As you might have heard, the FDA approved a new weight loss device called the AspireAssist. This brings up a multitude of complex issues that are not black at white and cannot be oversimplified. Today, we highlight one person’s response to the device while next week we will consider another perspective to the issue.
I have been guilty of joking with friends that “calories don’t count on Friday” or that “these chips actually have negative calories!” I have also wished I could go back and erase caloric intake after eating one-too-many pieces of birthday cake. Had I ever purged to complete these post-birthday party wishes, I can only imagine how easily I could have been lead down a road to disordered eating. The FDA recently approved an ‘obesity treatment’ called AspireAssist in which, a tube is inserted into the stomach to drain up to 30% of caloric consumption into the toilet following each meal. The announcement recommends that the device be used three times a day for optimal success by individuals with a body mass index (BMI) of 35-55. The patients must be monitored closely by their doctor to shorten the tube as they continue to lose weight, as well as to the replace a portion of the drain tube which automatically stops working after 115 cycles of use.
Justifying their endorsement, the press announcement cites that, when compared with a control group who received only nutrition and exercise counseling, individuals who used AspireAssist in addition to such therapy lost 8.5% more of their body weight. However, the use of such an invasive technique comes at a cost: numerous side effects like nausea, vomiting and diarrhea can occur, not to mention a long list of complications, including death, that can occur from the surgical placement of the gastric tube and the abdominal opening for the port valve. While the financial burden of such frequent trips to the doctor mandated by the use of AspireAssist is not mentioned in the article, even more disturbing is the lack of consideration of its potential psychological effects. This is an article put forth by an organization which connotes a sure sense of health and safety; it implies to anyone overweight that the removal of food after it has been consumed will effectively make one more ‘heathy.’ AspireAssist, in other words, is a form of purging, and its message rings clear everyone, regardless of their size.
We are psychologically driven to trust authorities. We are also psychologically driven to justify our actions and twist facts to match up with what we want the truth to be. To someone who has already begun to convince themselves that their purging behavior is normal, healthy, or necessary, an article like this only confirms that belief: “Vomiting at home is way less invasive version of this, so it must be okay.” It disturbs me that this logic is correct; it is the premise – that AspireAssist is a beneficial and healthy option for someone struggling with their weight – which is flawed. The whole idea behind this tube is that overweight individuals who are trying to lose weight are universally eating 30% more calories than needed. Isn’t that assumption much too sweeping a generalization? Are they at all concerned about malnourishment?
These questions remain unaddressed by this press announcement, and I think it’s because lines get blurred when it comes to obesity and eating disorders. In the media and mainstream health education, we learn about all the health risks of obesity, and we see pictures of overweight people eating super-sized McDonald’s meals. We also learn about individuals who struggle with eating disorders, and see a portrayal of a stick-thin woman looking in the mirror at her distorted perception of herself as ‘fat.’ I think these polarized images implicate the assumption that the overly-thin simply need to eat, and the overweight simply need to not. This is an inaccurate portrayal of both health and disordered eating which leads us to a faulty prognosis of how these individuals should proceed, rooted in a sense that we know what is best for them. By so doing, we are robbed from a compassion for individuals struggling with healthy eating, as well as the humility to recognize the situation is far from black-and-white. None would recommend a purge of 30% of caloric consumption to an individual with a normal or underweight BMI, out of concern for their health and well-being. Obesity and eating disorders need to be understood and addressed head-on. Ironically, it seems the efforts to lower the prevalence of obesity and eating disorders are at odds with each other, when in reality, both fight for the same cause. Body positivity and fitness are not enemies and I think it’s time we prioritize the health of all shapes and sizes. We need to stop separating empowerment into opposing camps of “#RealWomenHaveCurves” and “#MyWeightLossJourney.” Real women are all shapes and sizes, and they are all equally deserving of our respect. Healthy looks different for everyone, but I’m pretty sure it doesn’t involve a painful weight loss tube protruding from my abdomen.