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hydroGMA in Dortmund

Weight Doctors® hydroGMA targets the feeling of hunger. During a gastroscopy, the lining of the gastric dome, where most of the hunger hormone ghrelin is produced, is ablated, without an incision and without a foreign body in the stomach. Whether the procedure suits you on its own or together with an endo-sleeve is something we clarify in a personal consultation at Westfalenklinik in Dortmund.

Procedure
Gastroscopy, without an incision
Anaesthesia
Sedation or short anaesthesia
Stay
usually outpatient
At a glance

Everything important about hydroGMA

Procedure
endoscopic, via a gastroscopy
Incisions
none, no foreign body in the stomach
Anaesthesia
Sedation or short anaesthesia
Duration
Ablation about 15 to 25 minutes, examination around 40 minutes
Stay
usually outpatient
Back to everyday life
as a rule the next day
German health insurance
no cost coverage, self-pay service
Financing
possible through our financing partner
  • Without an incision: via a gastroscopy, usually as an outpatient
  • On its own or combined: possible together with an endo-sleeve in one procedure
  • Close by: consultation, preliminary examinations and aftercare in Dortmund

hydroGMA in Dortmund: consultation and aftercare at Westfalenklinik

For many people with excess weight, hunger is stronger than any resolution. Weight Doctors® hydroGMA targets exactly this: during a gastroscopy, the lining of the gastric dome is ablated in a targeted way, without an incision, without removing stomach tissue and without a foreign body remaining in the stomach. You discuss whether the procedure suits you at Westfalenklinik in Dortmund, together with the Weight Doctors, whose Dortmund obesity centre is in the same building. You also attend the preliminary examinations and aftercare in Dortmund.

For your appointments, you come to Westfalenklinik at Rosemeyerstraße 2–4, directly on the B1/A40, in the immediate vicinity of the Signal Iduna Park. By car, leave the B1 at the Dortmund-Hombruch exit and park on the building’s parking deck directly in front of the entrance. From the main station, take the U45 to Stadtgarten and then the U42 to Theodor-Fliedner-Heim. Read more on how to get here under Directions.

Why hydroGMA targets hunger

That hunger so often wins when losing weight is not a question of willpower but a normal reaction of the body: when its energy reserves shrink, it responds with signals that increase appetite. The hormone ghrelin plays an important role in this. Most of it is produced by cells in the lining of the upper stomach, the gastric dome (fundus). During a diet, ghrelin levels can rise, precisely when perseverance would be particularly important.

If the top layer of the lining in the gastric dome is ablated, ghrelin production can fall and the feeling of hunger can ease; the effect can build up over a few weeks. Like GLP-1 therapy, hydroGMA therefore targets the feeling of hunger, but manages without continuous medication. Ghrelin is not a simple switch, however: sleep, meals, other hormones, emotions and habits all play a part. The procedure is therefore supportive; long-term success requires a change in diet and exercise.

How hydroGMA works: ablation in three steps

hydroGMA is a gastric mucosal ablation. A gastroscope is inserted through the mouth into the stomach, and the probe of the MOVIVA® system, which combines a water jet and argon plasma in one instrument, is advanced through its working channel. The technique behind it, hybrid APC, has been used routinely in endoscopy for many years; for the treatment of excess weight, the procedure is new.

  • Marking

    The area in the gastric dome that is to be treated is marked endoscopically. All steps are carried out with a single probe.

  • Protecting

    A water jet injects a cushion of saline solution under the lining, protecting the deeper layers of the stomach wall.

  • Ablating

    Heated argon plasma ablates the top layer of the lining, where the ghrelin-producing cells are located. This takes about 15 to 25 minutes, the entire examination around 40 minutes.

No stomach tissue is removed, and the shape of the stomach stays the same. The procedure is usually carried out under sedation or short anaesthesia. Afterwards, you recover in the recovery room and, as a rule, go home on the same day.

hydroGMA on its own or together with the endo-sleeve

hydroGMA is possible as a treatment on its own or together with an endo-sleeve in one procedure. The principle is the same for both paths; the difference lies in whether the stomach is additionally reduced in size from the inside with sutures. The endo-sleeve deliberately leaves out the upper part of the stomach, the gastric dome, and this is exactly where hydroGMA works. In this way, a smaller stomach volume and less hunger come together.

  • hydroGMA on its own

    usually under sedation and, as a rule, as an outpatient. Often the right starting point if you would like a gentle endoscopic procedure without surgery.

  • hydroGMA with endo-sleeve

    both steps in one session under general anaesthesia, first hydroGMA, then the endo-sleeve; hydroGMA extends the procedure by about 30 minutes. Afterwards, for safety reasons, you currently usually stay one night in the clinic for observation.

Initial data, some of it not yet fully published, tend to show greater weight loss for the combination than for hydroGMA on its own. Which path makes sense depends on your starting weight, your goals and your medical history and is decided together with you in the consultation in Dortmund.

Two women with different figures forming a heart with their hands, symbolic image for hydroGMA

Who hydroGMA is an option for

Many people with excess weight know this cycle: at the beginning of a change in diet, things go well. But the more weight is lost, the louder hunger seems to become, portions feel too small, and appetite turns into cravings.

hydroGMA is often suitable in these situations:

  • You would like to lose around 10 to 15 kg and would rather have one procedure than regular injections: hydroGMA on its own.
  • You would like to avoid the side effects of a gastric balloon: hydroGMA on its own manages with a single procedure, and there is no second appointment for removal.
  • An endo-sleeve is an option for you, and strong hunger is your main obstacle: the combination of both procedures in one intervention.
  • You would be suitable for stomach surgery but rule out an operation: the combination as a non-surgical alternative, accompanied by diet, exercise and coaching.

We always check in person in Dortmund whether hydroGMA suits you: in a consultation, with a gastroscopy and with a view to your medical history, your medication and your expectations. The treatment may not be suitable in cases including active stomach ulcers, severe clotting disorders, certain previous stomach operations, pregnancy or serious general illnesses.

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Your path to hydroGMA

This is how hydroGMA proceeds if you are advised in Dortmund:

  1. Step 1

    Beforehand

    Consultation in Dortmund. We discuss your previous attempts to lose weight, your health and your goals, and clarify whether hydroGMA on its own or together with an endo-sleeve makes sense. You can book your appointment online.

  2. Step 2

    Preparation

    Checking suitability. A consultation and medical history, a gastroscopy and a look at medication, blood clotting and anaesthetic risk clarify whether anything speaks against the procedure. You come to the procedure with an empty stomach, as instructed by the doctor.

  3. Step 3

    Day of the procedure

    The procedure in Wertheim. hydroGMA is carried out at the Weight Doctors® Nationalklinik in Wertheim, usually under sedation or short anaesthesia and in around 40 minutes. Afterwards, you recover in the recovery room and are discharged once the doctor gives the all-clear, as a rule as an outpatient.

  4. Step 4

    The next day

    Back to everyday life. As a rule, you are back to everyday life the very next day. A feeling of pressure in the upper abdomen is possible and usually temporary.

  5. Step 5

    The first weeks

    Bland diet and stomach protection. Following a specific plan, you initially eat liquid and gentle food and receive medication that protects the lining. During this time, the effect builds up.

  6. Step 6

    Afterwards

    Aftercare in Dortmund. Follow-up appointments, also by video, the app and a personal coach accompany you while you change your diet and exercise.

What hydroGMA can do

hydroGMA has been scientifically tested, but it is a young procedure. So far, the data come mainly from small pilot studies. In a first clinical study, ten women with obesity had lost an average of 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, and tendentially more in combination with an endo-sleeve.

In the treatment of excess weight, hydroGMA is not yet an established standard procedure; large long-term studies are still under way. Results vary from person to person and depend largely on diet and exercise; there is no guarantee. Because the ghrelin-producing cells can grow back over time, the feeling of hunger can return. A second hydroGMA is then possible in principle; there are not yet any firm recommendations on timing.

Woman in sportswear measuring her waist with a tape measure, symbolic image for the risks of hydroGMA

What risks does hydroGMA carry?

As with any medical procedure, risks can occur. Common and usually temporary are nausea, upper abdominal pain or a feeling of pressure, a feeling of fullness, bloating and a sore throat; these usually subside on their own within a few days.

Rare are bleeding, infections, ulcers of the lining, an injury to the stomach wall (perforation), scarring or reactions to the sedation or anaesthesia. Insufficient weight loss or renewed weight gain are also possible; in rare cases, further treatment or surgery is necessary.

If complications such as bleeding or a perforation occur, the necessary measures are taken immediately, for example endoscopic haemostasis or closure of the perforation. The doctors inform you in detail about all risks before the procedure.

What does hydroGMA cost, and does German statutory health insurance pay?

Weight Doctors® hydroGMA is a self-pay service; German statutory health insurers do not cover it. We will tell you the price on request and discuss your budget openly in the consultation at Westfalenklinik in Dortmund. Financing is possible through our financing partner; more on this under Financing your treatment.

Frequently asked questions

What is hydroGMA?

Weight Doctors® hydroGMA is a gastric mucosal ablation, that is, a targeted ablation of the stomach lining. Via a gastroscopy, the top layer of the lining of the gastric dome (fundus) is treated, where the cells that produce most of the hunger hormone ghrelin are located. The MOVIVA® system is used.

Is hydroGMA an operation?

No. The procedure is carried out via a gastroscopy, without an abdominal incision, without removing stomach tissue and without a foreign body remaining in the body. Nevertheless, it is a medical procedure with anaesthetic and procedural risks.

How long does the treatment take?

The ablation itself takes about 15 to 25 minutes, the entire examination around 40 minutes. Together with an endo-sleeve, hydroGMA extends the procedure by about 30 minutes.

When does hydroGMA take effect?

Not immediately. The effect can build up over a few weeks while the body breaks down the existing hunger hormone and the treated lining heals.

How much weight can I lose with hydroGMA?

In studies to date, up to 15% of starting weight is reported with hydroGMA on its own, and tendentially more in combination with an endo-sleeve. These are initial data, some of them not yet fully published. Results vary from person to person and depend heavily on diet and exercise; there is no guarantee.

Is hydroGMA already a standard procedure?

No. The underlying technique has been established in endoscopy for years. In the treatment of morbid obesity, however, hydroGMA is a new technique and not a standard procedure; the data are currently limited. We advise you openly on this.

Does hydroGMA replace a change in diet?

No. The procedure can influence the feeling of hunger and support weight loss. For a long-term result, diet, exercise, behavioural change and aftercare remain decisive.

Can the treatment be repeated?

Yes. Because the ghrelin-producing cells can grow back over time, the feeling of hunger can return; a second hydroGMA is then possible in principle. There are currently no generally applicable recommendations on the best timing.

What risks does hydroGMA carry?

Common and usually temporary are a feeling of pressure in the upper abdomen, nausea, a feeling of fullness or a sore throat. Rarely, bleeding, infections, an injury to the stomach wall (perforation), scarring or reactions to the sedation or anaesthesia are possible. Insufficient weight loss or renewed weight gain are also possible.

Who is hydroGMA not suitable for?

The treatment may not be suitable in cases including active stomach ulcers, severe clotting disorders, certain previous stomach operations, pregnancy or serious general illnesses. An individual assessment always takes place before the procedure.

Where does the procedure take place?

hydroGMA is carried out at the Weight Doctors® Nationalklinik in Wertheim, both on its own and together with an endo-sleeve. You can attend the consultation, the preliminary examinations and the aftercare at Westfalenklinik in Dortmund.

What does hydroGMA cost, and does German statutory health insurance pay?

hydroGMA is a self-pay service; German statutory health insurers do not cover it. We will tell you the price on request and discuss your budget openly in the consultation. Financing is possible through our financing partner.

Where in Dortmund will I be advised?

At Westfalenklinik, Rosemeyerstr. 2–4, 44139 Dortmund, directly on the B1/A40 near the Signal Iduna Park. By car, take the Dortmund-Hombruch exit and park on the building’s parking deck; from the main station, take the U45 to Stadtgarten and then the U42 to Theodor-Fliedner-Heim.

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