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A Rather Extreme Way to Diet
January 14, 2013 3:25 AM   Subscribe

Dean Kamen, inventor of the SegWay, has a new invention out! This one is for dieting, and it sucks food out of the stomach before the body can absorb it. The AspireAssist has not been approved by the FDA, although it's available in parts of Europe. How it works.
posted by barnacles (108 comments total) 8 users marked this as a favorite

 
Skin-Port? No, thank you.
posted by ShutterBun at 3:36 AM on January 14, 2013 [2 favorites]


With yucky old bulimia all the vomiting was dangerously close to exercise, this handy device means you never need to flex those retching muscles again! Yay!
posted by samworm at 3:38 AM on January 14, 2013 [41 favorites]


My takeaway: i can eat 30% more.
posted by stupidsexyFlanders at 3:38 AM on January 14, 2013 [4 favorites]


I'm sure I saw this in one of the ad breaks in Robocop
posted by Luddite at 3:40 AM on January 14, 2013 [43 favorites]


My takeaway: tikka masala, garlic naan, pilau rice.

I've said too much. I didn't mean it Dean. Keep that thing away from me. I'm serious.
posted by MuffinMan at 3:48 AM on January 14, 2013 [1 favorite]


The upwardly mobile versus the aspirational.
posted by a non e mouse at 3:49 AM on January 14, 2013 [17 favorites]


Be careful of what you say here because, well...This
posted by HuronBob at 3:49 AM on January 14, 2013 [3 favorites]


This has got to be a hoax.
posted by Malor at 3:51 AM on January 14, 2013 [8 favorites]


How marvelously Roman.
posted by atrazine at 3:51 AM on January 14, 2013 [5 favorites]


This is another Andipose plot, isn't it?
posted by Ursula Hitler at 3:52 AM on January 14, 2013 [4 favorites]


Hole-y crap.
posted by Callicvol at 4:00 AM on January 14, 2013 [4 favorites]


Finally, a stylish alternative for those not lucky enough to have a colostomy bag or chemo port.
posted by headnsouth at 4:02 AM on January 14, 2013 [4 favorites]


"Human Centipede: an Inventor's Aspirations" - in theaters soon.
posted by Philosopher Dirtbike at 4:03 AM on January 14, 2013 [1 favorite]


"When one anus isn't enough"
posted by zippy at 4:06 AM on January 14, 2013 [36 favorites]


It does seem like we're kind of in the dark ages still when it comes to controlling obesity. Hopefully in the future we'll have kinder ways to help people regulate their weight; for now, though, every additional tool in the drawer is an opportunity to help someone, somewhere, for whom nothing else will work.
posted by pipeski at 4:11 AM on January 14, 2013 [1 favorite]


This will surely change dieting in the same way the Segway has revolutionised transport!

(So, in his perfect world you don't walk, and you don't digest... what's next for this visionary?)
posted by Mezentian at 4:15 AM on January 14, 2013 [16 favorites]


A technology like this featured in a piece by Robert Heinlein, but I think he presumed that the technology would actually package the chyme internally and remove it automatically rather than have the patient suck vomit out of a rubber-ringed wound in their abdomen.
posted by Joe in Australia at 4:16 AM on January 14, 2013 [1 favorite]


First, the existing bariatric surgery options are considerably more monstrous than this, and the long term results on them are not nearly as good as participants are frequently sold on. I know a lot of people who've been through it to very 'meh' results, and the risks are high.

Conceptually, this makes sense. Restrictive diets are extremely hard to stay on, especially the kind of severe change you need if you're very obese, rather than just a bit overweight, to actually take the weight off in a span of time where you feel like you're successful. So a lot of people fall off right there. Even more fall off later, when you have to switch to a "maintenance" habit that isn't as restrictive--you're essentially having to switch your eating habits repeatedly.

So take the restriction out of the eating part. Start, from day one, learning to eat at your new "normal" 1800-2000 calorie a day diet (or maybe a bit less), a perfectly ordinary amount of food, but not deprivation. You'll fail sometimes and succeed others, but chances are, that's a more doable change than, say, 3000+ down to 800, and I do know people who've had doctors give them target numbers like that. You get bariatric surgery and you're expected to deal with a new stomach that can only hold a couple tablespoons--that's not normal. This, all the restriction happens in a separate habit from your eating. Eventually, when you don't need it anymore, that restrictive part reduces and goes away, and you're left with just your "normal" eating. You can spend your time creating healthy habits that fit into an ordinary social existence, not trying to adhere to completely unreasonable standards and learning how to fail.

Totally makes sense. But this is the Segway guy. So the reality is that the negative side effects will probably be ridiculous or it'll cost amounts of money that nobody will be able to pay, and it'll be a historical blip. But it's a step in the right direction, I think.
posted by gracedissolved at 4:29 AM on January 14, 2013 [8 favorites]


I reserve many grains of salt for some of Dean Kamen's inventions, but I find no mention of him on the Aspire Bariatrics website and the only mention that he's involved is that he's on the patent application. And given his/DEKA's background in medical pumps, that doesn't surprise me. So I'm a bit hesitant to go all LOLSEGWAY and call this "Dean Kamen's Latest Invention."
posted by olinerd at 4:29 AM on January 14, 2013 [3 favorites]


Will it work with beer?
posted by R. Mutt at 4:29 AM on January 14, 2013 [6 favorites]


>So take the restriction out of the eating part. Start, from day one, learning to eat at your new "normal" 1800-2000 calorie a day diet

As someone who has lost over 130 lbs in the past year, starting from a BMI over 47, I would suggest that just eating 2000 calories/day would result, in someone morbidly obese in a daily rate of weight loss in excess of 1/3 lb per day. If people get their heads right, it's a lot less anxiety than the diet-industrial complex would have you believe.
posted by mikelieman at 4:35 AM on January 14, 2013 [25 favorites]


There are a number of bariatric appliances out there right now, and none of them work particularly well. My GP and I were discussing the various surgeries out there, and he recalls a time when stomach stapling was touted as the cure for obesity, until it failed utterly... and that lap-band appliances seemed to be doing the same thing: restricting intake of healthy food (lean meats, veggies, fruit) while letting baked goods and potato chips and icecream through without a fuss.

I can definitely understand the inclination to avoid drastic surgery like R+Y gastric bypass, sleeving and Duodendal Swap - you are literally mangling someone's intestines and stomach to the point where they can't process food efficiently enough even to get needed vitamins - but appliances like lap-band, gastric sleeve and now this don't address the hormonal and endocrinological aspects to obesity: unreasonable hunger and craving, inability to judge when enough is enough, food-motivated behavior, etc. When you have non-appliance based surgery, part of the process is removing a huge chunk of your stomach, including where the glands that control appetite and satiation are located. At the same time, you're stuck drinking flavorless shakes and bland purees during the months of recovery - the brain just can't dump it's problems into appetite anymore.

Between the two, you get a reset on your eating behavior. It is STRONGLY recommended that you see a nutritionist and counselor/psychologist as part of the treatment to guide you into positive habits post-recovery, and even then, with a stomach the size of your thumb, you are warned you will gain some weight back... you will not go to beach-model beautiful, and you will have to fight tooth and nail to keep your weight under control the rest of your life, while taking vitamins daily to survive.

Devices like this pump avoid dumping syndrome and other unpleasant physiological side effects of other bariatric surgery types, but on its own, I'm not sure it's going to be effective. That, and it will need a very strict regimen to clean and maintain - I'd be concerned about compliance issues and the potential catastrophic effects of non-compliance (rotting food in the pump, for instance.)
posted by Slap*Happy at 4:35 AM on January 14, 2013 [4 favorites]


As someone who has lost over 130 lbs in the past year, starting from a BMI over 47

As someone who did the same, get ready to gain all of it back and then some in the next 5 years. Too early in the game for you to give anyone life-advice.
posted by Slap*Happy at 4:39 AM on January 14, 2013 [18 favorites]


So, while people are starving around the world, the first world is eating too much and needs to get rid of it via a pump? How is this different from the Romans and their vomitoriums?
posted by greenhornet at 4:46 AM on January 14, 2013 [3 favorites]


>As someone who did the same, get ready to gain all of it back and then some in the next 5 years

I suspect that I've gotten that licked to. The secret is picking the right metrics for sustainability. Monitoring my daily-rate-of-weight-change *for the rest of my life* is a no-brainer. 30 seconds a day and I have clear, actionable feedback on my choices in the past 24 hours effect on my weight.

And that's the key. Learning that cause/effect relationship without stress, anxiety or grief. Once that's done, everything else is straightforward.
posted by mikelieman at 4:49 AM on January 14, 2013 [6 favorites]


maybe we can stop surgically disfiguring fat people, that would be nice.
posted by PinkMoose at 4:49 AM on January 14, 2013 [14 favorites]


Instead of a skin-port, just redirect a portion of the food to an internal composter located in the appendix. A vibrating alarm alerts the user that the compost is ready, whereupon they can "deposit" it in their garden.
posted by orme at 4:55 AM on January 14, 2013 [6 favorites]


So, in his perfect world you don't walk, and you don't digest... what's next for this visionary?

On Columbus Day in 2006 or 07, I saw Dean Kamen in person. I was browsing at the Stoughton MA, IKEA and my wife leaned in and whispered to me "that guy's on his... hovercraft. What do you call those things?"

I looked over and about 20 feet away there was a short, slight man on a Segway looking at coffee tables-- he wasn't as tall as I am while standing on his scooter. I whispered back. "'Segway'. That's Dean Kamen. He's the guy who invented it."

"Really? He's very thin for someone who must really hate to walk." Then we mused about how ridiculous it looked to be slipping around IKEA on a Segway. I'm not particularly self-conscious, but even if I had the luxury of worry-free, frivolous spending, I could never imagine using one where people would see me.

When we were leaving, we saw Dean Kamen again. He was parked in one of the spaces designated for families (he was apparently alone) and he was wrestling the Segway into the back of a big SUV. I observed that the effort required to stow it was more than that required to walk around the store. I think he believes that exercise should come from getting your scooter in and out of your car. And he didn't look like he needed a food pump.
posted by Mayor Curley at 4:58 AM on January 14, 2013 [14 favorites]


maybe we can stop surgically disfiguring fat people, that would be nice.

Well, there's nothing I've read in the links that suggests it's mandatory.

From the "How It Works" link:

This therapy is used in conjunction with a lifestyle modification program, and requires careful and comprehensive medical monitoring.

This isn't just some sort of reverse-foi-gras process of sticking a vacuum down the throat; it requires a surgical process and some sort of medical oversight.

So I think pipeski's comment - for now, though, every additional tool in the drawer is an opportunity to help someone, somewhere, for whom nothing else will work - makes sense at this stage.

If they end up selling this for 19.95 on the Home Shopping Network then I think a discussion of responsible approaches to helping obesity would be worthwhile.
posted by dubold at 5:02 AM on January 14, 2013


They will build cities around this thing, just you wait.
posted by thelonius at 5:04 AM on January 14, 2013 [12 favorites]


I'm wishing for implanted computers that consume all that excess energy finding pictures of cats and strangers with whom to argue.
posted by jeffburdges at 5:05 AM on January 14, 2013


So, while people are starving around the world, the first world is eating too much and needs to get rid of it via a pump? How is this different from the Romans and their vomitoriums?

Just to clear something up. Vomitoriums were passageways below amphitheaters for crowds to get in and out, not places for people to vomit so they can eat more. The Romans did not have room dedicated to that purpose.
posted by Bulgaroktonos at 5:06 AM on January 14, 2013 [59 favorites]


They will build cities around this thing, just you wait.

Or we'll feed the 'treated waste' to someone, or some thing.
Regurgiated cheeseburgers will fatten the best cows.
posted by Mezentian at 5:07 AM on January 14, 2013 [1 favorite]


Slap*Happy, the problem with that "you will have to do X for the rest of your life" stuff with most of the bariatric surgeries, including without appliances, is the bit that, to judge from my stepdad and other people I know, they don't really stress to start with. It isn't that you won't have any other option than rigid compliance forever. It's that if you are less than rigidly compliant, you will find, over time, that it fails.

Which is to say, it's about as useful as just saying that people should diet and exercise, to begin with. If everything rests on someone's "will" to spend the rest of their life eating in an antisocial and obsessive way, that way failure lies. A few people will be successful, but the rate of serious complications is astronomically high for something where like 1/5 of people don't even maintain their weight loss over 10 years, and many many more don't maintain at so-called "healthy" levels. (My stepdad, for example, has a BMI over 35, but below where he started and considered a "success" still, he says, even though he's more than 50 pounds now over his low weight.)
posted by gracedissolved at 5:09 AM on January 14, 2013 [1 favorite]


Eat lots more healthy vegetables. Don't spend money on unhealthy stuff. Exercise more.

A raw carrot has about 30 calories, but fills you up and takes time. You'd consume 30 calories worth of chips in seconds while only becoming more hungry.
posted by jeffburdges at 5:16 AM on January 14, 2013


maybe we can stop surgically disfiguring fat people, that would be nice.

The health risks associated with obesity overwhelm the risks of invasive surgery. Health problems that are stone-cold killers that generally just go away in the year post-surgery:

Type II Diabetes
High blood pressure
Sleep apnea

Crippling health issues that clear up post-surgery, or are dramatically reduced post-surgery:

Chronic joint pain
Circulation issues
Chronic depression

The mangling isn't for cosmetic effect - bariatric surgery success stories are usually all fat. They're unappealingly overweight. They have to fight to stay that way, too, as the body does a fantastic job of re-adjusting to new circumstance, and wants you to be fatter. They're just not going to die of being fat, or be sick or injured on a permanent basis because they're fat, which are real problems.

So, while people are starving around the world, the first world is eating too much and needs to get rid of it via a pump?

Please note, in the US, obesity trends reflect social class - the poorer you and your family are, the more likely it is you will be morbidly obese. But, yeah, keep banging that "fat rich people" drum.

the problem with that "you will have to do X for the rest of your life" stuff with most of the bariatric surgeries, including without appliances, is the bit that, to judge from my stepdad and other people I know, they don't really stress to start with.

Yes, this has been a real problem with bariatric surgery. Recently, they've dramatically changed pre-and-post care process - there are a ton of hoops you need to jump through now, and the insurance company and the surgeon make damn sure you do it. It depends on the surgeon, but they're now serious about certification, and to keep your cert, your patients must be in post-op compliance. So there's more motivation to help the patient with the life-changes required.
posted by Slap*Happy at 5:24 AM on January 14, 2013 [13 favorites]


This is another Andipose plot, isn't it?

Adipose wrecks.

Humble brag: I made Harold Bloom giggle with this pun when he was at my bar in Charlottesville in the early 90s.
posted by wensink at 5:30 AM on January 14, 2013 [6 favorites]


Oh please can we not do the "if all fat people did X they'd be fine." thing again? Please? Obesity is a first world concern for sure, but it is neither trivial for most people to overcome nor the cause of society's downfall. It's not the reason we can't have healthcare. It resists direct solutions, but would be greatly helped by a culture that didn't lock kids in school seats all day or adults at desks all day, as we have discussed endlessly here.
posted by emjaybee at 5:31 AM on January 14, 2013 [30 favorites]


Obesity is a first world concern for sure

Not even, anymore.
posted by en forme de poire at 5:38 AM on January 14, 2013 [3 favorites]


Dean Kamen, inventor of the SegWay

Or you could frame it like this:

Dean Kamen, inventor of the insulin pump

suddenly, he doesn't seem like quite as much of a quack.
posted by dmd at 5:39 AM on January 14, 2013 [46 favorites]


Technology that allows one to continue eating like an idiot.
posted by rmmcclay at 5:41 AM on January 14, 2013


Eat lots more healthy vegetables. Don't spend money on unhealthy stuff. Exercise more.

A raw carrot has about 30 calories, but fills you up and takes time. You'd consume 30 calories worth of chips in seconds while only becoming more hungry.

*scribbles madly*
Lads, lads! I think we have it! Finally, someone's figured out the solution!
posted by atrazine at 5:41 AM on January 14, 2013 [42 favorites]


The thing that really mystifies me here is that with all joking aside, this is essentially medically-assisted anorexia/bulimia. How could any regulatory agency in their right mind approve this?

I understand the need for bariatric surgical procedures, but this just seems irresponsible as hell.
posted by Gev at 5:47 AM on January 14, 2013 [4 favorites]


How is this different from the Romans and their vomitoriums?

The Roman vomitoriums are based on a misunderstanding / mistranslation of a stadium exit from which the crowd spews forth.

This is fucking insane.
posted by Kid Charlemagne at 5:48 AM on January 14, 2013 [4 favorites]


The health risks associated with obesity overwhelm the risks of invasive surgery.

The health risks associated with obesity is not the same thing as "the health risks caused by obesity, and cured solely by losing weight".

As a scientist, it seems to me that the burden of proving that their product improves health outcomes is on AspireAssist. Proving that their product causes weight loss does NOT prove that it improves health outcomes over a lifetime. Body weight alone is not a measure of health. It is only a measure of weight. Proving that it lowers the risk of diabetes or heart disease for a few years is not the same thing as proving it lowers the risk of diabetes or heart disease over a lifetime.

Health problems that are stone-cold killers that generally just go away in the year post-surgery:

As far as I can tell from articles, long-term effects of weight loss surgery are more discouraging than you've presented. Reducing the chance of diabetes/etc. for a lifetime is a worthwhile goal for surgery, but reducing the chance of diabetes only for a few years until (like all other forms of weight loss, most of them less extreme) weight returns? I guess that's a personal decision.
posted by muddgirl at 5:50 AM on January 14, 2013 [4 favorites]


How could any regulatory agency in their right mind approve this?

The way it works is that the 'regulators' and 'regulated entities' exist in this strange state where while the numbers of each are static, individuals move from one state to the other apparently at random. The net-effect of this is that 'regulation' is a joke, since the people enforcing the regulations are essentially the people being regulated.
posted by mikelieman at 5:50 AM on January 14, 2013


You'd consume 30 calories worth of chips in seconds while only becoming more hungry.

Not even wrong.
posted by Kid Charlemagne at 5:54 AM on January 14, 2013


Dean Kamen, inventor of the insulin pump

suddenly, he doesn't seem like quite as much of a quack.


As someone who wears an insulin pump, amen.
posted by Benny Andajetz at 6:01 AM on January 14, 2013 [3 favorites]


If the numbers for colostomy and ileostomy patients are able to provide some sort of guide, we're going to have to weigh the potential benefits of this device against the likelihood that between 10 and 70% of patients will develop problems with the stoma (Skin-Port), perhaps more seeing as obesity is a risk factor for these complications. This recent review from the Cleveland Clinic provides a good roundup of the available info.
posted by The White Hat at 6:09 AM on January 14, 2013 [2 favorites]


We need a term for "discretely stopping to aspirate before segway-ing away posthaste".
posted by hoople at 6:10 AM on January 14, 2013


I'd think that Dyson would be a better inventor for this job...
posted by dr_dank at 6:13 AM on January 14, 2013 [8 favorites]


As far as I can tell from articles, long-term effects of weight loss surgery are more discouraging than you've presented.
"Morbid obesity increases the risk for mortality. The above study demonstrates that in patients being treated with bariatric surgery, the risk of 5-year mortality is reduced by 89%. This is a significant observation since it not only suggests the role of morbidity as a risk factor for early mortality, but also provides evidence that surgical treatment for obesity produces a significant reduction in mortality."
posted by Slap*Happy at 6:18 AM on January 14, 2013


The Cronenberg Diet
posted by davebush at 6:23 AM on January 14, 2013 [8 favorites]


As someone who did the same, get ready to gain all of it back and then some in the next 5 years. Too early in the game for you to give anyone life-advice.

As someone who also did the same, I'm up to almost 4 years without gaining any back, but I'll go ahead and wait another year before I tell anyone how I did it...

...well, no I won't. My way doesn't help anyone, though, because I couldn't lose weight no matter what I did until my body suddenly lost the craving for sweets... no idea why, and the weight just dropped off without any effort. I haven't had a soda or candy for 4 years, and don't miss it at all. Also, I gradually gained a craving for all the healthful foods I never ate before.

Bottom line, though, it's not as easy 'as just stop eating,' at least it wasn't for me. Hopefully this can help some people.
posted by Huck500 at 6:35 AM on January 14, 2013 [8 favorites]


Pair the AspireAssist with the Cinco Foodtube System and now we're cookin' with gas!
posted by Ice Cream Socialist at 6:38 AM on January 14, 2013 [4 favorites]


It just reminds me of the line about the the Flowbee type device from "Wayne's World".

"It certainly does suck."
posted by inturnaround at 7:02 AM on January 14, 2013 [1 favorite]


Muddgirl, that's an excellent point. The trouble with proxy measures is that we end up treating them instead of whatever disease state we are actually trying to treat, sometimes leading to surprisingly mediocre outcomes. High cholesterol is the example that comes to mind - statins lower cholesterol really successfully, but in healthy people they have way less of an effect on cardiovascular health than they "should" (e.g.). And of course weight is just another proxy when you get right down to it. Which isn't to say that it's unimportant, either, just that it's complicated.
posted by en forme de poire at 7:07 AM on January 14, 2013 [3 favorites]


I think I'll just stick with tapeworms, thanks.
posted by fifthrider at 7:16 AM on January 14, 2013 [3 favorites]


The thing that really mystifies me here is that with all joking aside, this is essentially medically-assisted anorexia/bulimia. How could any regulatory agency in their right mind approve this?

Safely removing 30% of the food is way less drastic than vomiting up everything. It doesn't sound like it's detrimental to the body. Even if you did it for every single meal, you wouldn't waste away (unless you were already eating dangerously low calories, i.e. you already had a disorder to begin with.) You're still getting a good portion of the vitamins and nutrients you need. And there's no problem with the acids produced from vomiting. Seems pretty different. (I agree with everyone else that the skin-port sounds like the worst body horror and probably wouldn't be too sexy when you take your shirt off.)
posted by naju at 7:32 AM on January 14, 2013


The SkinPort could probably be easily reengineered with minimal difficulty to allow tapeworms to be implanted directly.

Regarding the predictable lolsegways tangent, I fondly remember once being out on a walk one lovely spring day, and whiiiiiirrrrr being passed by a group of about a dozen old men on Segways. To a man, wearing the identical grumpy scowl. I'm still kicking myself for not immediately getting out my phone to film it.

Topically, if it turns out to be a medical appliance that can be better than more invasive and problematic "stomach stapling" or related bariatric surgeries, reducing risk with providing same benefit, great.
posted by Drastic at 7:32 AM on January 14, 2013


Poor Dean Kamen. The guy invents countless devices that have saved countless lives over the years, he created (or maybe just sponsored) a robotics league for kids that have probably inspired thousands to become engineers, he is a role model and an inspiration to many, by all accounts he runs his company in a rather people-positive way (his mom does his books, for god's sake), and as a spin-off from a stair-climbing, stand-upable, balancing wheelchair he created he builds an amazing personal transportation device that due to being over-hyped (no fault of his own, as far as I know) and poor marketing all his past achievements are forgotten and he becomes a punchline.

I don't think he invented this new thing so people could eat chips instead of carrots. I think he invented it to save a few lives of people who have no other choice.

Dean Kamen is a fucking American hero.
posted by bondcliff at 7:35 AM on January 14, 2013 [63 favorites]


evidence that surgical treatment for obesity produces a significant reduction in mortality.

I don't have time to dissect this study, but I'd direct any interested person's attention to how they formed their control group. I'm not a doctor so I don't have a complete understanding of ICD-9 codes, so maybe my concern is addressable.
posted by muddgirl at 7:40 AM on January 14, 2013 [1 favorite]


Agreed with everything bondcliff said. Dean Kamen is not a "quack." If you think he is a quack, you should really give your nerd card back.
posted by sweetkid at 7:40 AM on January 14, 2013 [2 favorites]


It seems to me that the proximate cause of most obesity is excess hunger. Weight loss surgery addresses that issue (as I understand it) both by reducing hunger and by reducing the ability of the hungry person to eat as much. This invention doesn't seem like it would reduce hunger, so wouldn't the patient eventually overeat by 30% extra to compensate for the lost calories?

(My axe to grind: the excess hunger can be less invasively treated at the source for many or most people including myself with a low-carb, high-fat diet. Unfortunately, anti-dietary-fat hysteria combined with a misunderstanding of the causes of obesity keep many people from giving it a real try.)
posted by callmejay at 7:49 AM on January 14, 2013 [2 favorites]


Oh thank god. What this country was missing was a way for us to consume more with fewer consequences.
posted by chundo at 7:50 AM on January 14, 2013 [3 favorites]


As someone who has lost over 130 lbs in the past year, starting from a BMI over 47, I would suggest that just eating 2000 calories/day would result, in someone morbidly obese in a daily rate of weight loss in excess of 1/3 lb per day. If people get their heads right, it's a lot less anxiety than the diet-industrial complex would have you believe.

That's great for you, but it doesn't make you a representative sample.

Oh please can we not do the "if all fat people did X they'd be fine." thing again? Please?

yes this

The Roman vomitoriums are based on a misunderstanding / mistranslation of a stadium exit from which the crowd spews forth.

THE HUNGER GAMES LIED TO ME
posted by NoraReed at 8:02 AM on January 14, 2013 [3 favorites]


I just...I can't...no.
posted by Mental Wimp at 8:03 AM on January 14, 2013


Kamen strikes me as a guy who has a million ideas, but no idea which ones are good and decides to make them all and let the market sort it out.

Thank god for the good ones, though.
posted by mccarty.tim at 8:19 AM on January 14, 2013


I can't help it, whenever I hear about this device, that scene from Monty Python's Meaning of Life pops into my head...the one where giant Mr. Creosote vomits into endless buckets during his marathon dinner. With a stomach port, that wafer thin mint wouldn't have had lethal consequences.
posted by Kokopuff at 8:20 AM on January 14, 2013 [1 favorite]


Poor Dean Kamen. The guy invents countless devices that have saved countless lives [..]

... he fucks ONE sheep..
posted by MuffinMan at 8:21 AM on January 14, 2013 [14 favorites]


Also, Troy would like a word with you about quack inventors.
posted by mccarty.tim at 8:22 AM on January 14, 2013


How do you know when you've extracted 30%? The video doesn't say.
posted by achrise at 8:40 AM on January 14, 2013


My understanding from their website is that you wait a specified amount of time (something like 30 minutes) and then do an extraction. Their claim is that by the time 30 minutes has past, you've metabolized a specific amount of food.
posted by muddgirl at 8:46 AM on January 14, 2013


pipeski: "It does seem like we're kind of in the dark ages still when it comes to controlling obesity. Hopefully in the future we'll have kinder ways to help people regulate their weight; for now, though, every additional tool in the drawer is an opportunity to help someone, somewhere, for whom nothing else will work."

You're joking, right? "Kinder ways to help people regulate their weight"? Maybe being kinder to people in general would be a good start.

IMO, this is yet another in a series of anything is better than being fat, even surgical disfigurement, malnourishment, and increased risk of premature death. No thanks. I'll stay fat.
posted by Lulu's Pink Converse at 8:58 AM on January 14, 2013 [3 favorites]


and as a spin-off from a stair-climbing, stand-upable, balancing wheelchair

I got a chance to check out the stair-climbing, stand-upable, balancing wheelchair. It was super cool and impractical for many if not most people who need a motorized wheelchair, for the following reasons:

1) seat doesn't lay flat, and I don't think the angle was adjustable either, so people confined to the wheelchair are at increased risk of bedsores
2) because of (1), the usual Federal insurance for wheelchairs doesn't cover it
3) probably because of (2), the maker withdrew the wheelchair from the market
4) the stair climbing features require upper body strength and coordination, so people with partial or full upper body paralysis can't use that feature
5) if your weight changes, a tech needs to come out to recalibrate the machine for the new center of gravity
6) there are edge cases where it is conceivable the device will dump you. Any wheel chair can tip, but this one allows you to try situations that are trickier. The user manual mentions some of these situations IIRC, and no doubt the firmware has safeguards, but it probably rules out using the device if you are frail and with an increased risk of fractures or breaks.


He's still an amazing and prolific inventor, and the portable insulin pump alone is enough to cement his reputation as a hero in medicine, but being a hero and amazing with some inventions does not automatically make every invention a good one.
posted by zippy at 9:00 AM on January 14, 2013 [6 favorites]


So he has invented the reverse G-tube? I don't want to be too hard on the guy because he has had some great ideas, but I am not sure this one will get too far.
posted by TedW at 9:05 AM on January 14, 2013


From those of us just joining the conversation from the West Coast I'd like to add a hearty WTF.
posted by 2bucksplus at 9:10 AM on January 14, 2013


I'm going straight back on my diet's strict form just as soon as I get home from Italy.
posted by jeffburdges at 9:11 AM on January 14, 2013 [1 favorite]


Well, the site says "a portion" is removed, and "aspiration only removes a third of the food". I think the delay is there to get the food more toward a slurry, since very little "energy" is extracted from solids in the stomach. That's primarily done by the small intestine. Alcohol is a different matter.
posted by achrise at 9:17 AM on January 14, 2013


A small gastric exhaust port, right above the main port.
posted by mobunited at 9:19 AM on January 14, 2013 [7 favorites]


Well, the site says "a portion" is removed, and "aspiration only removes a third of the food". I think the delay is there to get the food more toward a slurry, since very little "energy" is extracted from solids in the stomach.

Food is processed from the stomach to the intestine during that wait period, yes? I always imagined our digestive system is more of a continuous process then a batch one.

Also it's probably also a function of where the port is located in the stomach. Imagine a bucket with a port located on the bottom, vs. a bucket with the port located halfway up. I think I read that the port is nearer to the top of the stomach.

Our stomachs aren't buckets, of course.
posted by muddgirl at 9:23 AM on January 14, 2013


It appears that he didn't actually invent the insulin pump, but whatever.. It is nice that he likes to build stuff, it is a shame he is so hooked on PR.
posted by Chuckles at 9:34 AM on January 14, 2013


I'll wait until they can transmute the excess food calories with IronMan-type fuel cell, giving me super strength.
posted by bonobothegreat at 9:39 AM on January 14, 2013


Weird. As some have commented on already I could see this a being a potential alternative to gastric surgeries and something for use in more extreme situations. For reasons pointed out already it does seem a lot less invasive and perhaps not as permanent.

As someone who has dealt with moderate weight gain 40-50 pounds and some of the health changes that have come with it I've found the hardest thing is rejigging what I ate because of habit. I love food. I have a realtive who had gastric bypass and although it has led to weight loss her relationship with food is still front and center. Psychologically it's a struggle. Now that a lot of the weight is gone and some of the more acute health issues with it she at least is able to focus more on the food relationship.

It sucks though because what she can a does eat is still restricted because of the bypass so I see it as more a band aid type measure which stops her ability to work on whatever issues she has with I guess I could say 'real and all food.' It's a trade off.

Perhaps something like this, though it does make me feel real squiggy inside could be a better alternative because it could help deal with some of the health issue that can come with being obese in the short term and allow a person to be in a better position to deal with some of the underlying food and lifestyle issues that led to problem in the first place in a less restrictive way. I dunno it just seems so weird.


The whole weight issue just sucks and can be so complex. I'm happy at least that I finally figured out what I need to do to get my body back into a much more healthy situation. I'll just keep chugging along with my not really a diet solution that I finally figured out. It's been great and I no longer am concerned much about food and weight anymore and pretty much eat what I want which for a foodie is awesome. I am aware though that my solution isn't something that would work for everyone.
posted by Jalliah at 9:41 AM on January 14, 2013


My takeaway: they put tl;dr at the bottom of their articles now at Livescience! (they call it pass it on, but still)
posted by OHenryPacey at 9:47 AM on January 14, 2013


Food is processed from the stomach to the intestine during that wait period, yes?

Yes, but. It's not too hard to find answers to "how long does food spend in the stomach", and the consensus seems to be on the order of over 4 hours for total emptying. So waiting 20 minutes after the meal would not seem to allow 70% to pass.

I think I read that the port is nearer to the top of the stomach.

If you actually WTFV you'll see that although this is true, there also seems to be holes down the length of the tube (screen grab) allowing almost total evacuation. The video also speaks of multiple cycles of aspiration and refilling with water, with the possibility of repeating the process until the stomach is empty.
posted by achrise at 9:53 AM on January 14, 2013


Our stomachs aren't buckets, of course.

That's why Mr. Creosote had to ask for one.
posted by headnsouth at 10:07 AM on January 14, 2013 [4 favorites]


Lunchtime viewing!
posted by computech_apolloniajames at 10:09 AM on January 14, 2013


Rudy Rucker, you win this round.
posted by CharlesV42 at 10:10 AM on January 14, 2013


Wouldn't this be extremely prone to infection? I was under the impression that people with ports installed have a fairly high chance of sepsis and death.
posted by miyabo at 10:35 AM on January 14, 2013 [1 favorite]


He can't patent it. Zak McKracken already did it back in 1988 (see right hand page)
posted by EnterTheStory at 10:41 AM on January 14, 2013 [2 favorites]


It seems to me that the proximate cause of most obesity is excess hunger.

I think it's more accurate to say that the proximate cause of obesity is a chronic energy surplus. But as many people recognize, that doesn't necessarily tell us much of practical use. As to whether the ultimate cause comes down to excess hunger, I think it's more nuanced than that. The concepts and examples in this post from Stephan Guyenet really stuck with me on this subject:
Researchers have divided eating into two categories, which are important to understand: 1) 'homeostatic eating', in which food intake is driven by a true need for energy, and 2) 'non-homeostatic eating', in which food intake is driven by other factors. Eating in response to hunger is mostly homeostatic, while eating for pleasure, emotional/stress reasons, social reasons, or just because it's mealtime, is non-homeostatic.

...

A common sense example is all we need to begin to understand this. The holiday season is the scenario in which Americans are most likely to overeat and gain fat. That's not because we're suddenly hungrier on Thanksgiving-- holiday weight gain is driven almost exclusively by non-homeostatic overeating: the presence of readily accessible, delicious, energy-dense, diverse food, and social eating and drinking. The average American overeats during the holidays, gains fat, and hangs on to most of it indefinitely. ...

Holiday weight gain accounts for about half of total annual weight gain in American adults, and is therefore an excellent example of non-homeostatic overeating leading to weight gain (5).

Another example of non-homeostatic eating is soda consumption. People don't choose calorie-dense soda over plain water because they're hungry or thirsty-- they choose it because they like soda. Most people only weakly compensate for the extra calories they drink by eating less later.
posted by ludwig_van at 10:43 AM on January 14, 2013 [2 favorites]


So I got curious about the "how does it know when it's gotten 30%" question and did some googling. Unfortunately it looks like the only journal article on this is not available online. (Fuck you, Elsevier!)

I did turn up their patent application if anyone's into that sort of thing, but it's pretty vague on how that part of the system would work. At one point they're like "well, HYPOTHETICALLY someone MIGHT try to use a pressure sensor for that..." But I have no idea if they're actually using the pressure sensor idea themselves or just staking out that turf to make sure they can go after anyone else who tries to develop the idea.

The patent app also has an awesomely gross description of an early clinical study patient who didn't even have a pump hooked up to her tube, but just used the "siphon effect, which permitted the subject to freely drain the stomach by allowing the open tube to empty into a bucket," and drank ludicrous amounts of water in between siphonings to keep everything moving. I guess I'm not surprised they don't talk much about that option in their press releases....
posted by and so but then, we at 11:31 AM on January 14, 2013


I mean, to be fair, lots of totally legit medical procedures are super disgusting.

This does totally make my own personal bulemia alarm go all DANGER WILL ROBINSON and flail its little arms around. But I'm willing to admit that I might have a hair-trigger bulemia alarm, since it damn near killed someone I'm close to.
posted by and so but then, we at 11:41 AM on January 14, 2013


Another example of non-homeostatic eating is soda consumption. People don't choose calorie-dense soda over plain water because they're hungry or thirsty-- they choose it because they like soda. Most people only weakly compensate for the extra calories they drink by eating less later.

Well...yes and no. Like you say, there's nuance to this; the explanations/causes for obesity can't be really strictly divided, where there's a pie graph and one wedge is endocrine issues and one wedge is poverty and one wedge is disordered eating, etc. Because, if you've ever had trouble affording a meal, you know that soda is a lot more satisfying (in the short term) and cheaper than most of your alternatives. You can get a large soda at any given fast food place for under $2, and you can pretty much keep going back and refilling it for weeks.

Of course, the long term effects of drinking soda as a meal replacement are pretty disastrous, and suddenly the cause that started being pretty-easily labeled as "hunger" (or "poverty") turns into "physiological" and things spiral from there.
posted by kagredon at 11:42 AM on January 14, 2013 [1 favorite]


We need a term for "discretely stopping to aspirate before segway-ing away posthaste".

To komen. "After dinner at Per Se, I kamen."
posted by dersins at 12:05 PM on January 14, 2013 [1 favorite]


One man's food is anoth ..not always that man's food.
posted by Gyan at 12:12 PM on January 14, 2013


The percentage of people drinking soda as a meal replacement is probably like 0.000001% of all soda drinkers though.

I find that most of the people I know who are overweight also have overweight pets and they can't put the pets in a diet because they would "feel mean" which says to me there is a fundamental disconnect between how they see food and how I see it. I love tasty food as much as the average person, I ate cookies before breakfast this morning,I just don't see it as some kind of ultimate reward or indulgence. For me a tasty piece of food is a nice thing, like sunshine and backrubs, but its not THE nice thing. But evidently, for some people it is.

I think the answer is clearly more sunshine and backrubs not a storm drain for your digestive system.
posted by fshgrl at 1:15 PM on January 14, 2013


Wow.

And here I thought it was because the cheap corn-based dry pet food is way more fattening than the more expensive mostly-meat canned pet food.
posted by reprise the theme song and roll the credits at 3:27 PM on January 14, 2013 [3 favorites]


Go to a park every day for months on end and you will quickly notice that dogs weight generally quite closely tracks their owners. Fit people own fit pets and overweight people own overweight pets (in general, obvs not every single one, my normal sized parents have a dog like a bloated tick). I've been observing this for 20 years. And listening to friends who are outraged that the vet told them to restrict their dogs food despite the dog being enormously overweight.

So unless they miraculously have the same metabolic issue there is something else going on. From asking many people that appears to be a belief that restricting food is "mean" and they feel it would make their pet suffer or be unhappy. This is a totally foreign concept to me, and I guess many others. Clearly we have a different view of food
posted by fshgrl at 3:35 PM on January 14, 2013 [2 favorites]


Another invention that sucks.
posted by Blazecock Pileon at 4:31 PM on January 14, 2013


Oh neat so it's like direct debit for your tummy.
posted by turgid dahlia 2 at 4:46 PM on January 14, 2013


xkcd # 1160
posted by jeffburdges at 5:46 PM on January 14, 2013


This may not be the worst thread Metafilter's ever had, but it certainly isn't good.
posted by stavrosthewonderchicken at 8:59 PM on January 14, 2013 [1 favorite]


Seems like it'd be easier to simply set a bucket on the table and spit every third bite into the bucket instead of swallowing. You'd still enjoy tasting and chewing the same amount of food. And you'd end up with a bucket of slop that's pretty similar to the pumped product, without all the nasty surgery. As a bonus, your bucket of pre-chewed food might come in handy as dogfood or as pre-chewed food for baby or granny.
posted by gregor-e at 9:06 PM on January 14, 2013 [1 favorite]


Some interesting reading on Fat in society. The disgust some express here about this particular technology is similar to the disgust expressed about fat people in general and I wonder how much of it is an educated way to express the latter in a forum like Metafilter.

An interesting graphic on the complexity of dealing with obesity, the obesity system map

another interesting graphic on the simple steps people can take to contribute to improvements in their society. But just comparing those last two graphics there's still a sense of putting your finger in the dyke when involved in obesity services.

as someone mentioned above one simple solution that takes very little effort is for people to be kinder but when the research shows that even health professionals disciminate on the grounds of fat, what do we expect from Metafilter?

In this more than any other subject matter Mefites tend to discard their normal tendancies towards an evidence base and revert to individual lived experiences ("I lost 130lbs... and I've cracked in going forward" "people I know have had bad experiences with metabolic surgery so it's not as good as we think" and the most common "we all just know you eat carrots not chips")

The evidence of the effectiveness of bariatric/metabolic surgery in reducing weight and improving the comorbidities associated with obesity is conclusive. Wherever you look for the evidence, the Swedish Obesity Study (SOS) is probably the most well known but there are a myriad other studies.
Here in the UK the National Bariatric Surgery Registry (NBSR) produced it's first results in 2011 and the evidence particularly as regards remission of Type 2 diabetes came as a surprise to most health professionals not involved in the field. It has certainly had a major impact on health policy in the UK as we go through a painful change process to lop £20 billion off the running costs of the National Heath Service.

I'm currently part of the working group redesigning the clinical pathway for specialised commissioning of this surgery for the NHS. I have had bariatric surgery and I have helped out in patient charities and support groups over 8 years.

The vast majority of patients I have spoken to or intereacted online with lose their excess weight more or less as the published evidence shows (or better in many cases) when they have a good idea about their surgery type, good insight into their food behavior and any maladaptive eating, SUPPORT from others, and good follow-up from their medical team. Many published studies confirm these observations but at the monent N=67, or =323 or =459 still means we have more work to do before this can be said with any confidence.

Many, many patients I have spoken to have not "come-out" and in two cases that includes to their life-partner. Their accounts of the kind of bullying and discrimination they endured are shameful. After their surgery they seem to swap one set of bigots for another however as they are told they chose the "easy option" and if they'd just tried harder to diet and excercise........ ignoring the data that most patients have tried an average of 24 diets.
So its unsurprising to me that we don't hear more from successful bariatric patients as hear the most successful patients develop strategies of life-long maintanence of their condition (and avoiding social opprobrium which can act as a trigger) and their surgey stops defining them as individuals.

In fact one of the things I observe as I shadow various teams and services here in the UK is the huge numbers of highly educated professionals who have had bariatric surgery but who claim to have controlled their obesity "the hard way" through diet and exercise. I've seen celebrities, former "Fat-Cats" in the City, world reknowned health professionals and Researchers all talk about their successful weight reduction programme without referencing their surgery. It is far more common than most people think. I believe (but don't have the reference to hand) that in the USA more operations are done for obesity than gallbladder removals. Having said that the reporting of the horror complications still leads to a belief that this is far more dangerous than gallbladder surgery when the risks are largly similar.

Having said all that a large number of surgeons I've spoken to agree that it is almost barbaric to replumb insides and look forward to improved therapies and strategies which will make surgery for obesity a thing of the past. That may be because several of them have already made huge amounts of money in their private practice and are set for life.

There is also increasing concern that "Fat but Fit" patients are choosing the surgery for a variety of non-medical reasons.

Just like a diabetic I have to carefully watch everything I eat and drink on a daily basis for the rest of my life and get enough exercise to avoid piling on the pounds at times of celebration in particular. But thanks to an implantable device I am satiated with a small portion of any food I want to eat and it basically levels the playing field until my relationship with food and weight is that of someone who has a better weight regulatory mechanism. In the past even consuming 1.800-2,000 calories a day I would gain about 10lbs a year. Watching my thin husband pack away between 2,000-3,000 on a daily basis was frustrating as hell.

But I completely acknowledge that social pressure played a large part in my decision.
posted by Wilder at 6:05 AM on January 15, 2013 [5 favorites]


Oh come on. This is not a diet apparatus that we need. We already have the critical technologies; they just need to be combined.

Technology #1: Synthetic fecal bacteria transplantation.

Technology #2: the e. coli bacteria. We have a process that can modify the e. coli bacteria to produce long chain hydrocarbons directly.

Originally, there was Alli; the "shit yourself thinner" pill. Now, we basically have the means to adapt humans to "shit themselves gasoline."
posted by Xyanthilous P. Harrierstick at 7:28 AM on January 15, 2013 [1 favorite]


The toilet car seat may need some modification, but the key work has already been done.
posted by zippy at 8:59 AM on January 15, 2013 [1 favorite]


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