Food and sex without consequences.
Restrictive procedures are supposed to limit your intake by making you feel full. But lots of people cheat. You can stretch your reduced stomach by eating past the point of fullness. You can keep refilling it with high-calorie liquids, which may be why gastric bands and balloons haven't worked as well in Americans as in Europeans. Some doctors even offer to "readjust" your band so you can "relax more on holiday."
The most common stomach-intestine surgery, gastric bypass, is supposed to deter cheating by exposing you to " dumping syndrome," a punishment inflicted by your body if you eat too much sugar. But you can escape that penalty by resorting to intestine-focused procedures: biliopancreatic diversion (BPD) or duodenal switch (DS). Both procedures leave you with a stomach three to six times bigger than you'd get from a gastric bypass. "There is no incidence of the 'dumping syndrome,'" and within 18 months, "the stomach will have stretched out to almost normal size, allowing the DS patient to eat very well," notes one purveyor. Another advertises that BPD "allows the morbidly obese patient to lose the excess weight without changing the eating behavior."
How do these surgeries let you pig out and still lose weight? By cutting 80 percent of your absorptive small intestine out of the digestive tract. The more you cut out, the less food you absorb. That's why gastric bypass sheds more fat than bands do—and intestinal surgeries shed even more. Reports indicate intestinal procedures are spreading. This year, surgeons persuaded the federal government to pay for them under Medicare.
Intestinal bypass is no picnic. It's traumatic, and it means taking supplements for the rest of your life. The ideal solution would be to find the same benefits in a pill. Wouldn't you know it, two studies have come out this month suggesting that a compound called resveratrol neutralizes the harmful effects of a high-fat diet in mice. "Guilt-free gluttony might not be a fantasy," scientists concluded in Nature.
Think about that as you try to sweat off this year's turkey. Maybe next year, you won't need an ounce of self-discipline to keep off the pounds. Something to give thanks for. Or not.
Will Saletan covers science, technology, and politics for Slate and says a lot of things that get him in trouble.
Photograph of an obese woman on Slate's home page by PictureArts.