Reader Question - What About Those Jaw Locking Weight Loss Devices

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Recently I received an email from a reader asking - since I believe that weight loss surgeries fail to meet the requirements of an ethical, evidence-based intervention, do I think that magnetic jaw-locking devices are a better option? The reader had been told (misled) that these devices have “no negative side effects,”

The short story is that locking people’s jaws shut to stop them from eating is wrong and horrific on every level, and it would be wrong and horrific even if it was actually likely to lead to significant long-term weight loss, which it is not.

First of all, there are certainly situations in which wiring someone’s jaw is medically necessary, but (and I can’t believe I have to type this) bolting someone’s mouth shut for the express purpose of not allowing them to open it to eat is not now, nor will it ever be, a humane healthcare intervention.

These devices have been marketed based on the belief that the reason long-term weight loss fails so often is that fat people can’t submit to long-term starvation for long enough if we can open our mouths. Except that’s not remotely valid - research shows again and again that dieting does not lead to long-term, sustained weight loss for more than a tiny fraction of people at best. These devices were also initially publicized based on the results of a two-week study that included five people (they started with a whopping size, but one dropped out - of a two-week study.)

During those two weeks, the participants reported issues including discomfort, speech issues, feeling tense and embarrassed, and decreased satisfaction with life. The researchers (and we’re using the term loosely here) completely ignored these reports and claimed that there were “no adverse effects.” The researchers also pointed out that with the similar treatment of jaw wiring that was used in the past “many jaw-wired patients felt anxious and some developed acute psychiatric conditions. In addition, after 9-12 months, patients developed periodontal disease. After wire removal, a transient, and in some cases persistent, limitation of jaw movement was also observed.”

You might be asking yourself what happens if someone needs to open their mouth because of choking or another emergency? The study explains that:

“A safety feature was incorporated into the device which allowed for the disengagement of the device in the case of an emergency, such as a panic attack or where a possibility of choking arises. This device was demonstrated to the subject and another individual of their choosing and they were asked to keep the emergency release device with them at all times. The device was designed such that the configuration maintained the airway, allowed speech and allowed feeding using a liquid diet.”

What it doesn’t say is what happens if someone has a medical emergency that renders them unable to provide the special emergency disengagement device to healthcare professionals (or even explain why the jaw has been locked shut,) because, let’s be clear, “maintaining the airway” and “allowing for intubation” are two extremely different things.

Also, completely unsurprisingly, the participants in this two-week study had already regained weight in the two weeks following the two weeks in which their jaws were bolted shut. Which may explain why they are trying to sell this based on a two-week study and the ludicrous idea that people can just keep taking it off and putting it back on. When this launched Jess Campbell created a great breakdown of this here.

The original study was published on June 25, 2021. On December 10, they published a correction. It would seem that they misstated the BMI for the five subjects…twice.

More concerningly, they included this in their “correction”

In addition, the authors wish to include the following ethics declaration: 'The authors note that, as anticipated by the ethics application, patent protection in the device was sought, with that being done through a new, non-active, holding company in which the research collaborators had proportionate ownership interests.

A I find myself saying repeatedly as I look at the research around weight and health, if I had turned this “study” in for a freshman-level research methods class I cannot overstate how hard I would have (rightly) failed the assignment, so the fact that it both passed approval for human subject testing and was published is a testament to the amount of weight stigma and willingness to harm fat people in healthcare. The fact that anyone even tried is a testament to the amount of money that can be made.

This is a grim reminder that many of the people who are impacting fat people’s healthcare believe that life as a fat person is a less than human existence, and thus any amount of inhumane treatment (including risking our lives and quality of life) is worth it for even the smallest chance that we might get a tiny bit thinner even for a short time. Still others are simply willing to let fat people suffer (and die) to line their own wallets.

Again, the existing research is VERY CLEAR that extremely low-calorie liquid diets don’t lead to long-term weight loss and don’t “jump start” a weight loss journey because the human body is wired to see the complete lack of solid food and extreme caloric restriction as a famine situation, causing it to become a weight gaining, weight maintaining machine for our own protection. Of course that takes more than two weeks to see. In this case, remember, it took four weeks.

And again, whether or not it “works” is immaterial because it’s not ok to bolt people’s mouths shut to keep them from eating. So even if a fat person is desperate enough to try locking their jaw shut in an attempt to escape weight stigma or because they had been misled into thinking that this would make them healthier, that wouldn’t make it ethical for a doctor to prescribe this.

Weight stigma in healthcare tells us to blame fat bodies for health issues, but then completely ignores the deleterious effects of weight stigma (which is perpetuated by the idea that fat people should have our mouths bolted shut,) weight cycling (which the research tells us will be perpetuated by this device,) and staggering inequalities in healthcare access (which include being told that rather than supporting our health in the bodies we have, it’s “healthcare” to bolt our mouths shut in ways that could seriously compromise emergency care.)

In short, in addition to having basically no chance of creating any long-term weight loss or positive health changes (which are two completely separate things,) it’s simply barbaric.

For more information about the people behind this, please check out this excellent post from Louise Adams at Untrapped.

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More research and resources:
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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.