated type  diabetes he said. The onagain offagain nature of the Maestro devices stimulation serves another purpose it prevents the vagus nerves gut signals from going silenta communication loss that would likely prompt the central nervous system to find a compensatory workaround. As a result said Lea the Maestro device appears to be safe and effective for longterm use and unlike surgical alterations to the digestive system reversible. Women who have had the device implanted and became pregnant were able to have it inactivated during their pregnancy and then reactivated afterward he said. While the cost of the device has not yet been set Lea said that getting the device implanted and activated will likely cost somewhere between  and an amount that is more than gastric banding but less some of the most complex gastric bypass surgery. The company has begun negotiations with private insurers and the device has been been recognized as exploratory by the board that sets policy for Medicare reimbursements and Lea expressed hope that some might agree to cover the procedure as early as later this year. Watching the nations weight as well as your own Me too. Follow me on Twitter LATMelissaHealy httpstwitter.comLATMelissaHealy and like Los Angeles Times Science  Health https on Facebook."