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Obesity

Need to lose weight? Install a stomach pump

By Brian Dodson
January 12, 2013
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A new approach to surgical weight-loss installs a self-operated stomach pump (Photo: Shutterstock)
Various approaches toward surgical weight-loss (Photo: National Institutes of Health)
The AspireAssist stomach tube and port installed in a patient's stomach and abdominal wall (Photo: Aspire Bariatrics)
A new approach to surgical weight-loss installs a self-operated stomach pump (Photo: Shutterstock)
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There's good news and bad news in the fight against morbid obesity. The good news is that there is a new approach to surgical weight-loss which is far less invasive than conventional operations. The bad news is how it works.

Gastric restriction and gastric bypass are existing surgical methods to modify the digestive system, permanently or temporarily, so that fewer calories are absorbed from food. In gastric restriction, the effective size of the stomach is reduced, either by surgery ("stomach stapling") or by mechanical means (stomach band or balloon). Gastric bypass often includes restriction, but also alters the digestive system so that fewer calories are absorbed from food.

Various approaches toward surgical weight-loss (Photo: National Institutes of Health)

The AspireAssist Aspiration Therapy System also works through induced malabsorption of nutrients. Effectively a form of gastric bypass, it works by removing part of the food in the stomach before it can enter the intestines. An outpatient surgical procedure inserts a small silicone rubber tube, very much like a feeding tube, into the stomach. The tube connects with a valve at the point where it exits the skin, and there is an access port affixed to the skin over the abdominal wall.

The AspireAssist stomach tube and port installed in a patient's stomach and abdominal wall (Photo: Aspire Bariatrics)

In operation, a patient eats normally, with no restrictions. After eating, the food is temporarily (1-2 hours) stored in the stomach. Twenty minutes after eating, the patient attaches a handheld flow system to the valve, and empties their stomach contents directly into the toilet. Provision for rinsing the stomach and diluting the remaining stomach contents is provided.

Essentially, the AspireAssist is a self-operated stomach pump. While this may seem a bit disgusting, the stomach tube and the access port can be implanted or removed in a short outpatient procedure far less invasive than either bypass or restriction surgery. The very similar stomach feeding tubes are routinely used in patients for decades with very few complications, and experience with the AspireAssist reportedly confirms the low complication rate.

The real question, however, is how well does AspireAssist work? In several clinical trials, obese patients eating (and pumping) normal diets three times a day lost half of their excess weight (typically 20 kg (44 lb)) after a year of treatment. This is an effectiveness level similar to gastic restriction operations – gastric bypass typically produces more rapid weight loss, but involves a very serious operation.

The AspireAssist is currently used in medical practice in the European Union, and is in clinical trials in the US. The video below shows the aspiration procedure.

Source: Aspire Bariatrics via New Scientist

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ObesityObesityImplantTreatmentWeight Loss
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Brian Dodson
22 comments
Alex Hall
It's not bad but I think this is misleading. Pretty much agree with what NeatBodies wrote in their weight loss book: Losing weight is all about a sequence of biological reactions:
1. Creating the right metabolic state. 2. Spiking Muscle Insulin Sensitivity. 3. Depleting Glycogen 4. Breaking Fat 5. Burning broken fat. The better you trigger them in order, the more fat you are going to lose.
It's a good read if you have 30 minutes to spare and are serious about results.
Michael Mantion
WTF are you serious?? who on earth would do this. A lap band is perfect. Its safe, adjustable, removable. There is not an idiot alive that would have this implanted. I can see so many problems with this, there is no way this will ever become a reality.
Paul van Dinther
This sounds incredibly medieval to me as do the other methods. Basically the real problem is too much food intake for whatever reason. Sounds to me that that is where treatment needs to take place.
What I do like about this invention is that it highlights the absurdity of the obesity problem.
John Parkes
It's not elegant, but neither are the more invasive methods. Surgery doesn't change one's appetite, only one's ability to consume... Every desire is triggered by chemical/electrical signals in the brain, eating is also a physical act, making over eating a physical habit, and a chemical reward for the brain. That twin habit is hard to alter, a lot like smoking...unlike quitting smoking the rewards are not immediate, it takes a very long time to see appreciable results while constantly battling twin habits, that of the physical act, and that of the chemical reward. Over eating is an addiction...we need to find chemical methods of treating all addictions, providing a reward without having to indulge in the behavior. A long term meal service should be mandatory with the reward chemicals during the treatment, this would alter the physical habit while abating the chemical habit. The chemical reward program could be diminished during the meal program until the desired results are achieved and new habits replace the old. There are drugs that cause massive weight loss, but they are deemed unsafe by the FDA...i do not doubt that they are. Being obese is also unsafe...but chemical means alone won't break years of conditioning to over eat, the physical habit. Until we master chemistry, and psychology we are left with brute force...there's nothing wrong with brute force in appropriate measures, but it's slow and grueling work...someday future generations will see our efforts as barbaric...as we see medicine of a century ago.
Ross Nicholson
Alternatively, a swallowed device that lodges in the stomach may render food undigestible or merely less digestible. Alternatively, the pump might discharge via the intestines and anus (with base). Alternatively, a stomach-lodged pump might discharge via an esophageal stomach tube, (perhaps with long term general anesthesia). Alternatively, the axillary skin gland emissions triggering excessive eating may be topically drugged or otherwise blocked from functioning. Perhaps neutered intestinal worms as therapy? Perhaps a diet of oil, fat, and vitamins?
EricH
WTF indeed! Less invasive with a permanent stoma, actually stimulating even more perverted and addict-like comsumption behaviour? What do you mean, less invasive? Makes you wonder who's paying for this, the less ethical side of the food industry, or medical product developers with broken ethics?
PG
I have one of these valves but it's in a different location. I think I was born with it.....
Scion
It seems incomprehensible to me to be addicted to anything. I simply can't understand or empathise because it seems so alien a concept. That said I'm well aware that much research has gone into addiction and demonstrated a chemical / neural process involving dopamine and such. I also read an article about those people that have difficulty in forming addictions due to a large amount of some restricting neurology that prevents dopamine from being too rewarding. I suspect I am one of those people and so simply don't gain that much joy from any one thing (trust me I enjoy things, but nothing is so good that I'd do it to the detriment of my life). Having said all of this and even assuming some people get addicted in a very real way. Isn't the treatment to address the underlying bad behaviours? That is, if we assume an addict will be addicted to something, aren't there things they could be addicted to that are not harmful or maybe beneficial? The question of why someone would go through with a manual pumping of their stomach rather than not eat a doughnut seems like it could only be answered through intensive therapy. Perhaps this device could signal to people they have a problem? I mean pumping your guts straight into the toilet would be quite confronting I'd think.
CF_Perth
Disgusting! Perhaps they should call this thing 'igluttony' after the practice of gorging oneself and either keeping it or expelling it and then returning for more.
Given the non-renewable resource of food in the world, anyone who allows food to be wasted in such a manner has far greater problems than obesity. Maybe these people should concentrate their efforts on solving the cause rather than inventing a food wastage system.
Starlord22
What has happend to society that we are now cannot apply self discipline. What a waste. Gluttony is the real problem. Why not fix that?
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