When bias guides research


Content warning: discussion of weight loss, weight loss methods

Researchers at the University of Otago in New Zealand announced on June 28 they had developed a new world first: a magnetic lock that effectively wires a jaw shut leaving users to rely on a liquid diet so they can kickstart weightloss.

You can read all about it here on this Twitter thread, the university’s website, and the journal which published their results. The researchers say their goal to provide a tool to address the global obesity epidemic.

Rapid weight loss causes physical harm. There’s a reason wiring jaws shut fell out of practice, the outcomes weren’t great, and included long term dental and mental health issues. While there has also been an uptick in surgical interventions (gastric bands, sleeves etc), there have also been post operative issues to manage as well.

The Twitterati have been vocal, with multiple comparisons to chastity belts, racks, and other medieval implements of torture. Others have highlighted the ethical, social and medical issues such research seems to have overlooked.

The researchers recruited seven healthy (oh the irony) obese females. Six completed the study (one left for reasons unrelated to the study). All of the participants regained some weight (about .73 kg average) in the first two weeks after the device was removed. Information about their weight status six months or a year after the study was completed was not included in the journal article.

The study met the university’s requirements for ethics approval. Despite the limited number of participants and the short time frame of the study (two weeks), the researchers felt comfortable enough with the results to propose expanding their research to include a gender balance. As well, they proceeded to modify their device (make it smaller, less obvious etc) to improve acceptability and tolerance.

The study raises significant red flags. Other studies with low numbers of research subjects (can I remind you of the infamous Lancet study on vaccines and autism?) have contributed to significant negative impacts on public health. The study does not disclose any conflicts of interest, but we do not learn who owns the patent on the device or how much they plan to sell it for.

The supports provided the six participants are also not usually those provided routinely to other obese individuals who are told to lose weight. The authors said participants had access to a dietitian, were supplied with liquid meal replacements, and had access to dental care and medical supervision. Obese individuals often have to pay for similar services/options.

I suppose I should be cheered by the fact that so many people have come out against this news. However, the fact that someone thought this was a good idea in the first place and it received ethical approval is quite disturbing. The authors recommend repeated cycles to aid momentum. I think this suggests a devolution into disordered eating with frequent gain/loss cycles.

I sincerely hope this device is investigated not as a welcome medical intervention but as a dangerous tool. There has been ample work looking at the roots of obesity and the kinds of supports needed to support individuals in nourishing their bodies appropriately, beginning with the social determinants of health. There is nothing new or innovative about this technique as it is merely a less permanent form of jaw wiring. It is, however, an excellent way to promote weight stigma, eating disorders and increased physical, mental and oral health issues in otherwise healthy people.



LEAVE A REPLY

Please enter your comment!
Please enter your name here