From Mental Illness to Personal Responsibility: A Technological Transformation of Bulimic Purging

The continuing crusade against overweight and obese individuals has taken yet another bizarre and grotesque turn with the unveiling of “AspireAssist”, a personal “stomach pump [that] sucks food out of the user’s belly before the body can fully digest it”.

AspireAssist

Such a development is not all that surprising. The so called obesity epidemic has transformed ethical and social norms to position those with bodies, habits or attitudes that represent obesity as fair game – the hunting metaphor is apposite.

The state of emergency that is the obesity epidemic has seen public health advocates earnestly recommend that obese children be placed in foster care, bioethicists argue that obese adults should be stigmatised and discriminated against, and hospital CEOs suggesting it is acceptable to refuse to hire overweight or obese people.

In this milieu of panic and desire for strategies that “really work”, AspireAssist has developed a personal stomach pump. The video on the ABC News website is more detailed, but the clip below is clear enough.

According to AspireAssist it “works by removing a portion of the food from the stomach before it is absorbed”. By using AspireAssist 20mins after eating, the pump removes 30% of the stomachs contents to reduce the amount of calories, nutrients, fats etc absorbed by the body and thereby making the individual slimmer. My interest in AspireAssist is not the extraordinary and ethically questionable attempt to normalize bodies to conform to artificial measurements such as the BMI. But the way this technology transforms a practice that most medical professionals characterise as a mental disorder.

This act of removing the contents of the stomach to achieve the goal  “normal” weight and body image is not dissimilar to bulimia nervosa, a condition that since the 1980s has been regarded as a mental illness. The DSM-IV describes individuals with bulimia nervosa as engaging “in inappropriate behavior to avoid weight gain (e.g., self-induced vomiting), and are overly concerned with body shape and weight. However, unlike individuals with anorexia nervosa, binge-eating/purging type, individuals with bulimia nervosa maintain body weight at or above a minimally normal level.”

For an individual to excuse themselves from the table to go and vomit in the toilet 20mins after sharing a meal with friends would be, according to the DSM-IV,  inappropriate. Such behavior ordinarily invokes social concern and justifies medical intervention. However, the technology of the stomach-pump transforms medically defined deviance (purging) into medically approved compliance. Performing a near identical function to purging, the use of the personal stomach-pump does not incite medical intervention as it is the medical intervention and it does not invoke social concern as it is a response to the social concern of obesity.

AspireAssist’s stomach pump probably won’t become a common tool. The panopticon was not widely implemented either. But like the panopticon, the personal stomach-pump represents a rationality of a specific (bio)political moment in which the bodies of individuals are considered to pose such a threat to the population (and themselves) that spectacular interventions are justified that transform the logics of pathologies into the logics therapies.