The number of known cases of poisoning in Germany after special stomach treatments with Botox in Turkey has risen to twelve. They are spread across five federal states, as the Robert Koch Institute (RKI) announced on request. It was not said what it was. Last week there were initially nine reported cases of so-called botulism after injections of botulinum toxin into the stomach wall. In view of the initially rather unspecific symptoms, the RKI considered further cases of illness to be possible.

An association for infectious diseases in Turkey reported cases among Turks and foreigners last week. The patients all underwent the so-called “stomach botox”, which is mainly used for weight loss. A German specialist society views this treatment with skepticism. “The benefit of this procedure has not yet been well enough documented. We are observing this critically and are not making any recommendations,” said the President of the Association of German Aesthetic Plastic Surgeons (VDÄPC), Detlev Hebebrand. In the reputable sector, there has not yet been a large market for stomach botox treatments in Germany.

“The effect of such a treatment is unlikely to last longer than about six months,” said Hebebrand. “It is questionable whether the benefit of the intervention even goes beyond the effect of a dummy drug.” Observational studies involve people motivated to lose weight, which can skew the results. “Substantially higher amounts of Botox are used in these stomach treatments than, for example, for wrinkles on the face,” said the specialist in plastic and aesthetic surgery from Rotenburg. It is unclear how long it takes for the substance to be broken down in the body. It is an endoscopic procedure performed through the mouth and without general anesthesia. As a result, gastric movement should decrease. The aim is a longer lasting saturation.

Several providers in Turkey describe the intervention on the Internet in German, some with before and after photos. In addition, a conscious diet is sometimes recommended. Side effects include nausea and indigestion. What went wrong with the treatments in Turkey is so far unclear. The RKI had called on people who had received such stomach treatment in Istanbul since February 22 and had symptoms to go to the doctor. Typical signs are vision and speech disorders and weakness in the arms and legs. According to the authorities, there are also swallowing and breathing difficulties, which usually occur between three and ten days after the treatment. According to the RKI, the disease botulism is rare, “but very serious”. It is caused by highly toxic botulinum neurotoxins.