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Scarless weight-loss surgery: pacemaker for your hunger

Rating

3 Star

Scarless weight-loss surgery: pacemaker for your hunger

Our Review Summary

This TV segment focuses on an experimental obesity treatment: vagal blocking (VBLOC). The treatment involves implanting an electrical device which intermittently blocks the vagus nerve, which is involved with feelings of hunger and satiety.

The segment does a few things well:

It introduces a patient who, one month into the therapy, has had promising but not spectacular results.

It repeatedly mentions that the procedure is experimental, not yet available and unapproved for use in the U.S.

It makes clear that VBLOC appears to be less effective than gastric bypass surgery, with possible weight loss of 20 percent at six months compared to 50 percent for bypass. 

But the segment could have been stronger:

  • It should have included at least one fully independent expert who could put the technique into perspective
  • It should have provided more detail about the state and quality of the research upon which the promising results are based
  • It should have emphasized the potential harms of the treatment, not the least of which is that it might not work for some people. For a treatment with a price tag of $15,000 to $20,000, that’s a significant risk.

It’s worth noting that the host and reporter at the end of the piece discuss the fact that controlling physiological hunger is itself not a complete solution. People overeat for many reasons, including emotional ones. This is a responsible way to end the piece–with the thought that VBLOC may eventually be a useful treatment, but not a complete cure for obesity.

But the piece also raises a larger question: Is it responsible to report on the VBLOC technique at this time? The current trial is on a small number of people. A larger trial has begun, but none of the data have been peer-reviewed or published.

It may have been more prudent to wait until the research is published (if indeed it will be) before doing a story on this obesity treatment.  

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The broadcast reports a price of $15,000 to $20,000–and properly points out that this figure is speculative because the device is so early in testing.

The reporter should be commended for drawing this information out of a reluctant source.  

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The piece does not describe the findings of the early U.S. research (or other research overseas) in sufficient detail.

It’s not known who was in the trial, how many patients were tested, how many benefited, how many were unable or unwilling to continue the therapy, etc.

Some of this information was available in a San Franciso Chronicle article published on April 15, 2008. More information was available from a company press release announcing results from overseas research data.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The report focuses on presumed efficacy but minimizes safety issues and risks. 

The piece repeatedly states that the treatment has few side effects. This may apply to the surgery itself, especially as compared with gastric bypass surgery.

Yet there are several possible risks of the treatment itself that are not discussed, including the possibility that a side effect of blocking the vagus nerve will be discovered. It is also possible that the intermittent blocking of the nerve signals will become ineffective over time. 

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The segment is based on some early results of clinical trails of the VBLOC procedure. It does not provide sufficient detail to help viewers understand the type and rigor of the trial or even how many people have been involved so far. 

While the segments says the procedure has shown "impressive" results in Australia, it does not indicate what evidence the claim is based on. 

Does the story commit disease-mongering?

Satisfactory

Morbid obesity is a deadly condition. The piece does nothing to exaggerate its dangers. In fact, if anything it understates them.  

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The segment included an interview with one patient in the clinical trial who has shown modest results and one physician who is an investigator in the trials.

The segment should have included comments from at least one independent researcher or clinician familiar with treatments for morbid obesity, who could put this procedure in better context.

The segment should have noted that the trials are being funded by the device maker.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The segment compares VBLOC to gastric bypass surgery.

While this is a proper comparison, the segment should have also compared it to gastric banding, drug treatments and diet and exercise. Information about efficacy, safety and costs of these treatments is widely available and would have made the piece much stronger.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The segment states that the VBLOC treatment for obesity is in clinical trials and not available in the U.S.

Does the story establish the true novelty of the approach?

Satisfactory

The segment correctly says the treatment is being tested in the U.S. and in some other countries. 

It also explains that the mechanism–the suppression of hunger by blocking the vagus nerve–is a novel approach to weight loss treatment.

Does the story appear to rely solely or largely on a news release?

Not Applicable

We can’t be sure if the story relied largely on a news release, but we do know the only physician interviewed is one who is an investigator in the trials (funded by the device maker) and thereby has a vested interest.  

In fact, this is one case where the story might have been stronger if it had included some of the information about results of the clinical trials that appeared in a company press release.  

Total Score: 4 of 9 Satisfactory

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