What to Expect

What to Expect


01: Is the AspireAssist Right For Me?

You and your doctor should decide together if the AspireAssist is the right choice for you, based on your overall health, lifestyle, weight loss goals, and other factors.  Although many people find it to be a very effective tool for weight loss, remember that any weight loss method requires commitment and hard work.  Below are some things to consider carefully before choosing the AspireAssist.

You must be committed to making a complete lifestyle transformation

Eating behavior is associated with emotional and environmental triggers. To achieve your fullest potential with this therapy, you will need to address these issues. To make this transformation, various support resources are provided, including individual lifestyle counseling and/or patient support groups, and an online community forum. You must be an active participant in some or all of these activities, and open to working with your clinic and other patients throughout your transformation. Over time, the most successful people on the AspireAssist learn to select healthier foods, reduce portion sizes, and incorporate regular physical activity as they begin to lose weight. Snacks and high-calorie beverages such as beer or soda are often not aspirated, so you will need to limit your intake of these items to a healthy level and select low-calorie alternatives.

IT TAKES TIME TO ASPIRATE

Once you become proficient at aspirating and chewing well, it takes 5-10 minutes to aspirate a meal. In the beginning, however, it may take longer to aspirate each meal. Prior to getting the AspireAssist, you should make sure that you can fit regular aspiration after each meal into your schedule. Consider your schedule at work, at home, on weekends, and with your family or friends. Although missing an aspiration occasionally is OK, the most successful patients aspirate three times per day, almost every day.

YOU WILL NEED TO CHEW CAREFULLY

Large pieces of food will not fit through the tube, so in order to aspirate effectively, you will need to learn to chew each bite completely. While this may seem simple, changing the way you’re chewing (or any lifelong routine) is a challenge and take time to learn. Chewing thoroughly means meals will take longer to eat, but it will also help you become more mindful when eating. Successful AspireAssist patients report that thorough chewing helps them reduce portion sizes and stop eating when they are full.

CONSIDER YOUR SUPPORT NETWORK

It is important to involve your family and the people closest to you. You will need the support of the people around you throughout this process of change. They are a major influence on your health behaviors – such as supporting your efforts to become more active and eat more healthfully, and taking time away from your usual activities to aspirate.

ALLOW TIME TO RECOVER FROM THE PROCEDURE

The procedure recovery is generally quicker than with invasive bariatric procedures. Most patients return home the same day, but some experience significant pain for the first 2-3 days. This pain can generally be managed with medications, but you may need to take a couple of days off of work or other responsibilities to allow yourself to heal.

YOU’LL HAVE REGULAR DOCTOR’S VISITS

Your physician will ask you to return to his or her office every month or two in the first year (and less frequently thereafter) to monitor your progress, check your electrolyte and other blood levels, and make sure your Skin-Port site is healthy. If you have a busy work or family schedule, or live far from your doctor’s office, consider whether you can commit to the level of care required for this therapy.

 

02: Normal, Healthy Lifestyle

Losing weight shouldn’t take the fun out of life – the occasional dinners out with friends, a glass of wine with dinner, or a home-cooked meal with your family. With the AspireAssist, there are no specific restrictions on what and when you can eat and drink, although moderation is important. As you start to lose weight, you will gradually learn how to make healthy choices to match your leaner, healthier body.

The AspireAssist is a helping hand in your weight loss journey, but you will need to be committed to making this transformation! With the AspireAssist, the key to your success will be aspirating regularly after most major meals. For the most successful patients, it becomes part of their regular routine, like brushing their teeth. You will also need to learn to chew your food carefully and drink plenty of water to make sure your foods will aspirate easily.

Patients will also learn healthier behaviors through the lifestyle modification program. For many patients the early weight loss success, combined with the lifestyle modification program, encourages them to adopt a healthier lifestyle over time. Additionally, the AspireAssist may reduce the stress and anxiety around eating, further contributing to increased feelings of confidence around food and healthy eating.

03: What to Expect After the Procedure

The weight loss journey with the AspireAssist is different for everyone. This section will give you a general idea of what you can expect with this therapy in the first few days, weeks, months and beyond.

Recovery Stage (First 1 to 3 Days after the Procedure)

You have just embarked on a journey that will positively change your life and you are undoubtedly excited to get started! First though, you need to let yourself heal. Over the next week or two, the stoma, or the newly-created pathway where the tube is placed, needs to settle around the tube, much like your skin heals around a newly pierced ear. Most patients return home within an hour or two after the procedure. Your doctor will prescribe pain medications and antibiotics for you to take at home. You may experience some pain or discomfort in the first few days, but the medications will help. Patients can usually begin showering two days after the procedure, but your doctor will give you specific instructions based on your health and progress. You will also be given instructions on how to care for the stoma site.

Healing Stage (Day 3 through 10)

Your healthcare team will continue to check on you to make sure you are healing appropriately. Patients generally return to work and resume regular activities within a few days, but it is likely you will experience some abdominal discomfort during this healing stage. Although you will have resumed your daily life, you should make sure you are caring for your stoma site and taking any medications as prescribed. By the end of this stage, your stoma site should be healed, and you’ll be able to take baths, swim, and exercise fully. 

Skin-Port Attachment (Day 10-14)

After 10 to 14 days, you will return to your doctor’s office to have the Skin-Port attached to the A-Tube, right at the surface of your skin. This only takes a few minutes and is completely painless. You may begin using the AspireAssist immediately after this attachment. Your healthcare team will show you how to use the AspireAssist successfully, including when and how to aspirate effectively. This is a perfect time to begin your Lifestyle Modification Program and begin making gradual changes to your diet and exercise habits.

After this appointment, you will take the AspireAssist Starter Kit home with you. This kit includes: 1) the Companion, a small device (about the size of your palm) that helps the food drain from your stomach, 2) related accessories, and 3) a small Carry Bag to store the device. The Carry Bag is small and discreet so it can be carried in a purse or briefcase. You should begin taking the Carry Bag with you at all times to make sure you’re prepared to aspirate whenever you eat a meal. 

04: What to Expect in the First Year

GETTING STARTED WITH THE ASPIREASSIST (MONTH 1)

In the first month, many patients see weight come off very quickly! The target weight loss is about 1 to 2 pounds per week, but weight loss is likely to be even more rapid during the first few weeks. Each person’s journey will be very different, and it may take some time to get used to the device. During this time, you will begin learning how to fit it into your daily routine and how to be comfortable using the AspireAssist. By the end of the first month, patients may feel more energetic and in control of their health already. Your clothes might be fitting looser, too!

You will also be monitored carefully by your doctor to make sure you are losing weight successfully and in a healthy way. Most patients will have a follow-up visit with their physician a few weeks after starting the AspireAssist. During this visit, your healthcare provider may also shorten your tube, to adjust for any weight loss around the tube site.

During this time, you may also become involved in a support group with other patients using the AspireAssist. These groups are an excellent way to stay motivated, learn from each other and stay on track throughout your journey!

CONTINUING TO SEE RESULTS (MONTH 2 – 6)

Rapid weight loss will continue if you aspirate regularly! By now, you should be aspirating more quickly and effectively. You will have established a routine that incorporates where and how aspirating fits into your day. This is the time to focus on aspirating after every meal, about 2-3 times per day. It is important that you continue to be monitored regularly by your healthcare team. Patients generally return to their physician’s office about once a month for a checkup. These visits may include blood tests to be sure your electrolyte and other blood levels stay in a healthy range, and A-Tube shortening as needed.

By the end of six months, patients who aspirate regularly lose about 40% of their excess weight. With these dramatic changes in weight, many patients begin to make positive changes in their lifestyle. Through the lifestyle modification program, you will learn to make better food choices and slowly increase your physical activity levels. Over these few months, you will likely drop a size or two. Reward your hard work by shopping for some new clothes!

FOCUS ON POSITIVE LIFESTYLE CHANGES (MONTH 6 – 12)

For many patients, weight loss continues at a slower pace after 6 months. With reduced body weight, you will need to decrease the amount of calories absorbed by your body to continue losing weight. Aspirating regularly now is more important than ever. This is a great time to focus on making lifestyle changes towards a healthy, balanced life. Exercising will be easier than ever with a leaner body, and your lifestyle counseling will arm you with many tools to develop healthier eating habits.

Although your physician will continue to monitor your progress, physician visits will usually become less frequent after six months. Skin-Port shortening will also be less frequent now. Many patients achieve their goal weight loss by the end of their first year by continuing to aspirate regularly and making gradual changes in their lifestyle.

05: Maintaining Weight Loss

Maintaining Your Success (Year 1 and Beyond)

Once you’ve reached your goal weight, you need to stay focused on maintaining your weight loss! After one year, many patients find they are eating more healthfully than ever – eating smaller portion sizes, incorporating healthy, nutritious foods into their diet and limiting snacking. With these new eating habits, many patients can maintain their weight loss with less frequent aspirations – once per day or less. For others, they will begin to gain weight if they reduce their aspiration frequency. You and your healthcare team will work together to figure out what works best for you.

Although your physician visits will decrease after the first year, your healthcare team will continue to monitor your progress periodically. If you have a patient support group, maintaining contact with this group after one year will be important to staying motivated to keep the weight off long-term.

Removing the AspireAssist

Some patients may wish to have the AspireAssist removed after they have reached their weight loss goals. If you have made significant changes to your lifestyle, this may be possible without weight regain. We recommend that all patients stop aspirating for at least three months before having the AspireAssist removed, to determine if they can maintain their weight loss without it. Many patients choose to keep the AspireAssist in place to ensure that they maintain their weight loss.

06: Frequently Asked Questions

Q: Do patients eat more to compensate for aspirated calories?

There is no evidence in our clinical studies of patients using the device as an excuse to eat more, or eating more to compensate for aspirated calories. In fact, clinical data indicate that patients exhibit better self-restraint, less disinhibition, and no tendency to binge eat. These results suggest that many obese people eat excess calories because of environmental influences (stress, social activities, desire to taste specific foods etc.), rather than a signal from their bodies to eat a certain amount of calories every day.

Q: Is the AspireAssist permanent?

Lifestyle Therapy is given in conjunction with the AspireAssist so patients can gradually learn healthy eating and exercise behaviors while they are losing weight. For those patients who are successful in modifying their lifestyle sufficiently, the tube can be removed without re-gaining weight. Our trials show that most patients who start this therapy elect to continue it to ensure that weight loss is maintained. However, if the AspireAssist is needed to maintain weight loss, it is likely weight regain will occur if therapy is stopped.

Q: Do patients get enough nutrients while using the AspireAssist?

Aspiration only removes about a third of the ingested meal, and food removal is uniform. It effectively provides “portion control” without deprivation, so it’s similar to being compliant with a reduced calorie diet. Additionally, patients are monitored carefully for nutrient or electrolyte imbalance, and to ensure that weight loss occurs at a healthy rate.

Q: Why does the system only remove 30% of the calories?

After a “complete” aspiration (when food stops draining), about 70% of the calories are still left in the stomach or intestines. This happens for several reasons: 1) some food has already been passed to the small intestine for absorption; 2) the tube sits mostly in the upper portion of the stomach so food in the bottom portion of the stomach is not aspirated; and 3) some food may not fit through the tube. Our studies have shown that patients attempting to completely empty a meal can remove about 30% of the calories on average.

Q: Are infections a problem?

In clinical studies, we have seen no major infections, but have seen occasional minor infections which were resolved with conservative treatment. As with PEG tubes, the body “heals” around the implanted tube, reducing susceptibility to infection. Patients are instructed to regularly inspect their site for redness and inflammation and contact their doctor if they notice any change.

Q: How is this different from bulimia?

Bulimia is a psychological illness characterized by excessive and uncontrolled binging episodes followed by purging. Bulimia is medically unsupervised, while the AspireAssist is used under the control of a physician and electrolytes and metabolites are carefully monitored. The AspireAssist does not cause bulimia. Successful aspiration requires careful chewing and slower eating, which is quite opposite from an uncontrolled binging episode. One of the primary dangers of bulimia is the damage to the teeth and esophagus due to stomach acid; the AspireAssist poses no such risk.

Additionally, there is little overlap between people with bulimia and obesity. Patients who wish to begin therapy with the AspireAssist will undergo screening for bulimia and other psychological illnesses to make sure they are eligible for therapy.

Q: Can patients do normal activities, like take a bath or swim, with the AspireAssist?

Yes, once the body has healed around the tube, people with the AspireAssist can swim, exercise, or engage in other activities that are part of normal daily life!

Q: When will the AspireAssist be available?

The AspireAssist received CE mark approval for sale in Europe in December 2011, and is now available on a limited basis in Europe and select additional regions. The AspireAssist is currently an investigational device in the U.S., and is not commercially for sale within the United States. Although we expect to seek FDA approval in the future, we do not know when it will be commercially available in the US.

07: Success Stories

See what AspireAssist users are saying about their weight loss journeys, and how they achieved success with the AspireAssist!