Effects of Gastric Antral Botulinum Toxin Injections in Obese Subjects

Inclusion Criteria: * Age ≥ 18 years and ≤ 60 years * BMI ≥ 35 kg /m² * No history of diabetes, gastric or small bowel surgery, known gastroparesis, prior peptic ulcer, esophagitis, or gastrointestinal stricture. * Not pregnant or nursing. Women of childbearing potential must have a negative urine pregnancy test within 48 hours prior to each gastric emptying study, and the Botox injection procedure. Exclusion Criteria: * Unable or unwilling to provide written informed consent * ASA Class III or higher * Chronic upper abdominal pain, nausea, or vomiting * Allergy to botulinum toxin * Delayed gastric emptying (abnormal T ½) on baseline scintigraphic gastric emptying test * Active esophageal, gastric, or duodenal ulceration at time of diagnostic EGD * Allergic to both penicillins AND quinolones * Subject has taken warfarin (Coumadin) or clopidogrel (Plavix) in the week preceding EUS