Zap or Chill? Targeting Fat Without Surgery February 04, 2010 ![]()
News on devices to cool-treat "offending jiggle" or to "zap your belly, flanks and hips." Reasonable balance, but doesn't emphasize potential harms and the total lack of evidence for health benefits. Our Review Summary
This story does a solid job describing two newish treatments purported to dissolve targeted fat--the Zeltiq cooling system and the Zerona laser. The story manages to deliver the most important facts while maintaining some tongue-in-cheek distance. This is, after all, a purely cosmetic procedure for people bothered more about how their bodies look than their unhealthy lifestyles or disease risks. This cocked-eyebrow approach serves readers well.
Why This Matters: The idea of losing visible fat quickly is sufficiently compelling that consumers spend many millions of dollars on treatments ranging from surgical removal of fat to topical creams. With two new technologies with plausible scientific validity entering the spot-fat marketplace, the New York Times provides a useful service by explaining what is known and not known about them. Click on Criteria for definitions. The story explains that Zerona is available nationwide through medical spas, chiropractors, dermatologists and plastic surgeons. Zeltiq, the story says, is available at over five dozen clinics identified on a website. ![]() Discuss costs? - SATISFACTORY
The story states the price for the Zerona device: $1,700 to $3,800 for six sessions. The price of Zeltiq is also reported but is not as clear: We learn only that one doctor charges "$700 per spot"--but not how many treatments are provided or needed, what constitues as "spot," and so on. ![]() Avoid "disease-mongering"? - SATISFACTORY
The story does not medicalize the fat-melting treatments; it makes clear they are elective and cosmetic. No claims are made for medical benefits of the treatments or the risks of love-handles or muffin-tops. Still, a positive statement that there are no known health benefits would have been useful. ![]() Evaluate the quality of evidence? - SATISFACTORY
The story does a solid job describing the amount and type of evidence supporting the devices' efficacy--it's mainly anecdotes, doctors' casually reported cases, and some preliminary research. The story is usefully framed with the following statement: "It is too early, however, for consumers to know how effectively either device works." ![]() Quantify the potential harms? - NOT SATISFACTORY
The story fails to point out the potential harms of these devices. The story correctly suggests these two new technologies lie somewhere between the invasive, surgical liposuction and highly questionable infomercial products. It also says they'll shortly be joined in the market by competitors that use ultrasound technologies. ![]() Quantify the potential benefits? - SATISFACTORY
The story duly reports that unpublished research showed Zeltiq resulted in 22 percent body fat loss in targeted areas. It reports that published, funded research showed patients lost an average of 3.5 inches after six sessions of Zerona laser work. ![]() Appear to rely solely or largely on a news release? - SATISFACTORY
The story does not draw from a news release. ![]() Use independent sources and identify conflicts of interest? - SATISFACTORY
The reporter interviewed ten sources--two patients [one with good results, one with poor], one federal spokesperson, and seven doctors. Six of those doctors are not objective due to financial interest in the devices' efficacy. But one is fully independent. ![]() Compare the new approach with existing alternatives? - NOT SATISFACTORY
The article could have devoted more space to comparing these procedures to the process, benefits, and risks of liposuction. It could have distinguished between the two new treatments and the existing heat treatments and topical creams also sold by some of the same dermatologists, chiropractors, plastic surgeons and web infomercials that support Zeltic and Zerona. It does get points, however, for mentioning two new ultrasound products about to enter the market. Total Score: 8 of 10 Satisfactory The U.S. Preventive Services Task Force is considered the gold standard of preventive health recommendations - including on screening tests. It's a good source for journalists and consumers.
About 70% of the stories reviewed from 2006-9 failed to adequately discuss costs, or to explain how big (or small) are the potential benefits and harms of treatments, tests, products and procedures.
We have documented a disturbing trend of news stories taking an advocacy stance, promoting certain screening tests outside the boundaries of scientific evidence.
Stories on new technologies like Cyberknife, DaVinci robotic surgery systems, and proton beam cancer therapy often fail to scrutinize the evidence and/or to discuss the costs involved.
Rather than suggesting that everyone should be screened for everything, news stories could explain: "All screening tests cause harm; some may do good."
The first 38 network TV network morning health news stories reviewed in 2009 earned an average score of 1.2 stars. 13 of the 38 stories got ZERO stars.
Both TIME magazine and BusinessWeek have published terrific stories explaining the importance of the Number Needed to Treat - or NNT.
Knowing relative risk reduction is like knowing you have a 50% off coupon but not knowing whether it's for a Lexus or a lollipop. Absolute risk reduction tells you what the "coupon" is worth. Read more.
The website NoFreeLunch.org posts "a database of health care professionals who have pledged to accept no gifts from industry and to rely on non-promotional sources of information."
To help journalists cover stories responsibly, we post a list of independent experts who state that they do not have financial ties to drug or medical device manufacturers.
We apply the same ten standardized criteria to the review of every story.
We have about 30 story reviewers. Each story is reviewed by 3 different people.
Gary Schwitzer's seven words you shouldn't use in medical news: cure, miracle, breakthrough, promising, dramatic, hope, victim. Read why.
|