pipups

I am an “Aspire Assist” user for the last 4 years. This method should be compared to Gastric Bypass or Gastric Sleeve. Those procedures aren´t for everyone. Neither is the Aspire Assist. We all have a problem eating so we gain weight. The difference between the methods is – as I see it :
I have just a tube in my stomach. An ordinary procedure that is very simple. If I don’t want it or need it, I can have it taken out. Nothing is changed inside. The side effects mentioned above are very minor, compared to horrible ones with GP.
I need to learn how to chew my food properly. And this will automatically make me eat less. I now can realize when I am full so I can stop eat in time. I definitely can NOT binge!
Since the problem is in the head, I have time on my side to change my behavior with food, and learn how and what to eat. I am not forced to do anything if I don´t want to. The behavior change is by will.
It is NOT AT ALL that I can eat a ton of food and then just express it. The chewing is crucial. If you don’t chew – you can´t use the device. And I promise you… after 45 minutes chewing your meal, you are tired of it! And my meals, when eating mindful, is more delicious nowadays. The first period I use it to lose weight. When I reached my goal, I can use it to maintain my weight. And the body needs time to adjust.
Nobody is mentioning anything about waste to a person who eats a lot and then let it pass through the "normal" system. I just take it out a little before it passes. This is not more of a waste than the other in my eyes.
I see the Aspire Assist method as this:
The method is not dangerous! (Makes me feel safe) I can eat what I enjoy! (Makes me happy) The reward system in the brain gets satisfied! (Makes me happy) I lose weight, and I keep it! (Makes me happy)

Hi all of You. Som questions to be answered. It is true that Aspire doesn't force users to eat better or less to Loos their weight. As all the restricted methods does. But we have seen, with our 165 patients over a time span of 4 years, that the users of Aspire can and will change eating behavior. It all comes down to chewing everything eaten to a size less that the inner diameter of the A-tube. When doing that, time to eat will be very much longer and you get satisfied with a lot less food that before. You eat less! Junk food taste awful so you stop eating a lot of those things. Instead of forcing people to eat less with restrictive surgery, Aspire gives a person the possibility to change eating behaviour over time. I strongly believe that if you have decided to once and for all loose weight and never regain it, you can change your eating behaviour. Aspire giver a person a chance to see the result 3 times a day. If you chew the food enough you can flush 30% out after each meal. If you don't chew enough, you can't flush. That is the therapy on the physical side. But, long term you will need a lot of support and for some also therapy. That goes for all the other surgical methods too, by the way. In Sweden we had a program to support our users and a secret Facebook account. All users can get a mentor, if they want and support each other. EWL first year is now 65% and stable after 4 years. No complications for any of our users. But, some said that they don't want to continue the use so they removed the A-tube and are back on sqare 1. Completely reversable. The mot important difference from the other surgical procedudures.

I just read an article about the new AspireAssist device by Dr. Yoni Friedhoff. He's a medical professional I trust and look up to:
The Aspire Assist: Surgical Bulimia Or A Case Study In Weight Bias?
I can't tell you how many people have contacted me about the Aspire Assist. What's been genuinely shocking to me is that the sentiment surrounding the online commentary, as well as the emails I'm receiving, is hugely reflective of weight bias - including from colleagues who I know are champions in the fight against weight related stigma. I wrote this post when the Aspire Assist was first launched, and I'm updating and reposting it in the hopes of triggering at least a little bit of reflection.

Is this new device simply a condemnable medical bulimia machine?

That's certainly the tenor of the discussion out there as generally the reports on this are either pretty angry or simply express revulsion.

Superficially it really does sound horrifying, and undeniably, at first blush it's not what I would consider to be the intervention I'd always hoped for. But when researching the story of course I needed to know - what type of studies have been done on it to date?

Believe it or not, their very early data's interesting. Now this isn't peer reviewed published data, just a presentation, but in it they describe the 111 patients who were randomized to receive an Aspire Assist. 74% of them completed the year long study (vs. only 50% of the control group who received the same lifestyle counselling as the Aspire Assist group but no Aspire Assist).

The results were dramatic. This 15 minute long outpatient endoscopic procedure led completers to lose nearly 40lbs on average representing a loss of 15% of their presenting weights. The completers of the control group meanwhile lost on average just 4lbs.


Not surprisingly, there were post-operative adverse effects - the most common being irritation or granulation of the stoma (the exit port). There were only 4 subjects who reported "serious" adverse effects and all were quickly resolved.

Eating behaviours were also monitored. Pre-surgically subjects were screened for binge-eating, bulimia, and night eating syndrome. None of the Aspire Assist patients were reported to experience worsened eating behaviours, while one control subject developed bulimia.

Interestingly, self-reported data actually demonstrated improvements in Aspire Assist subjects' eating behaviours with more thorough chewing, more Water consumption greater meal planning, more mindful eating, and decreased calorie consumption (confirmed by the fact that losses were greater than would be predicted by simple aspiration).

And as far as tolerability goes, the vast majority reported satisfaction with the device, with 93% of survey respondents reporting that they would be somewhat or very likely to recommend it to others.

Comparing the Aspire Assist to the other endoscopic bariatric procedure, the intra-gastric balloon (a procedure that has not been raked over society's coals) the Aspire Assist appears to lead to markedly larger losses with greater response rates and fewer serious adverse effects.

So yes, back to the shock, horror and repulsion, while I readily agree that on its surface both the premise and procedure is less than appetizing, I'm pretty sure that safety and efficacy, not grossness, are what determine the utility of an intervention. If larger, longer, studies reproduce these results whereby the Aspire Assist doesn't lead to or exacerbate disordered eating, involves minimal risk, has minimal adverse metabolic or nutritional consequences, and leads to sustained losses which in turn had demonstrable medical or quality of life benefits, why wouldn't I consider it?

As I've written before it'd be wonderful if everyone lived incredibly healthful lifestyles and in turn those incredibly healthful lifestyles guaranteed weight loss (they don't BTW), but I think my job as a physician is to ensure people are equipped to make informed decisions, not to make decisions for them, or to judge the ones that they make. If the Aspire Assist proves to be both safe and efficacious in the long run, I'll happily discuss its pros and cons with each and every suitable patient. I'll also happily discuss more traditional bariatric surgery, pharmacotherapy, purely behavioural therapy and also the option of doing absolutely nothing with them. And I'll do it all in a nonjudgmental manner too - because my job is to ensure my patients are aware of the risks and benefits of all of their treatment options, including watchful waiting, and then to support them in whatever informed decision they make. To do otherwise in my mind is contrary to the spirit of medicine and suggests one of two exceedingly common and unfair weight biases. First the one that often angrily asserts that unless a person is willing to make formative lifestyle changes, they're not worthy of being helped, or the second - that if only patients wanted it badly enough, they'd just fix themselves. Honestly, if desire were sufficient is there anyone out there who'd struggle with anything?

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.

If you bypass the usage with Aspire, you gain weight. With weight gaining, the tube will become too short, and you have 2 choices. Either you jump on to the train again, using the Aspire as it should be used. Or, you will be told by ur nurse it doctor that the tube have to come out. An extra control that the patient uses the device in the right way.

I am an “Aspire Assist” user for the last 4 years. This method should be compared to Gastric Bypass or Gastric Sleeve. Those procedures aren´t for everyone. Neither is the Aspire Assist. We all have a problem eating so we gain weight. The difference between the methods is – as I see it :
I have just a tube in my stomach. An ordinary procedure that is very simple. If I don’t want it or need it, I can have it taken out. Nothing is changed inside. The side effects mentioned above are very minor, compared to horrible ones with GP.
I need to learn how to chew my food properly. And this will automatically make me eat less. I now can realize when I am full so I can stop eat in time. I definitely can NOT binge!
Since the problem is in the head, I have time on my side to change my behavior with food, and learn how and what to eat. I am not forced to do anything if I don´t want to. The behavior change is by will.
It is NOT AT ALL that I can eat a ton of food and then just express it. The chewing is crucial. If you don’t chew – you can´t use the device. And I promise you… after 45 minutes chewing your meal, you are tired of it! And my meals, when eating mindful, is more delicious nowadays. The first period I use it to lose weight. When I reached my goal, I can use it to maintain my weight. And the body needs time to adjust.
Nobody is mentioning anything about waste to a person who eats a lot and then let it pass through the "normal" system. I just take it out a little before it passes. This is not more of a waste than the other in my eyes.
I see the Aspire Assist method as this:
The method is not dangerous! (Makes me feel safe) I can eat what I enjoy! (Makes me happy) The reward system in the brain gets satisfied! (Makes me happy) I lose weight, and I keep it! (Makes me happy)

Hi, I am an Aspire Assist user. I have been using Aspire for 2 years. I decided to participate in the Aspire Assist study because I was able to lose weight on my own, but after a certain amount of weight, no matter what I did, I could not seem to lose more. I don't regret this decision, it was one of the best I have made in my life. That's why it's so disheartening to hear all the negative and hateful comments about the program.
This site is a site about people who had WLS or are considering it. Anyone who has WLS or is considering it, knows how hard it is to lose and keep weight off. I'm responding to the people who are curious about Aspire or considering Aspire. It is not assisted bulimia. If anything, it's early or controlled pooping. You are taking a 3rd of the food out of your body before digestion is complete. You will not absorb extra calories.
The reasons why I aspirate is calorie control. Sometimes I have a bad night and emotionally overeat. Sometimes I'm out with friends and overeat. By the time my brain registers that I'm full, I'm stuffed. Before my tube I would feel bad and sometimes compound the damage by eating more. Now with the tube, I get rid of some of the damage and do better the next day. I also work jobs where I can't move all the time and sometimes don't have access to healthy food choices. Again, I aspirate those calories. At the end of the day the A-tube is a tool. It doesn't work unless you use it. It is not a quick fix. I still can eat the foods I love.
What I love about the program is that it DOES teach you better food habits and choices. I have made a lifestyle change because of my A-tube. Watching what comes out of the tube has given me ideas of why, after eating certain foods, I still felt hungry. Certain foods I will never eat again because I can see what going on inside my body. When I started, still learning about the device, I would look at my food as it was coming out the tube. It was mostly watery and chunky. I still could name some veggies.
One day, I ate garlic bread and I noticed it was greasier than normal as I was watching it come out of the tube. It was disgusting because it stuck and clung to the tube. I could see actual
fat and I could not help but think the rest of the fat that is in my body and what damage it is doing. Is it sticking to me the way it sticking to my tube? I threw out the other half of that garlic bread.
I was grateful the tube was a mirror that day. Sometimes we eat bad choices and don't realize it or realize it and rationalize it. After the tube I couldn't do that anymore.
Aspire Assist has taught me to learn how to modify some food choices and explore others. I discovered veggies that I never would had tried before and love them. When eating foods that have higher fat, I eat smaller amounts. I learned to know the difference between mental hunger and physical (mental is worse for me personally). I am more active and blessed be to at a job that does allow me to move more.
I am nearing the end of my journey with Aspire. I have lost the weight I wanted to lose with it, plus more. I am in maintenance, so I use the device less. That makes me feel empowered because again it is a tool not a quick fix. I like it when I exercise and make good choices. I don't need to aspirate but I am grateful to have the device near me for slip ups because we all have bad days. When I do get my tube removed, the lessons I have learned from it will not go away.
Also, my body will still be way it was beforehand, with no shortened stomach or intestines removed. I am truly grateful to be a part of the study. I realize that this may
not be for everyone, what works for me may not work for you, but what works for you may not be for someone else. At the end we are all here because of the inability to lose weight with our own sheer will power. Don't knock down someone for using a method because you don't like it or understand it.

I am an “Aspire Assist” user for the last 4 years. This method should be compared to Gastric Bypass or Gastric Sleeve. Those procedures aren´t for everyone. Neither is the Aspire Assist. We all have a problem eating so we gain weight. The difference between the methods is – as I see it :
I have just a tube in my stomach. An ordinary procedure that is very simple. If I don’t want it or need it, I can have it taken out. Nothing is changed inside. The side effects mentioned above are very minor, compared to horrible ones with GP.
I need to learn how to chew my food properly. And this will automatically make me eat less. I now can realize when I am full so I can stop eat in time. I definitely can NOT binge!
Since the problem is in the head, I have time on my side to change my behavior with food, and learn how and what to eat. I am not forced to do anything if I don´t want to. The behavior change is by will.
It is NOT AT ALL that I can eat a ton of food and then just express it. The chewing is crucial. If you don’t chew – you can´t use the device. And I promise you… after 45 minutes chewing your meal, you are tired of it! And my meals, when eating mindful, is more delicious nowadays. The first period I use it to lose weight. When I reached my goal, I can use it to maintain my weight. And the body needs time to adjust.
Nobody is mentioning anything about waste to a person who eats a lot and then let it pass through the "normal" system. I just take it out a little before it passes. This is not more of a waste than the other in my eyes.
I see the Aspire Assist method as this:
The method is not dangerous! (Makes me feel safe) I can eat what I enjoy! (Makes me happy) The reward system in the brain gets satisfied! (Makes me happy) I lose weight, and I keep it! (Makes me happy)

I am an “Aspire Assist” user for the last 4 years. This method should be compared to Gastric Bypass or Gastric Sleeve. Those procedures aren´t for everyone. Neither is the Aspire Assist. We all have a problem eating so we gain weight. The difference between the methods is – as I see it :
I have just a tube in my stomach. An ordinary procedure that is very simple. If I don’t want it or need it, I can have it taken out. Nothing is changed inside. The side effects mentioned above are very minor, compared to horrible ones with GP.
I need to learn how to chew my food properly. And this will automatically make me eat less. I now can realize when I am full so I can stop eat in time. I definitely can NOT binge!
Since the problem is in the head, I have time on my side to change my behavior with food, and learn how and what to eat. I am not forced to do anything if I don´t want to. The behavior change is by will.
It is NOT AT ALL that I can eat a ton of food and then just express it. The chewing is crucial. If you don’t chew – you can´t use the device. And I promise you… after 45 minutes chewing your meal, you are tired of it! And my meals, when eating mindful, is more delicious nowadays. The first period I use it to lose weight. When I reached my goal, I can use it to maintain my weight. And the body needs time to adjust.
Nobody is mentioning anything about waste to a person who eats a lot and then let it pass through the "normal" system. I just take it out a little before it passes. This is not more of a waste than the other in my eyes.
I see the Aspire Assist method as this:
The method is not dangerous! (Makes me feel safe) I can eat what I enjoy! (Makes me happy) The reward system in the brain gets satisfied! (Makes me happy) I lose weight, and I keep it! (Makes me happy)

It's really great hearing this from an actual Aspire Assist patient! Thank you very much for sharing this info with our community.

If like to see more trials and results from 2-3 years later. I wonder if you can use this multiple times with breaks inbetween? I won't be judgemental about something that can change someone's weight and their outlook on life. I'm also thinking this could be useful for someone who needed to lose weight in order to qualify for surgery... Say knee replacement for instance.

I felt very angry and upset when first exposed to this technology a few years ago....I even wrote an article about how abhorrent the concept was.
Every time I get this angry, I start doubting my feelings. So I started researching the procedure and device and talked to a few patients that are using it. I got to know the procedure a little better, understood their expectations, needs, and results.
What I see are patients benefiting from this method with an outstanding safety profile...
Sometimes our mind tricks us with hate and anger.... I don't like this so I turn it into something more rational for me.
I recently heard a very moving presentation from one of the investigators and a patient. I personally don't know that I'd recommend it, but the truth is that now that it's approved doctors and patients will decide if this succeeds or fails.

I am an “Aspire Assist” user for the last 4 years. This method should be compared to Gastric Bypass or Gastric Sleeve. Those procedures aren´t for everyone. Neither is the Aspire Assist. We all have a problem eating so we gain weight. The difference between the methods is – as I see it :
I have just a tube in my stomach. An ordinary procedure that is very simple. If I don’t want it or need it, I can have it taken out. Nothing is changed inside. The side effects mentioned above are very minor, compared to horrible ones with GP.
I need to learn how to chew my food properly. And this will automatically make me eat less. I now can realize when I am full so I can stop eat in time. I definitely can NOT binge!
Since the problem is in the head, I have time on my side to change my behavior with food, and learn how and what to eat. I am not forced to do anything if I don´t want to. The behavior change is by will.
It is NOT AT ALL that I can eat a ton of food and then just express it. The chewing is crucial. If you don’t chew – you can´t use the device. And I promise you… after 45 minutes chewing your meal, you are tired of it! And my meals, when eating mindful, is more delicious nowadays. The first period I use it to lose weight. When I reached my goal, I can use it to maintain my weight. And the body needs time to adjust.
Nobody is mentioning anything about waste to a person who eats a lot and then let it pass through the "normal" system. I just take it out a little before it passes. This is not more of a waste than the other in my eyes.
I see the Aspire Assist method as this:
The method is not dangerous! (Makes me feel safe) I can eat what I enjoy! (Makes me happy) The reward system in the brain gets satisfied! (Makes me happy) I lose weight, and I keep it! (Makes me happy)