Sometimes a short news release is too short. This one, at 267 words in the main body, describes a study of direct brain stimulation to control eating behavior in only nine human patients, over two 8-day periods of time. The patients were divided into two groups. A control group received sham treatment and an experimental group received direct-current brain stimulation aimed at a part of the brain that might control eating behavior. The five patients who received the stimulation lost an average of 8/10 of a pound. The news release is accurate, but lacks context that might have pointed to potential obstacles for this avenue and put the early results into some larger landscape of research on obesity. This is a very small experimental treatment. Why not wait until there’s more credible results from a larger group to write the release?
Obesity is a well-known epidemic in the United States, causing chronic health problems and swelling demands on scarce health care resources if it continues. Any method that might help change eating behavior is exciting, but this too-short news release seems to raise more questions than it answers by trumpeting a study of only nine people over less than a month. Just a few more sentences quoting an expert from outside the study and some comments on costs would have helped. Or, wait and write a release after more than a handful of patients have been treated.
The news release does not provide any information on what the experimental therapy, known as transcranial direct current stimulation, might cost if and when it is available to the public. We’ll rate this Not Applicable because it’s too early to know what it might cost and the release doesn’t make it sound like the technology will be available imminently. However, we’d note that a close cousin of this method, transcranial magnetic stimulation, is FDA approved for major depression and migraine. Sessions cost about $300 each and may include 20 or more sessions and run several thousand dollars. The release could have mentioned this.
The story does quantify the very slight benefits of a very small study (fewer than 10 patients). Unlike the control group, five people who received active stimulation of their brain “consumed an average of 700 fewer calories and lost an average of 0.8 pounds on the second visit.” But the story misses an important point here — the reduction in calories consumed was not statistically significant. That important detail deserved comment.
The news release does not contain a single sentence regarding whether there might be harms if this technique were expanded and used in a wider setting as a treatment for obesity. We wondered: Would people get used to the stimulation if it were used on a long-term basis and stop showing the “benefit?” Are there other cognitive abilities that are in any way muffled by the stimulation? The release should at least acknowledge that there could be potential harms uncovered in further study. The limitations section of the paper itself even states that is was not entirely clear that the treatment reached the targeted brain areas and not other areas. We find this concerning if not a bit alarming.
The release describes the size (small) and the duration (short) of the study, but it offers no explicit comment on how those factors limit our interpretation of the study. The release should have pointed out that this is not meant to be anywhere near clinically available, but rather in the realm of understanding neurobiology of obesity.
There is no disease mongering in this release.
The principal investigator in this research is an employee of a federal agency. There does not appear to be any conflict of interest and funding sources are named.
The story does not compare alternatives. It does state that this new therapy of brain stimulation would be combined with existing known treatments for obesity, such as exercise. The first line of the release states “… when combined with diet and exercise.” This was a lost opportunity later in the story to discuss intensive behavior changes interventions and surgical treatment for severe obesity with known efficacy.
A brief comment that this is not expected to be available anytime soon would have been helpful to readers. However, the release does say that “More study is needed to confirm the safety and effectiveness of tDCS for weight loss.” While it’s a close call, we think most readers can gather from this that the technique isn’t likely to be available soon.
It’s clear this is being studied at a federally funded obesity center and that the approach of measuring calorie intake after stimulation is new.
We might have liked a headline that said “Tiny study showed some possible benefit to brain stimulation.” But the release did not use unjustifiable language.
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
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