Posted by Gary Schwitzer in Health care journalism
In The Atlantic, Lindsay Abrams wrote, “The Problem With All of This ‘Overweight People Live Longer’ News.” She began:
The counterintuitive findings that people who are overweight live longer, published today in the Journal of the American Medical Association, couldn’t have been more perfectly timed, coming as it has right when people are resolving to be healthier — which involves, for many, losing weight.
In many places where this story has been picked up, including The New York Times, The Wall Street Journal, and Time, the implication seems to be that the push to get people down to a “healthy” weight has been overblown.
But that being overweight is associated with increased lifespan isn’t new. It’s called the “obesity paradox,” and studies documenting it have lead to widespread speculation about the potential “protective benefits” of excess body fat.
For some health advocates, the implication is downright offensive. Walter Willett of the Harvard School of Public Health, for example, lost his cool this morning on NPR, declaring, “This study is really a pile of rubbish and no one should waste their time reading it.”
But the study’s author, Katherine Flegal of the Centers for Disease Control and Prevention, mounted a solid defense: “It’s statistically significant.” Those three words carry weight — if an association has been found to be significant, it tells us that if nothing else, we need to acknowledge that the results are in some way legitimate and warrant our attention.
The findings are without doubt interesting, which on its own makes the study worth reading. The problem is that despite the grandness of the meta-analysis — it takes into account over 3 million people! — it still has an extremely limited scope. It looks at BMI, and only BMI, in relation to death, regardless of cause. It’s impossible to report on its baseline conclusion without taking into account substantial caveats.
Read her entire piece to see her perspective on those caveats.
On the Knight Science Journalism Tracker, Faye Flam wrote, “New Study Deems Overweight the new Healthy. Stories Miss the Big Picture.”
I was surprised at the similarities between all the news stories I read. Nearly all took the standard dueling experts format with Harvard School of Public Health researcher Walter Willet playing the skeptic’s role. Some of the stories did a better job than others in letting Willet explain why he thought this latest study was “rubbish” as he put it.
I was still left wondering what the scientific basis had been for our current dividing lines between normal, overweight and obese. How did the medical community decide who was “overweight” before? Surely it must have been based on some science. What was the evidence in favor of the old standard and why did this new meta analysis suggest something so different? Does this new analysis really show that “overweight” is good, or merely that we haven’t yet figured out how to define normal and overweight?
The only network TV news story on the study that I happened to see was by Dr. Jonathan LaPook of CBS. I was almost deafened to anything else he said on the air when I heard him say, “Now here’s what I tell my patients….” I wrote to LaPook immediately after the program and told him that I thought that what he tells his patients (he’s a gastroenterologist) is irrelevant for a national TV news audience. I wrote that it was a classic “journalism versus doc-in-the-box” confrontation. Physician-journalists have to make up their mind: Are they journalists when they appear on the air? Or are they physicians giving advice to patients? He’s not my physician. I don’t care what he tells his patients. The program is labeled CBS News – not CBS MD Advice Column. He doesn’t have any right to use the national television platform to promote his own medical advice to a news audience. It crosses a line of journalism ethics. I can cite clauses in the codes of ethics of the Society of Professional Journalists and the Radio Television Digital News Association and in the Statement of Principles of the Association of Health Care Journalists that address the ethical pitfalls herein.*
Would a political reporter be allowed to give his/her advice to readers/viewers about whom to vote for? Never.
Then why would we accept a medical journalist giving his advice to patients as part of a story?
* Addendum 15 minutes later:
The Society of Professional Journalists’ code of ethics states “Analysis and commentary should be labeled.” At the time of the post-Haiti-earthquake physician-led news coverage, SPJ president Kevin Smith wrote “injecting oneself into the story … is not objective reporting, and it ultimately calls into question the ability of a journalist to be independent, which can damage credibility.” While the Haiti coverage is on an entirely different plane than commenting on the overweight study, the SPJ president’s comments about a physician-journalist injecting oneself into a story is the salient point.
The Radio Television Digital News Association Code of Ethics states “Clearly label opinion and commentary.” Dr. LaPook stopped being a reporter when he said, “Here’s what I tell my patients.” He then became a physician-advice columnist. But the segue came suddenly, without caveats or clear labeling or separation of reporting from advice commentary.
The Association of Health Care Journalists Statement of Principles states:
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