000 (2)Background
A continuous feeling of hunger is the major cause of weight loss failure in obese patients, making dietary leave. The aim of this study was to evaluate the effect of percutaneous electrical neurostimulation (PENS) of T6 dermatome on appetite, weight loss and dietary compliance.

Methods
A prospective, randomised study was performed. The patients were randomised into two groups: those undergoing PENS of dermatome T6 associated with the implementation of a 1,200-Kcal diet (group 1) and those following only a 1,200-Kcal diet (group 2). A third group of obese patients (BMI > 30 Kg/m2) with fecal incontinence undergoing PENS of posterior tibial nerve was evaluated.

Results
One hundred and five patients were included in the study, 45 in groups 1 and 2, and 15 in group 3. The median pain perception after PENS of dermatome T6 was 1. There were no complications. Only the patients in group 1 experienced significant reductions of weight, BMI, and appetite. All of the patients in group 1 experienced appetite reduction compared to 20 % of the patients in group 2 and 30 % of the patients in group 3 (p < 0.001). Weight loss ≥5 Kg was achieved in 76.7 % of the patients in group 1, 6.7 % of the patients in group 2, and 0 % of the patients in group 3 (p < 0.001). Dietary compliance after 12 weeks was 93.3 % in group 1, 56.7 % in group 2, and 50 % in group 3(p = 0.006).

Conclusions
PENS of dermatome T6 was associated with appetite reduction in all of the patients and, along with a proper diet, achieved a significantly greater weight reduction than diet alone.

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