What’s eating at you?

A new electrical “pill” may be able to regulate people’s appetites without any drugs or invasive medical procedures, a promising advancement in treating eating disorders and other medical conditions that benefit from adjusting someone’s food intake.

Developed by a research team from NYU Tandon School of Engineering and the Massachusetts Institute of Technology (MIT), the pill, dubbed FLASH, delivers electrical impulses to the stomach lining once it's swallowed. This targeted stimulation triggers the brain to modulate gut hormones related to hunger. 

In a study published in Science Robotics, the researchers revealed they were able to affect the release of ghrelin — an appetite hormone — using FLASH in pig trials, by orally administering a single pill. 

“The gut and brain communicate through a neural pathway known as the gut-brain axis, which regulates many bodily functions, including eating,” said Khalil Ramadi, Assistant Professor of Bioengineering at NYU Tandon and the Director of the Laboratory for Advanced Neuroengineering and Translational Medicine at NYU Abu Dhabi. Ramadi is the co-first and co-corresponding author of the study. 

“FLASH is the first ingestible electronic device shown to engage with the gut to modulate hormones that regulate brain activity on the gut-brain axis. By using the nervous system to alter the release of certain gut hormones, FLASH can potentially treat a host of disorders related to metabolism and eating without pharmaceuticals or surgery. This is a big step forward in how we approach these diseases,” Ramadi said.

People with some medical conditions use appetite stimulants and anti-nausea medications to help increase their food consumption, said Ramadi, but that can produce unwanted side effects such as restlessness, fatigue, uncontrolled weight gain, headaches, and muscle spasms. While electrical stimulation of the gastrointestinal tract can increase appetite, this approach has typically required surgery, which comes with inherent risks. The effectiveness of this method may be limited by the presence of fluids in the stomach and intestines, too. 

Alternative approaches, such as deep brain stimulation and vagus nerve stimulation, have shown success in regulating appetite but also involve invasive surgical procedures.

FLASH, with the absence of any side effects and no surgical intervention needed, overcomes drawbacks of those conventional methods used to boost appetite. Its design is also noteworthy, featuring a unique surface that mimics the water-wicking skin of a thorny devil lizard. This innovative feature shields the capsule from degradation and enables it to operate effectively within the highly wet environment of the gastrointestinal tract.

“FLASH represents a breakthrough for several reasons,” said Giovanni Traverso, Associate Professor in the Department of Mechanical Engineering at MIT, who collaborated with Ramadi on the research.

“First, it proves that pills don't have to contain drugs, and can instead be designed to deliver electrical impulses to regulate physiology. Unlike drugs, which have broad uptake in the gut, electrical pulses can be designed to target specific cells and locations for targeted therapy. A second crucial innovation is the surface design. The gut lining is an extremely wet environment, which presents difficulty when trying to deliver electricity. Looking to nature, we find other scenarios where micro-patterned surfaces can wick fluid, enabling sturdy electrical connections in the body” said Traverso.

According to Ramadi, initial research demonstrates FLASH’s efficacy in increasing hunger, making it potentially therapeutic for eating disorders such as anorexia and Avoidant Restrictive Food Intake Disorder (ARFID). 

But, by adjusting the type and location of stimulation, the technology may be able to modulate hormones in the opposite direction, reducing overall hunger and providing treatment for metabolic disorders like obesity or diabetes. With further development, it could potentially treat neuropsychiatric disorders, like depression or substance addiction, too.

FLASH’s research team is currently conducting additional preclinical testing with the goal of beginning human trials with an advanced prototype within 5 years. 

This study adds to Ramadi’s path-breaking body of work that advances the field of electrical ingestibles to treat diseases. Earlier this year, he and a group of colleagues announced successful trials of an electromagnetic “pill” that provides a window into the gastrointestinal tract using MRI machine-like technology. In 2021, he presented his work on electronic ingestibles as a TED Fellow. 

Ramadi is the co-first and co-corresponding author on the paper published in Science Robotics. Along with Traverso, his other MIT collaborators on the research are: James C. McRae, George Selsing, Arnold Su, Rafael Fernandes, Maela Hickling, Brandon Rios, Sahab Babaee, Seokkee Min,  Declan Gwynne, Neil Xi-Juna Jia,  Aleyah Aragon, Keiko Ishida, Johannes Kuosmanen, Josh Jenkins, Alison Hayward and Ken Kamrin. 

About the New York University Tandon School of Engineering

The NYU Tandon School of Engineering is home to a community of renowned faculty and undergraduate and graduate students united in a mission to understand and create technology that powers cities, enables worldwide communication, fights climate change, and builds healthier, safer, and more equitable real and digital worlds. The school’s culture centers on encouraging rigorous, interdisciplinary collaboration and research; fostering inclusivity, entrepreneurial thinking, and diverse perspectives; and creating innovative and accessible pathways for lifelong learning in STEM, from K12 to executive education and new advances in digital learning.

NYU Tandon dates back to 1854, the founding year of both the New York University School of Civil Engineering and Architecture and the Brooklyn Collegiate and Polytechnic Institute. Those institutions evolved independently before merging in 2014 to create what is now known as NYU Tandon. Located in the heart of Brooklyn, NYU Tandon is a vital part of NYU's New York campus and unparalleled global network. For more information, visit engineering.nyu.edu.