Adjusting a Waistline for a Wedding, but at What Cost? - New York Times

Barbara Fernandez for The New York Times

Jessica Schnaider, whose feeding tube diet filtered through the news media, said she went on the diet because she trusted the doctor (she has gone to him for 15 years) and had the money and desire to drop 10 pounds.

A Field Notes column last Sunday (“Bridal Hunger Games”) reported on some diets that brides use to drop 15 or 20 pounds before their weddings: Weight Watchers and a personal fitness trainer, juice cleanses, the Dukan diet, diet pills, hormone shots and, new to the United States, a feeding tube diet.

Readers began to respond as soon as the article went online and was posted on the Times’s Facebook page.

“If you’re with someone who wants a swimsuit model for a partner, then he is free to contact Sports Illustrated and ask to date one directly,” one woman wrote on Facebook. Or why not just buy a larger size dress, asked one reader, a man. Several commenters suggested that the solution to looking good in wedding photos wasn’t losing weight, but acquiring skills in Photoshop.

There were complaints about the commodification of marriage: “Just one more example of the disgusting spectacle weddings have become,” another grumped.

A man jokingly suggested reverse psychology: “I say balloon up so you look as big as a house on your wedding day (wear a fat suit if you have to).” Ten years later, he wrote, people “will say admiringly how great you look today.”

BluePrintCleanse’s Web site was mentioned in the column for suggesting that a bridal party cleanse together. “If a friend asked me to lose weight, or join her in such an awful venture, to be in her wedding, she wouldn’t be my friend any longer,” a woman wrote. (On the blog Jezebel, Erin Gloria Ryan was similarly incensed, saying: “Should I be mandating my bridesmaids tan in tandem and work out the same muscle groups to ensure uniformity?”)

But it was the anecdote about the “feeding tube bride” that was plucked from the dieting options and went viral as it filtered through other news media outlets and Web sites.

Melissa Gilson focused on the ethics of the K-E diet (800 calories a day for 10 days using the nasal tube), saying diet articles encouraged women to starve themselves. “If they didn’t have the tube and just stopped eating they’d be considered anorexic,” she wrote on Facebook. “But under a doctor’s care and with a tube in their nose, it’s a crash diet.”

A publicist for the American Society for Parenteral and Enteral Nutrition e-mailed to complain that the article was “disturbing” because it failed “to represent the medical and lifesaving uses of feeding tubes.”

Tammy Frank, a nurse in Boardman, Ohio, who has lost 70 pounds on the high-protein Dukan diet in preparation for her wedding on July 14, criticized the casual use of feeding tubes as well. “If all you need are the low-carb fluids, why not just drink them?” she wrote in an e-mail. “But it is going to be the next thing for dieters â€" almost as dangerous as women eating cotton balls. We are all dying to be thin. I’m just glad I found a healthy lifestyle that works.”

Dr. Louis Aronne, the director of the Comprehensive Weight Control Program at New York-Presbyterian/Weill Cornell Medical Center, who was quoted in the original article, e-mailed to say: “The tube approach might be appropriate in those with significant obesity as a short-term kick-start if other techniques that would help with weight maintenance were also utilized. But it hasn’t yet been studied as a weight loss technique to my knowledge, and I called several other experts in the field.”

Times readers were mild, however, compared with reaction elsewhere. A headline on National Review’s site read, “End of the World Watch: The ‘Feeding Tube’ Diet.” A post on the Time blog NewsFeed summed it up with, “Something old, something new, something borrowed, something eww.” The humor writer Dave Barry commented on his blog for The Miami Herald, “You may now remove the bride’s nasal feeding tube.”

“Good Morning America” and the “Today” show did follow-up segments on Monday about the “feeding tube bride,” Jessica Schnaider, a Miami businesswoman, and her physician, Dr. Oliver R. Di Pietro of Bay Harbor Islands, Fla. Ms. Schnaider said she went on the diet because she trusted Dr. Di Pietro (he has been her doctor for 15 years) and had both the money ($1,500) and the desire to drop 10 pounds.

Brickbats were thrown at her â€" “If we needed more proof that American women are cultivating a collective eating disorder, enter the feeding tube bride,” blogged Julie Gunlock on the Independent Women’s Forum.

Ms. Schnaider said on Thursday that people were uninformed. “I lost the weight,” she said. “There was no other consequence. I wasn’t putting myself at risk. I asked the doctor, ‘Is there any kind of medicine or drug in the mixture?’ because I didn’t want that. And he said, ‘No, just protein powder,’ so I was fine. It made sense to me. Why can they say it’s crazy?”

Criticism was directed at Dr. Di Pietro as well. Juniper Russo, a contributor to Yahoo, opined hyperbolically under the headline “Feeding Tube Diet? Irresponsible Doctors Condone Anorexia” that Dr. Di Pietro’s decision to put a patient on the diet was “an astonishing display of medical malpractice.”

After interviewing Ms. Schnaider, “Good Morning America” reported that “more and more brides” were using the diet. Dr. Di Pietro, an internist who alone has trademarks and patents on the K-E diet in the United States, became the plural “irresponsible doctors” in Yahoo’s headline.

There are other doctors in Europe who are licensed to do the procedure â€" and who do it for less money. The process, called the KEN, or ketogenic enteral nutrition, diet in Europe, was invented by Dr. Gianfranco Cappello of the University of Rome. It costs about $200 for the initial visit, $79 for the protein solution and $39 for the final checkup. Airfare from New York to Rome is as little as $613 on Finnair, meaning a diet excursion would come in at under $1,000.