Fighting Fat: Drain your stomach

Updated: Apr 24

The New Zealand Herald


In a new attempt to control New Zealand's obesity epidemic, severely overweight patients will have a stomach drain installed through which they pump out excess food.

Middlemore Hospital in South Auckland will run a trial of a device called Aspire Assist, which is installed in a 20-minute outpatient visit requiring no more than conscious sedation.

The backers of the technique view it as a relatively straightforward alternative to state-funded obesity surgery, for which the hospital is unable to meet demand.

Weight can be hard to shed and keep off long term. Thirty per cent of Kiwi adults and 10 per cent of children are obese. New Zealand is the third most obese of developed countries, although some Pacific island states have rates twice as high.

The Aspire Assist device involves joining the stomach to an external valve, via a tube through a hole in the skin. Twenty minutes after meals, the patient connects a hand-operated pump to the valve and drains around 30 per cent of the stomach's contents into a special container for disposal - unwanted calories discarded before they can be absorbed by the body.

Middlemore hopes to treat at least 10 people in a trial designed to see if their weight loss is sustainable and whether the treatment is better than obesity surgery. The trial is for people whose BMI is between 35 and 55, which equates to bodyweight of about 120-170kg for a person 185cm tall.

The maker of the device says that in a United States trial, patients lost on average 21kg after having it in place for a year.

The idea has attracted scorn from some, including nutritionist David Hill, of the Otahuhu Recreation and Youth Centre, who said: "It sounds a lot like bulimia - you eat and you purge."

But one of the trial's organisers, trainee specialist Dr Debi Prasad, rejected this, as the device was only temporary, being removed once patients reached their goal weight, and because they would be supported to adopt healthier eating habits and to do more physical activity.

Only patients who were motivated to lose weight in a healthy way would be treated, he said.

"Patients must be willing to aspirate 20 minutes after each meal, maintain regular monitoring by a physician and attend lifestyle counselling to learn healthier habits."

"We don't want people to have the operation and think that they can eat a whole box of hokey-pokey icecream and then they aspirate it later on."

He said the quantity of stomach contents each person could remove would be calculated by a dietitian based on their energy requirements.

Fight the Obesity Epidemic spokeswoman Dr Robyn Toomath, a diabetes specialist, said New Zealand needed more food and advertising controls to rectify its obesity-inducing environment, especially to protect children, but she also supports the trial.

"We do have a responsibility to care for those people who are already obese so, as surgery is the only effective mechanism for treating already obese individuals, I'm supportive of wider access to surgery."

Martin Johnston