{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:43:45Z","timestamp":1766169825281,"version":"3.48.0"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU112-IP-02"],"award-info":[{"award-number":["CMU112-IP-02"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intragastric injections of botulinum toxin A (BTX-A) have shown promise in aiding weight reduction among obese patients, with a favorable safety profile and minimal adverse effects; however, the inconsistent results from prior studies highlight the need to examine key factors in the research of intragastric injection of botulinum toxin A, such as the dosage of BTX-A, the number and placement of injections. This study examines the efficacy of varying high doses, multi-gastric sites botulinum toxin A injections for weight control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A total of 103 patients aged 18\u201365 with a BMI\u2009\u2265\u200925 kg\/m\u00b2 were assigned to four groups receiving endoscopic BTX-A injections at varying doses and sites: Group 1 (400 IU, fundus and body), Group 2 (300 IU, fundus and body), Group 3 (400 IU, antrum and body), and Group 4 (300 IU, antrum and body). Baseline comparisons used ANOVA, while a mixed model assessed the interaction among injection site, dose, and time on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline measures showed no group differences in bodyweight, BMI, or body fat. The mixed model indicated significant reductions in bodyweight, BMI, and body fat with gastric fundus and body injections. Site and dose interactions significantly affected bodyweight (p\u2009=\u20090.024) and body fat (p\u2009=\u20090.041), but not BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic intragastric BTX-A injections effectively reduce body weight, BMI, and body fat, particularly with injections in the fundus and body regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0339259","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:39:48Z","timestamp":1766169588000},"page":"e0339259","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the efficacy of intragastric botulinum toxin a injections with two different quantities and sites for obesity"],"prefix":"10.1371","volume":"20","author":[{"given":"Tien-Yow","family":"Chuang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hung","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Wen","family":"Penn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-0935","authenticated-orcid":true,"given":"Cheng-Di","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"issue":"2","key":"pone.0339259.ref001","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1017\/S1464793105006974","article-title":"The evolution of human fatness and susceptibility to obesity: an ethological approach","volume":"81","author":"JCK Wells","year":"2006","journal-title":"Biol Rev Camb Philos Soc"},{"issue":"5","key":"pone.0339259.ref002","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.physbeh.2005.08.054","article-title":"Factors promoting and ameliorating the development of obesity","volume":"86","author":"BE Levin","year":"2005","journal-title":"Physiol Behav"},{"issue":"4","key":"pone.0339259.ref003","doi-asserted-by":"crossref","first-page":"276","DOI":"10.4103\/sjg.sjg_534_21","article-title":"Comparison of safety and efficacy of intragastric botulinum toxin-A versus gastric balloon","volume":"28","author":"RM Tayyem","year":"2022","journal-title":"Saudi J Gastroenterol"},{"issue":"6","key":"pone.0339259.ref004","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.1210\/jc.2003-030151","article-title":"Pharmacological therapy of obesity: past, present, and future","volume":"88","author":"DS Weigle","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"pone.0339259.ref005","article-title":"Modern management of obesity","volume":"9","author":"BS Aditya","year":"2009","journal-title":"Clin Med (Lond)"},{"issue":"5","key":"pone.0339259.ref006","article-title":"Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression","volume":"81","author":"CS Bang","year":"2015","journal-title":"Gastrointest Endosc"},{"issue":"3","key":"pone.0339259.ref007","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.orcp.2023.05.009","article-title":"Treatment of obesity with intragastric injection of botulinum toxin. 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