Food and sex without consequences.

Science, technology, and life.
Nov. 24 2006 11:50 AM

Girth Control

Food and sex without consequences.

Did you enjoy stuffing your Thanksgiving turkey? I hope so, because right about now, you're probably regretting where you stuffed it. This is the time of year when we pat our bellies and wish we could eat without gaining weight.

Well, maybe we can.

William Saletan William Saletan

Will Saletan writes about politics, science, technology, and other stuff for Slate. He’s the author of Bearing Right.

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Our ancestors would have been thankful to have our problem. They spent their brief lives scrounging for enough sustenance to fend off starvation. But once our species developed the technology to feed itself, our taste for fat and our talent for storing it turned against us. We fumbled with elixirs, corsets, and quack diets. Science made diets more effective, but we still hate them.

If only we could manage food the way we've managed sex. Sex, like eating, is fun, and for good reason. Food nurtures us to maturity and keeps us alive so we can procreate and raise children. Sex passes on our genes. If food and sex weren't fun, you wouldn't be here. But in the age of abundance, these appetites are out of sync. Infant and juvenile mortality have plummeted. You don't need to get pregnant all the time to raise enough kids. You'll end up with too many if you let nature take its course. So we invented birth control.

The point of birth control is fun without consequences. You still want sex, and you still get it, but we tinker with the process so you don’t get pregnant. Last week, the U.S. Conference of Catholic Bishops complained that separating sex from procreation violates nature. Of course it does. Nature put the fun and the consequences together, but for reasons that no longer apply. Nature has produced a creature clever enough to take nature apart. We get the orgasms without the organisms.

Why not try the same with food? Keep the fun and lose the consequences. We invented birth control; why not girth control?

In fact, we're already working on it. Food abstinence, like sexual abstinence, was the original option. Then came the rhythm method: no snacking between meals. Randy teens fortify their resolve at True Love Waits; hungry adults do it at Weight Watchers. To relieve the hots, there's safe sex; to relieve the munchies, there's SlimFast. With foams and jellies, we can kill sperm in the reproductive tract; with lipase inhibitors, we can neutralize fat in the digestive tract. The pill blocks pregnancy by fooling your body into thinking it's pregnant; appetite suppressants curtail eating by making your body think it's full.

Even barrier methods are crossing over. To control fertility, you can insert a diaphragm or vaginal ring; to control obesity, your doctor can slide a gastric balloon down your esophagus. Once inflated in your stomach, the balloon takes up space so you eat less. Thousands of people are walking around with these balloons; many thousands more are wearing implanted gastric bands that constrict their stomachs. Last month, doctors proposed the digestive equivalent of a female condom: a sleeve that would be shoved up your intestines to block calorie absorption.

The girth control debate, like the birth control debate, pits chastity against practicality. Idealists point out that exercise, a balanced diet, and self-restraint are the best ways to control weight. Realists point out that diets, like abstinence, fail because people don't stick to them. The weak link is willpower, and the focus of current research is how to get around it.

The most obvious answer, as we learned with birth control, is surgery. Eight years ago, 13,000 people had operations in which doctors constricted, cut up, or removed parts of their stomachs or intestines. This year, the number of surgery patients will exceed 200,000. The stomach portion of these procedures is called "restrictive" because it reduces the amount you can eat. The intestinal portion is called "malabsorptive" because it bypasses your bowels so you don't absorb fat or calories. Food goes right through you.