Tasty Martin Parr/Magnum

Pass the sick bag. A device that allows people to empty a portion of their stomach contents into a toilet after a meal has just got the go-ahead from the US Food and Drug Administration. The device is approved for use by people who are severely obese, defined as having a body mass index of over 35 kg/m2.

The stomach-churning device, which is already available in some European countries, involves a tube being placed into the stomach in a short surgical procedure. The end of the tube contains a valve that lies flush against the skin.

Normally it is kept closed, but after meals, the person can connect the valve to another tube to drain about a third of their partially digested food into the toilet. It cannot remove more food than this, because the end of the internal tube is positioned higher than most of the stomach’s contents.


Manufacturer Aspire Bariatrics, based in Pennsylvania, says users need to chew their food well and eat more slowly to stop the 6 millimetre tube from getting blocked, and that this in itself helps reduce overeating.

“You get some solid chunks,” says Kathy Crothall, head of Aspire Bariatrics. “If a patient doesn’t chew their food very carefully they won’t get anything out of this device.”

The device, called AspireAssist, has a safety feature within the valve that means it can only be used three times a day for up to six weeks. After this time it stops working and part of the device must be replaced.

Weight lost?

In a trial of 171 people, those who used the device alongside lifestyle counselling lost 14 per cent of their body weight after one year, compared with 5 per cent in people who received counselling alone.

The company says people who have the AspireAssist device implanted need to have regular blood tests to check their electrolyte levels, which can go awry when people are frequently sick.

In trials, side effects have included indigestion, nausea and vomiting. There is also a risk that after people have the device removed, a permanent fissure could open up between the stomach and the abdominal wall.

“I can see it may give some patients a greater feeling of control over their condition, but worry this – like so many treatments today – fails to do anything about the real cause of the illness,” says David Unwin, a GP in Southport, UK.

Losing weight and keeping it off by diet alone is notoriously difficult, with an estimated 64 to 95 per cent of dieters returning to their original weight, or even ending up heavier.

The most successful treatment for obesity is to have a gastric bypass, in which the intestines are replumbed to reduce food absorption, although this has some health risks.

Other unusual approaches include having a pacemaker device implanted that stimulates a nerve between the brain and the stomach, which is supposed to reduce appetite. There is also a balloon-like device, which is implanted into the stomach and then inflated so that people feel more full.