Fighting against obesity one bite at a time

PHILADELPHIA - Americans perennially try to lose weight. They try diets. They try pills and supplements. Some even opt for surgery to make their stomachs smaller.

But many of these methods don't work long-term, or, in the case of bariatric surgery, not everyone is ready for such a drastic step.

Now one company, Small Bite Inc., thinks it may have an answer.

The tiny Haverford, Pa., start-up makes a device that fits in the mouth and restricts jaw movement, causing wearers to take smaller bites and consume less food - thus losing weight. It is intended to be used for six to nine months.

Many people eat too fast, and, as a result, take in too many calories before realizing they have had enough. It takes about 20 minutes from the start of eating until the brain senses fullness, researchers have found.

Small Bite's orthodontic device has been tested on 50 patients in Europe. The company is talking with the U.S. Food and Drug Administration about starting patient clinical trials early next year in Philadelphia.

Ben Franklin Technology Partners of Southeastern Pennsylvania, which allocates state funds to promising early-stage technology, announced last month that it was investing $300,000 in Small Bite.

Obesity has reached epidemic proportions globally, according to the World Health Organization. About two-thirds of American adults, or 133 million people, are overweight or obese.

"Food intake starts at the mouth. We thought, what can we do about it?" said Small Bite's co-founder and chief executive officer, Denis Mulder.

Small Bite's device is a form of behavior modification. It is designed to teach people to eat in smaller bites. "You can eat anything, but you have to cut everything in very small pieces," said Mulder.

The idea for the device came from Jan Renders, a 330-pound patient in Amsterdam who said he had been overweight all his life and had tried many diets.

Renders could have opted to have his jaw wired shut in order to shed pounds, but, as a singer in a band, he wanted to be able to open his mouth - to sing.

He had an idea of attaching "elastics" to his upper and lower molar teeth that restricted how wide he could open his mouth - and the amount of food he could put in.

Renders approached Amsterdam orthodontist Rene Linders, and they designed a device, made of dental polymer and attached with orthodontic adhesive to the upper and lower molars. The polymer strands are connected to a chain that rests against the lower front gum.

If the mouth opens too wide, the chain presses against the lower gum, "which is unpleasant, so you don't do it," Renders said. The device does not put pressure on the teeth or jaw.

After nine months wearing it, Renders said he had lost 130 pounds, going from 330 pounds to 200, a weight that he maintains today. "I have continued to eat in small bites," he said. "I've had a few weight fluctuations, like with a good vacation, but it's the difference of four kilograms - it's nothing."

"The unfortunate truth is that most treatments for obesity are pretty effective in the short term, but not so effective in the long term," said Gary Foster, director of the Center for Obesity Research and Education at the Temple University School of Medicine.

"So the greater the variety of treatments available to people who are trying to manage their weight, the better," Foster said. "This may be one approach that offers some relief, but it does await further investigation in large clinical trials."