Are Doctors Prescribing Bulimia as a Weight-Loss Tool?

Lose weight at any cost. This is the demand urgently and consistently made to patients classified as “overweight” or “obese.” Now, there is a device freshly minted with the FDA’s stamp of approval to help patients lose weight by encouraging them to engage in eating disordered behaviors.

I originally wrote about the AspireAssist Aspiration Therapy System back in 2013. The device has now gained FDA approval and is back in the media, affectionately nicknamed the “BulimiaAssist.” According to the manufacturer’s website, the AspireAssist reduces the calories consumed in a meal by surgically connecting a tube from the inside of the stomach to a port on the outside of the abdomen. The “Skin-Port” has a valve that can be opened or closed to control the flow of stomach contents. Can you guess where this is going? After the AspireAssist patient eats, they go to the restroom where they connect a small handheld device to the tube and empty a portion of the stomach contents into the toilet. The device drains about 30% of the food from the stomach before the calories can be absorbed into the body.

Newsflash: purging food was discovered eons ago by patients suffering from eating disorders—no surgical procedure required. But where is the money to be made in that? Bulimia nervosa is a dangerous eating disorder characterized by episodes of binge eating followed by purging or “getting rid of” the food through a variety of different methods including self-induced vomiting, laxatives, diuretics, and/or exercise. Bulimia nervosa afflicts approximately 4% of women and 0.5% of men in the US. Nearly 4% of those suffering from bulimia will die from the disease and nearly all struggling with the illness experience serious medical and/ or emotional effects. I should note that purging is not the only symptom of bulimia (you can read more on the symptoms here). The manufacturers of AspireAssist work hard to seperate their device from bulimia by emphasizing that users of AspireAssist are encouraged to eat less and chew their food to a liquid consistency so it can be drained effectively through the port. In my mind, these "differences" only emphasize the similarities to additional eating disorders such as the purging subtype of anorexia nervosa and a disordered eating behavior known as “chewing and spitting.” The device will have a safety feature in which it will automatically stop working after 115 cycles, at which point the patient needs to return to the doctor to have it reset. I wonder if patients whose devices become inactive or are removed will turn to more traditional purging behaviors once they can’t use the aspiration system to get rid of unwanted calories.

While this device has captured the public’s attention due to the yuck factor, it is certainly not the first time that the medical community has sanctioned weight loss techniques for people classified as “overweight” or “obese” that would otherwise be considered eating disordered behaviors in people classified as “average weight" or “underweight.” Pills, liquid diets, and calorie restriction are all common prescriptions and recommendations for weight loss that merge the line between dieting and eating disorder, assuming that there is any line between the two to begin with (check out my post "Should Dieting Be Considered an Eating Disorder?). Many of these weight loss methods have serious health risks, not to mention the cost to our emotional wellbeing. It seems counterintuitive to think about how many people are willing to put their emotional and physical health at risk in order to lose weight when one of the main reasons that people state for wanting to lose weight is to improve their health and feel better about themselves.

The truth is: weight is a lousy indication of health. Ample research shows that people can be healthy and confident at a whole range of shapes and sizes. When we shift our focus away from the numbers on the scales and towards a more global sense of health, we can achieve genuine wellbeing by nurturing—not fighting against—our body. Perhaps then we will finally open our eyes to the high price we have paid for weight loss by any means necessary.

Dr. Alexis Conason is a clinical psychologist in private practice in New York City specializing in body image and overeating disorders. To learn more about Dr. Conason's practice and mindful eating, please visit www.drconason.com, like her on Facebook, and follow her on Twitter.