Behavior Change Is Key
Keith Ayoob, an associate clinical professor of nutrition at Albert Einstein College of Medicine in New York City said he was horrified by the stomach-pumping machine -- but he's not surprised it was invented.
"People often wish they could just eat and make the calories go away," he said. "It was only a matter of time before someone came up with this.
"This is an enabling device, not a helping device," Ayoob continued. "It doesn't do anything to make someone change their relationship with food. Once you put this in someone, they're never going to want it taken out."
Crothall said that her company hadn't looked at how weight loss is maintained once the device is removed but was marketing the device for long-term use. She said that trial participants were offered counseling to help them modify their eating habits, but there was only anecdotal evidence that any of them made changes.
Cederhag said he'd eventually like to get to the point where he no longer needed the pump, but if he couldn't maintain his lower weight without it, he'd be fine with keeping the AspireAssist in indefinitely.
"If I have to continue to flush my stomach every day or every other day, then so be it," he said.
Backups and Bulimia
Ayoob also brought up the point that chunks of food could get stuck in the tubing of the device, much in the way debris backs up in a sink drain. One trial participant reported such "clogging," and had to avoid cauliflower, broccoli, Chinese food, stir-fry, snow peas, pretzels, chips and steak.
"With the tube it's much easier to eat smooth and creamy foods like ice cream, pudding and cake versus hard or crunchy foods like fruits, vegetables and lean meats" -- the foods most apt to promote weight loss -- Ayoob said
Cederhag said that clogged tubing was a problem for him at the beginning. But after experience and training himself to chew food more thoroughly it disappeared after the first few weeks of use.
Ayoob also worried that the pump was perhaps too much like a "bulimia machine" that mimicked the purging behavior seen in those with eating disorders. Crothall said patients were screened for bulimia beforehand. To prevent abuse, the pump only performs a predetermined number of aspirations until the system must be reset by a doctor.
Cederhag said the device helped him avoid "disordered eating" by allowing him to enjoy normal meals while still losing weight.
"I don't want to be seated at the table with an empty plate. This way I can eat together with my friends and my family, I can drink my beer or wine if I want to. And then I can just let go of 30 percent."