Monday, 7 January 2013

Horrifying Idea of the Day - a Permanent Implant to Drain Stomach Contents

Today I read about something that sounds like it would be perfectly at home in Orwell's dystopian future - - the "AspireAssist™ Aspiration Therapy System".  

According to the manufacturer's website: "With Aspiration Therapy, patients “aspirate” (drain) a portion of their stomach contents after each meal through an endoscopically-implanted tube, reducing the number of calories absorbed by the body. The tube is implanted in the stomach, and leads to a small, low-profile port at the surface of the skin. Aspiration performed about twenty minutes after a meal will remove about a third of the calories consumed. The AspireAssist is used in conjunction with a lifestyle modification program, and requires careful and comprehensive medical monitoring."

To put this into simple terms, patients implant a tube into their stomach through their abdomen, through which they pump partially digested food after meals to prevent that food from being further metabolized by the body.   As with other gastric bypass or bariatric surgeries, the device carries risks, and the manufacturer warns that common side effects include: "abdominal discomfort and constipation/diarrhea", as well as "infection, anemia, and buried bumper syndrome [aka the overgrowth of gastric mucosa over the inner bumper of a gastrostomy tube]".   The Independent reports "Initial setbacks – and here's the really yucky part – have occurred because the pump struggles to break up large foods. One patient reported "clogging" and had to avoid eating cauliflower, broccoli, Chinese food, stir fry, snow peas, pretzels, chips [french fries] and steak".

How does it work, do you ask?

"To begin Aspiration Therapy, a specially designed tube, known as the A-Tube™, is placed in the stomach. The A-Tube is a thin silicone rubber tube that connects the inside of the stomach directly to a discreet, poker-chip sized Skin-Port on the outside of the abdomen. The Skin-Port has a valve that can be opened or closed to control the flow of stomach contents. The patient empties a portion of stomach contents after each meal through this tube by connecting a small, handheld device to the Skin-Port. The emptying process is called “aspiration”."  The manufacturer recommends that patients initially aspirate after each major meal.  Over time, as patients "learn to eat more healthfully", they can reduce the frequency of aspirations.

In its FAQ the manufacturer states: "Aspiration Therapy does not cause bulimia. Bulimia is a psychological illness characterized by excessive and uncontrolled binging episodes followed by purging. Bulimia is medically unsupervised, while Aspiration Therapy is under the control of a physician and electrolytes and metabolites are carefully monitored. One of the primary dangers of bulimia is the damage to the teeth and esophagus due to stomach acid; Aspiration Therapy poses no such risk.   Additionally, there is little overlap between people with bulimia and obesity. Patients who wish to undergo Aspiration Therapy will undergo screening for bulimia and other psychological illnesses to make sure they are eligible for therapy."

I suppose I feel an immediate and visceral reaction to this product (which is not yet approved for use in the U.S. or Canada) because it goes against the whole "there is no quick fix" reality of lifestyle change that leads to long term weight loss.  Crash diets and dramatic programs may work in the short term, but if they are not sustainable in the long term, people revert to their original habits and gain the weight back (Oprah is an example, after her liquid diet).   

I know that bariatric surgery or gastric bypass are solutions for many people, and many have experienced significant weight loss using these tools.  But ultimately, any of these devices are only that - - tools - - that can assist an individual to adopt a healthier lifestyle.  Some people can do it without the need of surgical interventions, and others obtain the medical assistance that they need.  If a person does not change their underlying habits, however, no matter how they lose weight initially, they will revert.  The literature is full of examples of people who have regained weight after bariatric surgery.  None of these interventions are magic bullets.

I suppose that another reason that I dislike this approach is that it does nothing to alter a person's relationship with food.  If you are a person prone to bingeing, you can continue to binge.   The manufacturer's website promises that you can "eat normally" - - if your definition of normal eating is to eat double and triple portions, this device will do nothing to prevent that.  What the device does is permit an individual to siphon off a portion of the food consumed, thereby mitigating the negative impacts of one's eating behaviours.  But what about the bigger issue of moderating the food that is put into the body in the first place?  This device does nothing towards this end.  

I know that some people may be reading this and saying to themselves: "hey, that sounds like a fantastic idea!  I can't wait until it gets approved here!".  For me, I will stick my boring, but tried and true lifestyle changes and keep working out and eating sensibly, every day.  It's not as dramatic, but it's safe and works for me.  Plus I don't have a smelly hatch in my stomach - - that can't look good in a bikini...!


1 comment:

  1. Wow, that's disgusting. This is medical bulimia, and that's pretty scary. Who would be willing to deal with something so repugnant? With the money that it takes to pay for the procedure a person could see a personal nutritionist or trainer. I feel like that would be a better solution.