The Aspire Assist: Brilliant or Brutal? Surgically Assisted Weight Loss or Mechanized Bulimia?

So how do you think the boardroom table discussion went when this idea was first being kicked around?

"Um......so maybe we could make a hole in people's stomachs and then hook that hole up to a machine that hoovers up food before it can get digested?"

"Are you effin' kidding me?"

"No, I mean think about it, there are tons of people who aren't bulimic who think about being bulimic, this way we could make it all medical and stuff".

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 preliminary data's interesting. Now this isn't peer reviewed published data, just a poster presentation, but in it they describe the 11 patients who were given an Aspire Assist (that's what they're calling it) for a year. 10 of the 11 completed the year and from the poster it would appear they lost 44lbs on average.

So yes, back to the shock, horror and repulsion - I readily agree that on its surface both the premise and procedure is less than appetizing (honestly when considering this post before delving into it I had expected the post to be extremely negative), but if larger, longer, studies suggest it's well tolerated, 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 that living incredibly healthful lifestyles guaranteed desired weights (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.

Will carrying around a fake lump of fat help you lose weight?

That's certainly what the folks over at mypetfat.com want you to think.

According to them, buying a "pet" 5lb, 1lb or travel size blob of fake plastic fat will help to keep you motivated.

They recommend putting your 5lb pet in your fridge, by the cookie jar,on the table or by the scale.

What they're not telling you?

That they're selling the same anatomical fat models you'll find pretty much everywhere else but by marketing them to dieters and folks who are desperate enough to buy fat replicas to serve as table centre pieces, they feel justified in doubling the average retail price.

If you want yours, head over to the Anatomical Chart Company and buy one from them, and if you'd like to see the mypetfat site yourself, you'll have to type it into your browser as I don't want to reward their clearly predatory pricing with a link.

[Hat tip to my colleague and coworker Dr. Erik Howarth]

iPhone's new killer app food diary

Got an iPhone?

If you do and you want to track calories then there's a new kid on the block that may help. It's called Food Scanner and the premise is simple, all you've got to do is use your iPhone to scan a bar code or you can type in a food name and presto, nutritional information.

According to the creators there are already over 200,000 different foods in their database and you can of course add your own if they're not there.

For my Canadian readers, it may be worth contacting the folks at the Daily Burn to find out if it works with Canadian bar codes (does anyone know if they differ from the US?).

$0.99

If you want to see it in action you can watch the video.

(Oh, and I've got to say, while this may be the first such app for the iPhone, I can say with some certainty that it won't be the last with future apps not only able to track your food but also able to suggest healthier alternatives when you're shopping. Will cover that app when it launches.)

Jamie Oliver - the video game?

You know I love Jamie Oliver.

I even emailed his publicist once to let them know that if they were ever looking for an outspoken obesity doc to work with him, I'd be there with bells on.

Anyhow, not to diss Jamie or anything but what's up with What's Cooking? Jamie Oliver, a new game for the Nintendo DS.

I mean if you've actually got the time to sit and practice "shopping", "chopping" and "dressing the dish" on your Nintendo shouldn't you simply be cooking?

Not sure where Jamie was going with this license. Let's teach kids to pretend cook? Let's teach kids to experiment in the virtual kitchen where tastings a bit challenging? Let's teach kids to waste their time on a gaming system so that when it's dinner time there'll be no time to actually cook and they'll need to order take out or nuke something? I suspect the point was an interactive cookbook, but given the wealth of online, interactive cooking resources and Jamie's own along with lord knows how many other TV cooking shows, I'd say this is overkill.

Sorry Jamie, I love your work but this endeavour seems off to me.

Oh, and if you were wondering if it were a good game, here's what one review had to say,

"After the first few recipes, you quickly realize that this is a game of rolling through monotonous motions. Long before the game is finished, you will become very bored and have no desire to return."

Ouch.

World's most affordable treadmill desk!

$40!

Treadmill not included.

It's call the SurfShelf and this thing looks perfect. It's a simple stand that attaches to most treadmills that supports a laptop.

Walk at 1-2 miles an hour and build up your NEAT while working or pop in DVDs to watch videos while running. p

It'll also fit recumbent bikes, ellipticals etc.

Want one?

Click here!

World's Greatest Measuring Cup?

I can't imagine any other contenders.

Pour stuff in - digital measurement on handle.

Not sure about you folks but all my cheapy plastic cups end up having their side printed gradations erase over time.

It can even do imperial to metric conversions!

I want one!

[Via Engadget]

Nintendo puts out another useless "exergame"

I've blogged about the Wii before and how while it may be fun, it's far from exercise.

Today I bring you Treasure Hunt a new game for the Nintendo DS that at least one reviewer bills as,

"not only another blow in the fight against obesity, it's also a nice illustration of what our sister site likes to call the OFF=ON trend, whereby the online and offline worlds are increasingly overlapping"

To be clear, I think getting kids outside and playing is a great idea and certainly if you're going to have your kids play video games, by all means have them playing games that actually get them moving.

That said, the promotion of such games as tools in the fight against childhood obesity is ludicrous. Casually walking around in parks has about as much of a shot at landing a punch on childhood obesity as I do landing one on Mike Tyson.

[Hat tip to BMI's Director of Operations Lorne]

World's Greatest Treadmill Desk?

I love this desk. It's Steelcases's "Sit-to-Walkstation"

I've thought about building my own treadmill desk but my concern has been that certainly at times I'll need to sit.

This desk can do both (it moves).

It can be yours for "just" $4,899

(BTW, in case anyone's feeling stupidly and irresponsibly generous my birthday's at the end of August)

Sign of the Times - Ikea Video Game Playing Chair

It's called the Ikea Jesper Bench and the catalog picture above helps to explain what it's for.

I wonder when Ikea'll make an Insulin Table with refrigerated drawers, lancet dispensers and glucostrip disposal hole?

The chair can be yours for just $59.99 CAD.

[Hat tip to BMI's fitness director Rob]

An Amazing $15.99 Nutritional Stocking Stuffer!

It's called Mastercook and it's a recipe manager program.

Like many such programs it'll compile and store all of your family's recipes, it has a shopping list generator and thousands of built in recipes. However there are two things that really set this one apart for me.

Firstly it's got this great feature that allows you to cut and paste a recipe from virtually any recipe website directly into your cookbooks.

Secondly it's got a nutritional database built in and with the click of a button you can immediately get a nutritional breakdown of your recipe (calories, vitamins, carbs, protein, sugar, fibre, etc.) and best of all, it's scalable (meaning enter all of your ingredients and then enter how many servings you served and it'll scale the nutritional information down for you).

I love the program and for $15.99 CAD from Amazon.ca it's tough to go wrong (for some reason Amazon.com charges more - $18.99 USD).

If you're interested, links to both Amazon.ca and Amazon.com are below.

Don't Walk to Work, Walk AT Work

Treadmill desks hit the big time (the New York Times).

Promoted by Dr. James Levine and his NEAT (non-exercise activity thermogenesis) team as an easy means to combat obesity and adopted by world famous bloggers like bookofjoe's Joe (check out the picture down below to see Joe on his desk) now you can buy one from office furniture maker Steelcase for the not-so-low price of $4,000.

The way it works is pretty straight forward. Instead of sitting, you walk. Apparently walking at up to 1.5 miles an hour generally doesn't cause you to break a sweat and still allows you to type, mouse and talk normally.

My advice?

If you're interested, instead of forking out the big bucks pick up a used treadmill with arms on your local Kijiji or Craig's List and jerry-rig your own version on the cheap.

Here's Joe on his:

Tell Time with Chocolate

Seen by me first on Gizmodo I bring you the "Chococlock".

Who doesn't need a clock that every hour on the hour spits out a ball of chocolate to the tune of the Dance of the Sugar Plum Fairy?

If that's not enough you can hit bypass and it'll spit them out every second.



From the product page,

"Despite its silly premise, this kooky clock can actually assist in the workplace (stick with us here). Simply use your hourly chocolate treat as an incentive and that annual report will be finished in no time. "

Ingenious?

Want one?

$37 by clicking here.

We're all Doomed!

So Rob our fitness director sent me this video and I watched it duly amused figuring it to be a satire of just how lazy our world has become.

I was wrong though.

It's not a satire.

It's real.

Today for Funny Friday I bring you Interactive Toy's remote controlled cooler.

Click here to buy your very own - only $79.

Have a great weekend!

Please Don't Buy this for your Child

Just what every child needs - a scooter after all, walking's for suckers.

Buy this for your kid and you can feel confident that you're setting them up for needing one of these as an adult.

[Via Gizmodo]

World's Greatest Star Wars Product

I know, I know, TV's bad and contributes to obesity and so do video games.

I don't care.

I want one of these!

(Yes, I'm a nerd)

Any remarkably generous multi-millionaire readers out there who want to donate one?

Only $2,9995.

Stupidest Products Ever or Brilliant Exercise Inventions?

I'm at a bit of a loss here.

As far as I'm concerned, it's not just one incredibly stupid product, it's a whole incredibly stupid product line.

Treadmills, exercise bikes and cross trainers for children ages 3-8.

Gymkids is the braintrust behind the idea.

And these things aren't cheap. $200 or so per product.

Now I'm not knocking kids exercising, but why can't a parent just buy a kid some shoes and play with them? Or a bike? Or a jungle gym?

Gymkids explicitly states on their website that, "Supervision by a responsible adult should be undertaken at all times."

I would love to meet the parents that actually sit around watching their kids walk on itty-bitty treadmills instead of playing with them.

My wife suggested that perhaps it was for parents who themselves use home gyms so if the parent was working out, the kid could too - That said, can you picture a 3 year old running on a treadmill for any sustainable length of time?

Do other people think these are ridiculous or am I being overly critical?

The Incredible Eating Reminder Gizmo

One of the most basic tenets of successful weight loss and weight maintenance is that if your life includes hunger, success is going to be a huge challenge.

Hunger is one of the most basic human drives. Hundreds of millions of years of evolution have taught us to eat when we're hungry, and guess what, it's also taught us what foods have calories. We don't crave green leafy salads when we're hungry.

One of the best and easiest ways to minimize hunger in your life is to ensure that you practice pre-emptive eating. Eat before you get hunger and you'll have a much easier time controlling portions and choices.

Problem is, there's no internal cue to tell you to eat before you get hungry.

I've often recommended to patients that they buy watches that beep at them when it's snack time (I recommend no more than 3 hours between meals and snacks). Only thing is, those watches are kinda ugly.

In comes a patient with a brilliant solution. She bought a vibrating alarm pillbox. It's got five alarms and it's easy to set. She keeps hers in her pocket and when it vibrates, she eats.

I found one on Amazon.com for $14.95 and it's linked here:

Great idea!

Like-a-Bike

It's not a bike, but it's like-a-bike.

My wife wouldn't let me buy one, she said it was too expensive.

Basically picture a small, toddler friendly bicycle with no pedals. By using their feet, children are able to propel themselves forward and by lifting their feet up, they're able to start to learn how to balance.

Apparently kids who use these basically graduate to two-wheelers and skip the training wheels.

On the website there's a great video of a kid tooling around on one.

I may have to buy one without my wife's permission.

The Wee-Ride

As the newspapers will tell you virtually daily, childhood obesity rates are growing rapidly. Parents will often call me to ask me what they should do about their overweight kids and generally my answer's always the same - treat your lifestyles.

Kids are not going to live lives different from their parents. Live the life you want your child to live, and that includes healthy regular eating with no meal skipping or snack skipping, calorie awareness and exercise.

Perhaps the easiest way to exercise is to focus on what I often call "Functional Exercise" rather than gyms, and perhaps one of the best functional exercises is going out for family walks or bike rides.

The Wee-Ride looks like a great option in place of one of those rear baby carriage thing. With the Wee-Ride you can talk easily with your child while riding and not have to worry about what's going on behind you. You can also buy an additional mounting bar so the Wee-Ride can be swapped between parental bikes.

Remember of course, once your child is old enough to ride, a better option would be their own bike.

Tomorrow I'll post on a great bike related product for toddlers.

Geek-a-Cycle

Hot on the heels of bookofjoe's treadmill desk comes the self-proclaimed "Geek-a-Cycle".

Touted as a means to pedal your way to a healthier you.

May not cause dramatic weight loss, but certainly ala Dr. Levine's NEAT hypothesis of weight management, it certainly can't hurt.

Yours for just $349.95, computer equipment not included.