All the alarms went off yesterday when the European Center for Disease Control (ECDC, for its acronym in English) alerted to an outbreak of at least 14 cases of iatrogenic botulism (which can appear after the administration of botulinum toxin for medical purposes). therapeutic or cosmetic) detected on the mainland and related to trips to Turkey to undergo weight-loss operations. The cases were mainly reported in people from Germany (12), Austria and Switzerland who were injected with the toxin into the digestive system of patients to lose weight.
To begin with, it must be noted that this practice is not indicated in Europe as there is “sufficient scientific evidence to certify that it is a safe process,” Dr. Eduardo de Frutos, secretary of the Spanish Society of Aesthetic Medicine, explains to La Vanguardia. (SEME). Turkey, however, is not part of the EU and therefore “does not have the rigorous controls that exist here,” adds Dr. Iván Mañero, plastic surgeon and CEO of IM Clinic.
“Within medical practice -he continues- we are encountering many complications that come from Turkey. What used to come from South America now comes from this country, and this is a problem that will grow.”
But what does Botox have to do with losing weight? What is intended by injecting this protein into the muscles of the stomach wall is to relax them, thus slowing down digestion. “It should be borne in mind that these muscles are the ones that produce the peristaltic movements that help our digestive system to digest the food we eat,” recalls De Frutos.
If you eat -he continues- and your stomach is relaxed, “your digestion will be slower and heavier and, even if you eat little food, you will have a feeling of satiety”. And of course, the people who have undergone this intervention eat much less while the effect lasts -about six or eight months, wields Dr. Mañero-, and that makes them lose weight.
Botulinum toxin is a naturally occurring molecule that causes the disease botulism, which is acquired through food poisoning. When ingesting the toxin, it enters the body through the stomach. The first symptoms are usually gastrointestinal (nausea, vomiting, intestinal discomfort), but later affectations appear in the diaphragm, “which is a very important muscle in breathing,” recalls De Frutos.
There are patients with botulism who end up connected to a respirator until, little by little, they recover. Precisely, some of those affected by the botulism outbreak have been in the ICU. But the situation can be complicated to the point that “it can even lead to death due to the paralysis of all the muscles in the body,” warns De Frutos.
One of the problems with this technique that they apply in Turkey “is that they are injecting the toxin directly into the area where it enters the body to produce the disease, and in doses 20 and 30 times higher than those used in medicine.” aesthetics”, concludes De Frutos.
In aesthetic medicine, when Botox is applied to the face, it is done in very specific muscles and with very controlled doses. “It is a very safe treatment,” says De Frutos. The problem with injecting it into the stomach and in high doses is that “the spread of this toxin to the rest of the organs is much easier, so it is a much riskier treatment,” he adds.
To this we must add that perhaps the toxin received by the patients who traveled to Turkey was not in the best condition. Not surprisingly, the World Health Organization (WHO) issued an alert in August 2022 for counterfeit batches of this type of toxin detected in Jordan, Turkey, Kuwait, the United Kingdom and Poland. “However, it is not known if these batches have been used in the cases registered so far,” they argued from the ECDC, which does not rule out the appearance of new cases.
