This news release summarizes an Australian study of the effect of laparoscopic adjustable gastric banding surgery (placing an adjustable silicone band around the top part of the stomach) on 21 severely obese adolescents. The release states that two-thirds of the teens lost significant amounts of weight for up to five years and further describes the procedure as “a first option” to manage obesity during adolescence.
Researchers quoted in the text repeatedly and appropriately cautioned that the procedure “is not for everyone” and requires careful management, but the release remained determinedly cheery about the outcome. Importantly, it also failed to acknowledge the small sample size in this study and the lack of a control group, as well as the health complications that stymied a few of the participants. Also ignored was that one-third of the 21 participants either failed to lose weight or began to regain it over the course of the study. Lap band surgery for severely obese teens is clearly no panacea.
Obesity is a major health problem the world over, with nearly 14% of American teens identified as obese (2015 Youth Risk Behavior Surveillance System). Obesity brings with it significant physical and psychological problems, with teenagers extremely susceptible to the latter and looking for solutions that do not require behavior change. Any text advising a surgical solution for a non-surgical problem in adolescents must be grounded in sufficient data and, with even that caveat fulfilled, must be cautiously worded to make it clear that most overweight teens would be inappropriate candidates for the procedure. This release fails the first test and does not seem sufficiently worried about the second.
The cost of this surgical procedure is missing in action in this release. This is a problem, because costs in the US, as of 2015, average more than $14,000.
We give this a tepid “satisfactory.” The release specifies the range of BMI loss for individuals in the study but never gets around to explaining what BMI is or how a reader should interpret the numbers. As discussed in more detail in the Evidence section below, the release doesn’t share that a third of patient volunteers had the laparoscopic bands removed due to no change in weight loss or regained weight.
Although the study on which this release was based did reference “minor complications” and symptoms that required removal of the bands among some participants, the release ignores this information.
The release misleads readers a bit here. It identifies a sample size of 21 teenagers in the study. That is an accurate count of individuals at the very beginning of the study. But the research report then notes that the all-important follow up data, on which the analysis was based, were ultimately available for only 16 of those individuals. And it also specifies that, in seven cases, the laparoscopic bands were removed at some point in the follow up period because individuals either failed to lose weight or began to regain weight. This suggests that the procedure did not work for at least a third of that already small group of 21.
The release also mentions that adolescents with depression were excluded from the study but we’re not told how often those exclusions occurred.
The text makes clear that this strategy would be relevant only for severely obese teenagers and then goes on to define that term. But the definition (body mass index over 40/kg/m2 or over 35 kg/m2) will be difficult for the average reader to understand.
Funders are not mentioned in the release although that information is provided in the text of the journal article. The study coauthors all claim no conflicts of interest, but that information is not provided either.
The release states through a quote from the lead author of the study that the lap band procedure “is a good result when compared to BMI reduction using the few medications available or lifestyle measures,” but offers no actual comparisons with any non-surgical approaches to weight loss.
It is clear that lap bands are now in use. The question posed here is whether they would be appropriate for seriously obese teenagers.
The release makes it clear that this study’s novel contribution is its effort to gather date from “lap-banded” patients over longer periods of time than did previous studies.
The researchers use terms such as “safe” and “effective” to describe the outcome of the banding process. This was apparently not true for at least a third of the sample. Sources in the release do emphasize the use of lap bands as a temporary option for teens, an important point.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like