Pain, No Gain? Operant Conditioning Pain Patch

Pain, No Gain? Operant Conditioning Pain Patch
2010 03 02

A controversial new weight-loss technique has tongues wagging — and feeling tender.

The medical procedure involves stitching a small piece of polyethylene mesh onto a patient’s tongue, making it painful to ingest solid foods and forcing a low-calorie, liquid diet.

"The patch is a pattern interrupt," said Dr. Nikolas Chugay, the California-based plastic surgeon who developed the concept. "It is uncomfortable to eat solid foods, so people will all of a sudden remember, I am only to eat liquids."

The medical procedure involves stitching a small piece of polyethylene mesh onto a patient’s tongue, making it painful to ingest solid foods and forcing a low-calorie, liquid diet.

Since last September, Chugay says 35 people have opted for the surgery, resulting in an average weight loss of 20 pounds (over the one-month period the postage-stamp-sized piece of fabric stays stitched on).

"These are people who have been through . . . every conceivable diet; they’ve tried everything and for some reason they just cannot stop eating," he said, adding that the odd patient is looking to shed unwanted weight for special occasions, such as weddings.

The patch wearer is put on a diet of 750 calories a day — about half the consumption amount suggested for the average adult female and one-third the amount for the average adult male. Patients also come in for weekly assessments that include a psychological consult and a diet and exercise plan.

"It gives us a chance to train the patient how to eat right, how to exercise right . . . so when they take the patch out, they will continue on a diet that is sensible," said Chugay.

And it doesn’t come cheap. The 10-minute surgery — performed using a local anesthetic to attach four to six sutures in the direct centre of the tongue — costs about $3,000 U.S..

But critics of the tongue patch have called the procedure "barbaric" and "medieval" and "unnecessarily cruel."

"I don’t think pain is the way to try to encourage people to change their lifestyles," said Dr. Yoni Freedhoff, an Ottawa-based physician who specializes in bariatics, the management of obesity.

"If there was a quick and easy way to do this, we’d all be skinny . . . The notion that pain is required to teach these people what to do is not only a ridiculous assertion but unnecessarily cruel."

Freedhoff says it takes one to three years of "consciously working" at a new behaviour to forge it into a habit.

"Having a device in your mouth that causes you temporary pain when you eat will likely cause a temporary reduction in weight as you stop eating," he said. "Once that device is removed from your mouth — like all diets that involve suffering — almost certainly the weight will return when you go back to the lifestyle you had before you had the medieval torture device installed in your mouth.

"I really can’t think of any other thing in medicine where we (purposefully) evoke pain . . . To me, it sounds like medical madness."

But Chugay rebuffs his fault-finders, saying the procedure is safer than extreme measures such as gastric bypass or liposuction.

"There is nothing barbaric about it . . . It’s a very gentle, non-invasive procedure," he said. "It is not a standard diet procedure; you need to start on your own, make an effort. But if you can’t and you really need to lose the weight . . . this is the next step."

Article from: VancouverSun.com

Video from: YouTube.com

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