The most surprising thing about the Food and Drug Administration's approval of the obesity-control device called AspireAssist may be how little mainstream attention it attracted. Because, frankly, a weight-loss machine that lets you eat all you want and then drains the food out of your stomach is a pretty startling invention.
AspireAssist works like this: In a 15-minute outpatient procedure, a surgeon implants a tube into a patient's stomach. The tube is connected to a valve that lies flush against the skin of the abdomen. Twenty to 30 minutes after every meal, the patient opens the valve and uses a connecting device to drain the stomach contents into a toilet. "The device removes approximately 30 percent of the calories consumed," the FDA said in announcing the approval on June 14.
But is it actually just a "medical bulimia machine"?
That's what Yoni Friedhoff – family physician, obesity medicine specialist and professor at the University of Ottawa – asks in his blog Weighty Matters. "Superficially it really does sound horrifying," he continues.
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Although few major news outlets made much of the FDA decision, a number of bloggers responded – usually with fury.
"Bizarre FDA-approved weight loss system encourages eating disorders," raged the headline on a BigThink.com blog by Derek Beres. "Aspire is a corporation as concerned with courting investors as clients," he writes. "Like any company, continued growth is the true goal – it markets its device as 'long-term.' The expansion of the American waistline is its cash cow. Like the food industry itself, Aspire relies on addictive impulses for success: keeping shoving in the bad stuff, we'll shovel it right back out."
"I am absolutely, utterly and totally appalled that it was approved," says Florida endocrinologist and diabetologist Joseph Gutman, quoted on TheVerge.com. "This is mechanized bulimia. It's a device that makes bulimia okay." Gutman says he's rounding up physicians to jointly sue the FDA to take the device off the market.
The FDA approval said that the machine is intended for obese people who have been unable to lose weight by other methods and that it should not be used by anyone with an eating disorder.
Friedhoff, though he notes the initial skepticism, takes a thoughtful approach, saying it's too soon to judge what AspireAssist can and should do. So far, he says, the data is "very interesting" – though he warns that it is not data from peer-reviewed published studies, just from the manufacturer's presentation.
He notes that the patients in AspireAssist's studies were reported to have lost an average of 15 percent of their weight in a year, and many – encouraged by the company's instructions – improved their eating habits overall. They drank more water, chewed longer, planned more-healthful meals.
"It's going to be at least a decade before we'll even have the chance of having the robust long-term data to make an informed decision," he writes. "Until then, all I can really say is that I'm looking forward to reading it."