The Positives. I appreciate that patients learn healthier behaviors in addition to having the procedure done. The device insertion takes only 15 minutes, does not typically require general anesthesia, and the procedure be undone with a 10 minute procedure. The company purports that their patients do not subsequently develop eating disorder pathology.
The Concerns. As an eating disorder-treatment specialist, I am concerned that the mechanism of action for weight loss is food removal. through a port in the stomach. I work with clients who compensate after eating with vomiting, laxatives, diuretics and non-purging approaches that include excessive exercise and fasting. I have also worked with clients who have diabetes and manipulate their insulin in order to manage their weight. On the surface, the Aspire Assist, as device-mechanized food removal, up to 30% of what was ingested, is not dissimilar to other forced food removals. Still, we do not yet have randomized controlled trial data on whether people exhibit an increase in eating disorder pathology following this procedure.
I recognize that a simple calorie in-calorie out approach has not been sufficient to mitigate our obesity epidemic. A study published in the Journal of American Medical Association found that popular diets including Zone, Ornish, and LEARN diets showed no significant difference in efficacy, although people randomized to Atkins, a low-carb diet, did show greatest weight loss at 12 months (Gardner et al., 2007). Type of diet, protein based or low-fat, did not have the impact as expected. Of even greater concern, prejudice against overweight and obesity is considered the last acceptable prejudice. Largely due to this continued social stigma, obesity negatively impacts employment and relationships in addition to health.
Still, I urge caution until there is more randomized, controlled longitudinal data on all measures of outcome, including immediate weight loss, sustained weight loss, and eating disordered behavior.
Gardner, C. D., Kiazand, A., Alhassan, S., Kim, S., Stafford, R. S., Balise, R. R., Kraemer, H. C., King, A. C. (2007). Comparison of the Atkins, Zone, Ornish and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA, 297: 969-77.