A rare condition called achalasia makes it hard to swallow, causing people to lose weight and eat less. Researchers studied 43 patients who received a special treatment to fix the problem. After treatment, patients gained weight, built muscle, and their body’s energy system started working normally again. The study used advanced blood tests to show that the treatment didn’t just help people eat better—it actually fixed how their body was using food for energy. This research shows that treating the throat problem helps the whole body recover.

The Quick Take

  • What they studied: How does fixing a swallowing disorder change the way a person’s body uses food and builds muscle?
  • Who participated: 43 adults with achalasia (a rare condition that makes swallowing difficult) who received treatment. Researchers measured their health before treatment and three months after.
  • Key finding: After treatment, nearly all patients gained weight, built muscle, and their bodies started using food for energy more normally. The changes in muscle and fat were directly connected to how much protein was in their blood before treatment.
  • What it means for you: If you have achalasia, successful treatment may help your body recover lost muscle and weight. However, this study is small and focused on one specific condition, so talk to your doctor about what to expect for your individual situation.

The Research Details

Researchers followed 43 patients with achalasia before and after they received a procedure called POEM (peroral endoscopic myotomy), which fixes the swallowing problem by relaxing the tight muscle at the bottom of the esophagus. They measured body weight, muscle mass, fat mass, and used advanced blood tests called NMR spectroscopy to see what chemicals were circulating in the blood. This allowed them to understand how the body was using food for energy before and after treatment.

The study compared patients’ results to healthy control subjects to see what was different about people with untreated achalasia. By measuring the same patients before and after treatment, the researchers could see exactly what changed when the swallowing problem was fixed.

This research approach is important because it shows that a swallowing disorder affects not just eating, but how the entire body processes food and energy. Standard blood tests doctors usually do might miss these changes, so this study used more sensitive tests to reveal the full picture of what happens when someone can’t eat normally.

This is a real research study with a reasonable sample size of 43 patients. The researchers used advanced laboratory testing (NMR spectroscopy) which is more detailed than typical blood work. The study was published in a peer-reviewed journal focused on metabolomics (the study of chemicals in the body). However, the study is relatively small, and it only followed patients for three months, so longer-term results are unknown. The findings are specific to achalasia and may not apply to other conditions.

What the Results Show

After the POEM procedure, 39 out of 43 patients gained weight, and their BMI (a measure of body size) increased significantly. More importantly, patients gained both muscle mass and fat mass, showing that their bodies were rebuilding after the period of not eating enough.

The blood tests revealed something interesting: before treatment, patients had a metabolic pattern similar to starvation, where the body breaks down its own tissues for energy instead of using food normally. After treatment, this pattern improved and moved toward normal. The body started using food properly again to build muscle and store energy.

The researchers found a clear connection between the amount of amino acids (protein building blocks) in the blood before treatment and how much muscle patients gained afterward. Patients with lower amino acid levels before treatment tended to gain more muscle after treatment, suggesting their bodies were hungry for protein and used it efficiently once food became available again.

The study showed that standard blood tests doctors usually order would not have detected these metabolic changes. This suggests that patients with achalasia may have more serious metabolic problems than routine medical tests reveal. The research also showed that the metabolic improvements happened within just three months, indicating that the body can recover relatively quickly once the swallowing problem is fixed.

Previous research has shown that achalasia causes weight loss and nutritional problems, but this is one of the first studies to use advanced metabolic testing to show exactly how the body’s energy system is affected. The findings support the idea that POEM is an effective treatment, but they add new information about how deeply the condition affects the body’s chemistry.

The study only included 43 patients, which is a relatively small group. The follow-up period was only three months, so we don’t know if the improvements continue longer or if there are any long-term changes. The study didn’t include information about diet or exercise after treatment, which could affect the results. Additionally, achalasia is rare, so these findings may not apply to other swallowing or digestive problems. The study also didn’t measure how the metabolic improvements affected how patients felt or their quality of life.

The Bottom Line

If you have achalasia, the POEM procedure appears to be effective at restoring normal eating and helping your body recover lost weight and muscle (moderate confidence based on this study). Work with your doctor to monitor your recovery and ensure you’re eating enough protein to support muscle rebuilding. Standard blood tests may not fully show your metabolic recovery, so discuss with your healthcare provider whether more detailed testing would be helpful.

This research is most relevant to people with achalasia who are considering or have had the POEM procedure. It may also interest doctors treating swallowing disorders and researchers studying how digestive problems affect the whole body. People with other swallowing or digestive disorders should not assume these findings apply to them without talking to their doctor.

Based on this study, significant weight gain and muscle rebuilding can happen within three months of successful treatment. However, individual results vary, and some people may see changes faster or slower. Continued improvement may occur beyond three months, but this study didn’t measure that.

Want to Apply This Research?

  • Track weekly weight and take monthly progress photos to monitor body composition changes. Also track protein intake (grams per day) and note how easily you can eat different foods, as these are directly connected to muscle rebuilding.
  • After treatment, focus on eating adequate protein at each meal (aim for 20-30 grams) to support muscle rebuilding. Log your meals in the app to ensure you’re meeting protein goals, especially in the first three months after treatment when your body is recovering.
  • Set up monthly check-ins to review weight trends, muscle-building progress, and protein intake. Create alerts to remind yourself to eat protein-rich foods at each meal. Share progress reports with your healthcare provider to ensure your recovery is on track.

This research describes what happened in a study of 43 patients with achalasia after treatment. Individual results vary, and this study does not replace personalized medical advice from your doctor. If you have achalasia or difficulty swallowing, consult with a gastroenterologist or your primary care physician before making any treatment decisions. This study was published in August 2025 and represents current research, but medical understanding evolves. Always discuss new research findings with your healthcare provider to determine how they apply to your specific situation.