Dozens of people across Europe have come down with a dangerous neuropathic illness called botulism after receiving "gastric Botox" injections in Türkiye. According to the European Centre for Disease Prevention and Control (ECDC), the outbreak has been traced back to two private hospitals where the procedures were conducted, and several of those affected have been admitted to intensive care.
Botulism is a rare but extremely serious condition that is caused by botulinum neurotoxins (BoNT), which attack the body’s nerves and can trigger paralysis, breathing difficulties, and even death. The toxins are produced by a bacteria called Clostridium botulinum, which most commonly occurs in improperly preserved canned foods although the microorganism’s spores can occasionally be inhaled or infect open wounds.
The bacteria produces seven different types of BoNT, one of which is used to manufacture Botox. Heavily diluted and highly purified, the processed toxin rarely causes symptoms in those undergoing cosmetic procedures.
However, the ECDC has reported 67 cases of botulism among patients who received "stomach botox" injections to help them lose weight between February 22 and March 1. Fifty-three of those affected came from Türkiye, with 12 cases occurring in Germany, one in Austria, and one in Switzerland.
All of those who developed the condition had traveled to Türkiye for their injections, with 60 cases traced back to a clinic in Istanbul and the remaining three linked to a location in Izmir.
“The symptoms have ranged from mild to severe and several cases have been hospitalised,” says the ECDC in a statement. “Among those hospitalised, a number are reported to have been admitted to Intensive Care Units (ICU) and received treatment with botulinum anti-toxin.”
While it’s not yet clear if the complications arose due to sanitary conditions at the clinics where the procedures were administered or impurities within the product itself, the ECDC says that Botox is “not approved for the treatment of obesity by intragastric injection.” The relevant departments at both hospitals have therefore had their activities suspended and investigations into the conduct of those involved have been launched.
Botox is typically used for cosmetic procedures such as the elimination of wrinkles or lip size enhancement. It is also sometimes administered therapeutically for the treatment of muscle spasticity and other conditions. However, injecting botulinum toxin into the stomach wall relaxes the muscles and slows stomach emptying, according to Johns Hopkins Medicine. It can help you temporarily feel full after eating, which can help with weight loss. The effect lasts around three months.
When handled properly, Botox poses little threat to patients, although as the current outbreak highlights, the substance can be highly dangerous when used inappropriately.
The ECDC says it “strongly encourages EU/EEA citizens to avoid intragastric treatments with BoNT for obesity in Türkiye as this is currently associated with a significant risk of developing botulism.”