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There’s a new weight loss regimen that trumps almost all other extreme diets in terms of ill advisability and downright cartoonishness. The K-E Diet has doctors putting feeding tubes into healthy people – usually young women before their wedding days – to help them lose weight: Up to 20 pounds in 10 days. The “patients” tote around a solution in a bag or purse, which delivers fats, protein, and water (no carbs) through the nasogastric tube into the stomach. Patients consume about 800 calories a day, and do not eat any actual food over the 10-day period.
To put it lightly, there are a few issues at play with the diet, which range from medical to ethical. The K-E diet puts the body into a state of ketosis, where it is burning fat instead of carbohydrate. In the short term this isn’t so bad, but might lead to bad breath and stress the liver and kidneys. Healthy people will generally rebound from this short bout of ketosis, but might be fatigued, or constipated from the lack of bulk and fiber in the solution.
The bigger issue is the fact that the diet pushes us further into the any-means-possible attitude toward weight loss. David L. Katz, MD, MPH, founding director of Yale University’s Prevention Research Center, voices his serious concerns about the diet, underlining that “it is appalling… because it opens up a whole new world of shockingly bad ideas.”
Since we’re willing to go the feeding tube route (which, by the way, is generally a medical procedure for people who cannot eat for legitimate reasons, and is not terribly pleasant), why not use other dramatic medical methods, Katz asks. “Why not medically controlled anaphylaxis for weight loss?” he wonders. “Why not a medically induced coma/anesthesia for weight loss? There is truly no limit to our weight-loss idiocy, and the willingness of the unscrupulous to capitalize on it.”
Another issue is that because weight loss happens so quickly in the K-E diet, it’s a virtual guarantee that it will come back on later. It’s a Band-Aid solution to the larger problem. Weight loss works over the long term only when one actually changes the behavior and lifestyle choices that led to overweight in the first place. “In terms of quick weight loss,” adds Katz, “it is a guarantee of quick rebound, since it involves no useful behavior change whatsoever. It has nothing at all to do with health, and basically endorses the notion that weight loss by any means is acceptable. If that is so, I recommend a 10-day cocaine binge. It will work as well, and probably be more fun, than a nasogastric tube.”
Finally, the obvious ethical issue deserves some attention. What doctor would in good conscious give a feeding tube to an otherwise healthy patient because he or she wanted to lose weight for an event? “The job of physicians is not to come up with any way to satisfy a patient’s whim no matter how fundamentally at odds with health. Our professional mission is to promote and protect health – and to serve the patient IN THAT CONTEXT.”
It’s a sad situation when doctors agree to dramatic medical methods to please their patients. “We are abdicating our profound responsibilities and most sacred pledges,” says Katz, “ when we renounce a commitment to health, and adopt an ‘oh what the hell…’ approach. It is a disgrace. Again, I think this opens up whole new roads in the realm of shockingly irresponsible idiocy on the part of doctor and patient alike. On behalf of my profession, I am ashamed.”
It’s hard to imagine that this method is in line with the Hippocratic oath that doctors take as they begin their careers. If the feeding tube diet becomes an acceptable form of weight loss, what methods will follow?
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