The Vomitorium —
Trigger warning: This post is about a surgical implantation that is essentially medically-assisted bulimia.
There’s an apocryphal story of Julius Caeser narrowly escaping an early assassination attempt by returning to his room to puke up his supper rather than visit the bathroom, where the assassins awaited him. Thanks to Aldous Huxley (my favorite author), people have misinterpreted the term “vomitorium” as a special room where the Roman elites would purge after their grand feasts.
While there are vomitoria built into ancient Roman amphitheaters, they are nothing more than large exits for the crowds to “spew forth” after a show. Even though there isn’t an official room for a post-binge expulsion, there does seem to be a history of vomiting after meals. The advantages are obvious: you can indulge as much as you want without the discomfort or weight gain associated with binge eating. The disadvantages are also obvious: food is meant to be eaten and digested, not regurgitated, and there are health consequences for doing so.
These days, vomiting after meals to prevent weight gain is recognized as a serious eating disorder (ED) known as bulimia nervosa.
According to the Mayo Clinic, the risk factors for bulimia include being female (of course), age, family history, psychological or emotional issues, societal pressure, and performance pressure in sports. You’ll notice that the psychological aspect is just one of several contributors to bulimia. The fact that females are vastly more susceptible to bulimia shows that developing an ED is not some uncontrollable affliction of unknown origins, but one of the many inevitable consequences of the inordinate amount of pressure society puts on women to be as thin as possible.
There are a range of serious and life-threatening health complications due to the effects of bulimia and expelling food from one’s stomach, rather than allowing the natural process of digestion to proceed:
- Dehydration, which can lead to major medical problems, such as kidney failure
- Heart problems, such as an irregular heartbeat and heart failure
- Severe tooth decay and gum disease
- Absence of a period in females
- Digestive problems, and possibly a dependence on laxatives to have bowel movements
- Anxiety and depression
- Drug and alcohol abuse
Bulimia is a serious issue that affects between 1-3% of the population, though stigma ensures that it’s an under-reported issue. Recognizing the symptoms of bulimia is vital for preventing a person’s condition from escalating. Those symptoms include:
- Being preoccupied with your body shape and weight
- Living in fear of gaining weight
- Feeling that you can’t control your eating behavior
- Eating until the point of discomfort or pain
- Eating much more food in a binge episode than in a normal meal or snack
- Forcing yourself to vomit or exercise too much
- Misusing laxatives, diuretics or enemas after eating
- Using dietary supplements or herbal products for weight loss
So, there are three components to bulimia: obsession with body image and weight, uncontrolled binge eating, and a method of expulsion.
Until recently, the method of expulsion has been the most disturbing aspect of bulimia. If you chose to throw up, the acidity can erode your teeth and cause esophageal damage. This leads to people joking that bulimia is awesome, if only they didn’t have to throw up!
Thankfully, Aspire Bariatrics has figured out a way to make that dream a reality!
Good Morning America even lauded the invention as “a gadget that lets people eat pretty much what they want and forget about the calories.” Others criticize the Aspire Assist for being “disgusting.” And concern for health problems abound:
The bad news? Well, where to start?
How about with a problem that Aspire already knows about: “Initial setbacks — and here’s the really yucky part — have occurred because the pump struggles to break up large foods,” like cauliflower, steak, pretzels, and Chinese food, says Gillian Orr at Britain’s The Independent, so the tube sometimes gets clogged. There are also “significant doubts about the safety of this product,” says Dr. Manny Alvarez at Fox News. Draining 30 percent of your stomach is a recipe for dehydration, irritation of the stomach lining, and depriving your organs of a third of “vital electrolytes such as sodium, potassium, and calcium.”
There’s also the problem of how permanent the surgery is. In an interview with GMA, Katherine D. Crothall, president and CEO of Aspire Bariatrics, explains that they haven’t really examined this issue:
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.
But considering the fact that people who have bariatric surgery reversed will inevitably regain the weight, it stands to reason that the same will happen the minute you remove the bulimic port your body. Perhaps you can fool your body into accepting the removal of 30% of your calories for a while, but restore that 30% and your body will sock it away in fat tissue for a rainy day.
But the most disturbing thing of all is that the Aspire Assist is not actually an improvement to one’s health. To improve your health, you need to eat healthier foods and get some exercise. These changes alone will not result in much weight loss for most people, which becomes discouraging and often leads to the abandonment of those lifestyle changes.
Now, patients can completely skip those lifestyle changes and just have a bulimic port installed, so you can still eat crap food and be sedentary, but now you can lose approximately 50 pounds doing it.
THIS IS NOT HEALTH!
This is a simulation of health in a culture that equates thinness with health. Thanks to this completely fucked up paradigm of healthcare, physicians have prioritized weight over lifestyle, which justifies any and all methods of getting thin, regardless of the side effects.
And I guaran-damn-tee that Aspire Assist has some unpleasant side effects, though the research is largely preliminary. Regarding these risks, Dr. Yoni Freedhoff weighs in:
So is the Aspire Assist brilliant or brutal? Given it’s just been born, it’s going to be at least a decade before we’ll even have the chance of having the robust long term data to make an informed decision. Until then all I can really say is that I’m looking forward to reading it.
I’m sorry, but it is barbaric that surgeons have used human guinea pigs for decades to “perfect” bariatric surgery, which has cost countless lives and healthy constitutions in an attempt to short-cut healthy lifestyles. And now, here we stand again, selling fat people a product that has barely been tested because obesity is seen as such a life-threatening emergency that we can’t wait for the long-term trials to finish.
Aspire Assist is not healthy in any way, shape or form. The unhealthy aspect of bulimia is not just the vomiting or laxative use, it’s the nutritional deficiencies created by the expulsion of food, however that expulsion occurs, period.
With all of this in mind, I had the opportunity to interview the man who first proposed the idea of aspiration therapy. Dr. Samuel Klein is the Director of the Weight Management Program at Washington University. He’s also on the Board of Directors for Aspire Bariatrics. Last week, I posted my interview with Dr. Klein on the traditional methods of weight loss and why they don’t work.
As I mentioned in that post, I was absolutely giddy at the prospect of interviewing Dr. Klein because of his leading role in the Weight of the Nation documentary. As a result, I did a lot of research on him, which is when I first stumbled across Aspire Bariatrics. I kept it under my belt because I wanted to ask him some tough questions about the company and, as far as I knew, nobody else was really talking about it.
The interview took place just before Thanksgiving, and I’ve been waiting for the opportunity to publish it ever since. So here it is, in its entirety, my interview with Dr. Klein on Aspire Bariatrics.