This was a broadcast story about a bioimpedance analysis as a means for assessing body fat mass. The story feeds off the general understanding that obesity is associated with an increased risk of heart disease, diabetes, and several types of cancer and fuels that with the notion that even normal weight individuals who appear to be trim might actually be obese. The story was built on the incorrect assumption that ‘normal weight obesity’ had the same risks associated with it as obesity estimated from body mass index scores.
The story committed troubling disease-mongering, as there may be important adverse health consequences in labeling normal weight people as unhealthy.
The story did not:
There was no discussion about the costs for bioelectrical impedance testing at home or in the clinic.
There was no discussion about what benefit was to be obtained from having an assessment of body fat mass using this methodology. And there was no discussion of the accuracy of bioimpedance analysis.
There was no mention of possible harms of treatment; yet the story included a seemingly healthy person who was going to make lifestyle changes based on the measure without any discussion of the possible ramifications. When you encourage normal weight people to lose weight, might you be promoting eating disorders?
There was no discussion about the evidence that ‘normal weight obesity’ puts a person at increased risk; there was not even a mention of what risk they were talking about. In addition, there was no discussion about the accuracy of this measure.
The entire focus of this piece is disease mongering. Is it really necessary for a normal weight young woman to be concerned about her so-called ‘normal weight obesity’? She said she would change her diet based on the results of this test. But will losing weight reduce her % of fat mass? And what exactly is it that this doctor is concerned about? Epidemiological studies indicate that normal weight adults have the lowest risk of adiposity-related health conditions and premature death.
This story included comments from only one doctor. It did not provide an adequate discussion of the rationale for such testing, who the appropriate target population might be, or whether the information obtained was considered valuable by other clinicians with expertise in this area. Several sources of information should have been used rather than the thoughts of a single clinician.
There was no discussion of the various methodologies for assessing body fat mass and how bioelectrical impedance compares with the gold standard methods. The story provided no framework for viewers to understand when a measure of body fat might have clinical relevance.
Although shown to be a simple box with a few wires, the story provided no insight into whether this device is FDA approved, whether it is for clinical or home use, and whether there is variability in the accuracy of the devices.
The story implied that bioimpedance analysis was a new measure of adiposity. Reference to this type of measure for estimating body fat can be found in the late 1970’s.
We can’t be sure if the story relied on a news release; we can be sure that only one doctor and his one patient were profiled. Also, it is noteworthy that the Mayo Clinic issued a news release on bioimpedance analysis just a few days before this broadcast.
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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