Is Otago University's new dieting device really just a human muzzle? / Hilary Willett
A few years ago, I worked at a pet shop. I’ve always loved animals. My daily routine included meeting a lot of people who adored their pets. Some pet-lovers would have spent the day showing me photos of their animals in brand new sweaters, wearing Christmas headbands, or eating birthday “cakes” made from sausage meat. These people loved their animals. Eventually, I had pet “regulars” as well as people. They knew the minute they saw me that they needed to sit, stand, or roll over because I had the good treats. This brought their humans joy; they loved seeing their animals so happy and excited. For anyone who is needing a dose of the best of humanity, it can be found in a pet shop.
However, not all interactions were easy. Sometimes in a pet shop, you also saw the hard edge of caring for animals. Perhaps there were behaviour issues. Perhaps there was sickness. Perhaps the owners were facing the realities of their animals growing old. Whatever it was, most visitors to the pet store were deeply concerned whenever there were issues with their pets.
Behavioural issues were the hardest. Anyone who has worked with animals knows that personality, genetics, and experience can just make behaviour management really hard. In those moments, reassurance and gentle education was the whole job. “No, your dog isn’t just a bad dog. See his ears and tail? He’s afraid.” “No, your cat doesn’t hate you. He’s hiding because you just moved; he needs to get used to his environment.” More often than not, with a few minor adjustments, the animal would come around. Unfortunately, in some situations, the animal had significant behavioural issues that could put others at risk. In those cases, the conversations became harder.
Talking about muzzling an animal is, usually, the last resort. Any pet shop worker worth their salt will try every other option first. The reason: animals hate it. Pet shop workers know this. It is a deeply unpleasant experience for everyone. Even unwanted facial contact is upsetting for animals. Putting a muzzle on an animal is upsetting for owners and the pet. The animal would do nearly anything to get out of it. The owner often became distressed during a fitting. In these moments, it was our job to reassure the owner that the animal can still breathe, eat, drink, pant and so on. We would give follow-up details of animal behaviourists in the hopes that the muzzle would be temporary. No one wants the muzzle. The only reason for them, ultimately, is because the animal is a danger to others.
Imagine my surprise then, upon reading a press release last Monday that gleefully promoted a muzzle for humans.[1] The reason for this muzzle: to fight the “obesity epidemic”. “DentalSlim Diet Control” is a device developed by researchers from the University of Otago to ensure human compliance with liquid diets. Using magnets and “custom-manufactured locking bolts”, this “cutting edge” technology locks a human being’s mouth. People who wear the device are unable to open their mouths wider than 2mm. Less than many muzzles, actually.
This DentalSlim device passed all ethics protocols at the University of Otago, seemingly without a hitch. This was perhaps because the straight-figured researchers (mostly dentists) assured their ethics committee that the plus-sized people fitted with the human muzzle would still be able to speak, breathe and drink—uncannily familiar to my pet shop reassurances. This was enough; ethics approval was granted. Eureka.
Putting aside the concerns that a human muzzle might illicit in your average non-academic, I decided to keep an open mind and actually read the research. Perhaps a human muzzle had some benefits. Fortunately, the scientific article was helpfully included at the bottom of the press release.[2] For anyone interested, “An intraoral device for weight loss: initial clinical findings” was published in the British Dentist Journal on the 25th of June, 2021. Once again, the concept of a human muzzle didn’t seem to raise any concerns.
The introduction in the abstract set the tone: “Obesity is a global epidemic, increasing the risk of many associated health issues.” No debate for these researchers. Dentists know all about obesity. Engaging with any of the research that is thoroughly questioning the assumption that larger body mass equates to poor health is for suckers.[3] In this article, obesity is an open and shut case. Preferably shut, with custom-manufactured locking bolts.
The aim of the DentalSlim trial was clear: “…to investigate the acceptability of tolerability of an intraoral device, designed to facilitate weight loss.” This was interesting to me. Despite Professor Paul Brunton’s back-pedalling claim that this device was for “specific cases where there was a clinical need to lose weight quickly”,[4] I didn’t find reference to these specific cases of clinical need anywhere in the aim (or indeed anywhere in the article). Also, what exactly is a “clinical need”? More importantly, who decides when there is a “clinical need” to lose weight in a medical environment that is rife with fat-phobia and fat discrimination?[5]
Liquid food for thought.
I moved from the abstract to the article proper. Here I discovered that obesity led to a whole raft of physical issues. I also discovered that the evidence cited regarding these issues was around three decades old.
Bray G A. Complications of obesity. Ann Intern Med 1985; 103(6(Pt 2)): 1052-1062.
Pi-Sunyer F X. Medical hazards of obesity. Ann Intern Med 1993; 119(7 Pt 2): 655-660.
Interestingly, not much has changed in how we view obesity since the ’80s and the ’90s. Well, apart from the research done in 2012 that concludes eating fruit and vegetables, exercising, moderate alcohol consumption, and not smoking decrease mortality regardless of BMI.[6] And the research in 2013 that shows being fit is more important than losing weight.[7] And the research in 2015, showing that cardio fitness is a “more powerful predictor of mortality than body mass index”.[8] Apart from that research, it’s exactly the same as the ’80s.
Speaking of, did you know it was also in the ’80s that people had their jaws wired shut for six months as a weight-loss method? Apparently, the participants got quite anxious and developed jaw problems. This is, presumably, the main reason we want to use magnets now instead.
But all is well, because aside from the severe initial pain experienced by participants in the “DentalSlim” study, the difficulty speaking, the embarrassment felt, and the feeling that life was less satisfying, the invention is a success! People lost weight! And many people even started diets afterwards. Which, as we know, is still an appropriate outcome for plus-sized individuals even though we know that dieting doesn’t work.[9]
As I sat back and reflected on the human muzzle, I found myself recalling the owners that had to muzzle their pets for safety. It was a brutal process; there were often tears over the distress of their pet. I wondered whether anyone had thought to cry over the fact that in a clinical trial, a muzzle had been put on a human being.
I wondered if any of the participants discussed this clinical trial with a counsellor first? As a fat person myself, I understand the desperation to be thin. The stigma, the shame is so real. I wondered if any of the researchers knew what that was like, to inhabit a plus-sized body? It is a body that invites disgust and judgement. Perhaps if the researchers had known, they might have shown just a little more animal intelligence regarding the lives of fellow human beings.
Perhaps what it comes down to is that we consider fat bodies to be a danger to society. In a thin-obsessed world, larger people represent a failure to conform. Straight-figured people are afraid to be like them, so they judge them, shame them, and now, they muzzle them. We are afraid to acknowledge that a fat person can be healthy because the moment we do, we lose our one morally superior justification for thinness. We might actually have to recognise that thinness contains image-based privilege and social capital.
Regardless of what the researchers say, the “DentalSlim Diet Control” device is a human muzzle and a product of bias and fatphobia. We don’t even treat our pets this way. No pet was ever muzzled over food.
Hilary Willett has a Masters of Theology and a BAHons in English. She is now training to be a Anglican priest in Auckland Diocese. A proud South Islander at heart, she has lived in Auckland for almost ten years and worships at Saint Lukes Mt. Albert Anglican Church.
[1]https://www.otago.ac.nz/news/news/releases/otago830110.html?fbclid=IwAR37xoRE90QmmnvUzCWeLDBzmZfyuPCZLHiFkTT7CWOVZxE9De6Wr3snfWQ
[2] https://www.nature.com/articles/s41415-021-3081-1
[3] https://www.apa.org/science/about/psa/2018/05/calorie-deprivation
[4] https://www.nzherald.co.nz/nz/dentalslim-diet-control-researcher-defends-weight-loss-device-after-it-sparks-ridicule-on-social-media/52LYRRM56OSNQMS43F37MO7G6I/
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/
[6] https://pubmed.ncbi.nlm.nih.gov/22218619/
[7] https://pubmed.ncbi.nlm.nih.gov/24438729/
[8] https://pubmed.ncbi.nlm.nih.gov/26166058/
[9] https://www.healthline.com/health-news/diets-work-for-one-year