Opinions 25 July 2016

Stomach tap a desperate measure

Stomach tap a desperate measure - Featured Image
Authored by
Jane McCredie
UNITED STATES regulators recently approved a device, nicknamed the “stomach tap”, that allows obese people to drain part of the contents of their stomach directly into the toilet after every meal.

This is how the Food and Drug Administration (FDA) described the AspireAssist device’s operation when announcing the approval:

“Approximately 20 to 30 minutes after meal consumption, the patient attaches the device’s external connector and tubing to the port valve [which surgeons have installed on the abdomen], opens the valve and drains the contents. Once opened, it takes approximately 5 to 10 minutes to drain food matter through the tube and into the toilet.”

According to the manufacturer, users need to chew thoroughly to prevent blockages in the tube. “You get some solid chunks,” a company spokeswoman was quoted as saying in one report.

Unlike the FDA, the manufacturer avoids the use of words like “drain” in describing how the device works, instead saying that users need to “aspirate” after each meal. Which sounds so much nicer. I know obesity is a huge health issue, that it can be agonisingly difficult to overcome, and that diet and lifestyle interventions generally don’t cut it … but, seriously, what is wrong with us?

When I’m on the treadmill at my local gym, consuming fossil fuels to keep a band of rubber revolving so that I’m forced into physical activity, I find myself thinking our ancestors would be bewildered by the world we’ve created.

Lack of exercise and excess of kilojoules were not problems faced by most of our predecessors on this planet.

That remains the case for many. The United Nations estimates nearly 800 million people, spread across parts of Africa, Asia and Latin America, are chronically undernourished.

Those numbers have been improving in recent years, though who knows what lies ahead as the global population explodes, heading for a projected 12 billion by the end of the century.

The planet is already groaning at the effort required to keep today’s seven billion supplied with fast foods and smart phones.

But, hey, why not send a message that it’s okay to gorge on whatever we want without worrying about the consequences?

As long as we make sure to “aspirate” afterwards.

This might seem like just the next step on from bariatric surgery, which has become more accessible in recent years thanks to increased Medicare coverage for the procedure.

But there is at least one fundamental difference: bariatric surgery helps people to eat less, whereas the stomach tap could actually have the opposite effect.

That’s likely to be a real problem in parts of the world, such as the US, where weight loss surgery tends to be an option reserved for the wealthy.

In fact, part of the pitch from the manufacturers of the stomach tap is that it may be “affordable for patients who cannot afford bariatric surgery”.

In approving this device, the FDA noted the results of one clinical trial, which found an average loss over 1 year of 12.1% of body weight in 111 patients treated, compared with 3.6% for 60 patients in the control group.

Both groups received lifestyle therapy and, perhaps as a result, both showed small improvements in outcomes often associated with obesity, such as diabetes, hypertension and quality of life.

By comparison, this much larger longitudinal study of patients undergoing weight loss surgery found weight reduction after 1 year ranged from around 15% to nearly 35%, depending on the procedure.

In an ideal world, of course, we would not need either of these desperate measures.

Physical activity and healthy eating would be habits ingrained in us from childhood. In obesity, as in all things, prevention is better than cure.

Jane McCredie is a science and medical writer based in Sydney.

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