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The observational study referenced in this news release suggests that people who have bariatric surgery may have a lower rate of death than those who try to lose weight using nonsurgical alternatives.
Although the study is larger than many similar ones, it suffers from some of the same limitations; mainly difficulties matching the two study groups in such a way that the differences in their outcomes can be attributed to something other than chance.
This news release does touch on these limitations but would have served readers better if it had included more on the costs and risks involved in bariatric surgery, as well as some discussion of nonsurgical alternatives.
As bariatric surgery to treat obesity becomes increasingly popular, there’s growing interest in the potential long-term benefits and risks involved. Bariatric surgeries are booming, even in children. This makes long-term studies addressing safety and efficacy increasingly important.
The decision to pursue bariatric surgery is a complicated one. News releases and published articles touching on this emotionally charged topic serve readers best when they provide a balanced perspective on surgical vs. nonsurgical options, benefits vs. risks, and both the long-term and short-term costs involved.
Three types of bariatric surgery (laparoscopic banding, Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy) are the primary interventions evaluated in this study. The costs for these common weight loss procedures are not mentioned in the news release.
Some information — even broad cost ranges of bariatric surgery compared to nonsurgical care — is warranted.
The release states that “The rate of death from any cause over about 4.5 years was lower among obese patients who underwent bariatric surgery compared with patients who managed their obesity with nonsurgical care.”
The release further notes that “The association between bariatric surgery and a lower rate of death from any cause adds to the limited literature describing the beneficial outcomes of these surgical procedures for obese patients.”
But the results state only that the rates of death were “lower” over the 4.5 year follow up period. There is no attempt to put the size of the difference in context.
The release doesn’t discuss any potential harms associated with bariatric surgery — and there are several. While the focus of this study was on rates of death, not on other outcomes, any discussion of this surgery that might sway a reader to try it needs to include a summary of potential complications and risks.
The issue of harms might have been included in the “limitations” section of the release.
The news release does well in describing this retrospective cohort study as observational and that a significant limitation is the imbalance that occurs in trying to match surgical and nonsurgical groups by age, sex, body mass index, and diabetes status.
It would have been helpful to make it clear that patients were not assigned randomly, and many surgical candidates were excluded because they could not be matched. These limitations, along with some confounding socioeconomic factors, would have been helpful to include in the bulleted section, “Study Limitations,” which we were happy to see included.
There is no disease-mongering in this news release.
Funding sources and conflicts of interest are not addressed in the news release. Is is suggested readers consult the original article (link provided) for more information.
The nonsurgical alternatives to treating obesity are not clearly explained in this news release.
The release doesn’t address availability. However, bariatric surgery for obesity is becoming increasingly common and is now available worldwide. The release would have been stronger had it informed readers about the eligibility criteria for the surgery.
The news release notes that there are many studies looking at the short-term outcomes of bariatric surgery, but less that address longer-term effects, as this one does.
There is no unjustifiable language employed.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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