This is the third and last segment in a multipart series on dietary approaches to weight loss. It featured a young woman who had type I diabetes who had used weekly consultation with a nutritionist to help advise and motivate her during the process of making lifestyle changes. Although there was some attempt at moving the focus from weight loss to healthier living, the pieces really remained one about approaches to weight loss. The segment failed to provide much information to help viewers evaluate the health risks of obesity and the extent to which weight loss changes these risks.
As this was part of a series, it would seem appropriate to recap the various programs detailed and how they compare in terms of structure, costs, level of caloric restriction, and reasonable weight loss expectations. The biggest weakness of the series was its failure to provide evidence about the efficacy of each dietary strategy discussed. An expert in the obesity field could have provided an overview of the evidence, some needed balance, and added perspective about important aspects such as recommended pace of weight loss, avoiding recidivism and potential harm associated with the highlighted diets.
A price range of $35 – $200 /session was given; combined with the information that weekly sessions with the nutritionist were scheduled for this program, a viewer could calculate the total cost range that might be involved with this approach.
It really would have been very interesting and helpful to viewers to see how the various approaches for weight loss featured in the various segments compare.
There was some discussion around the idea that for this individual, the lifestyle changes in diet and exercise were more about health and less about weight loss per se. The segment alluded to improvement in maintaining her glucose level. And while the physician talked some about markers such as cholesterol levels and blood pressure, and mentioned cancer and heart disease risk in general, there was no discussion about what the magnitude of benefit.
Although the featured person losing weight on today’s segment was poised to represent those individuals mentioned in previous segments as having a ‘complicated medical history’, the various dietary approaches presented in the series were as appropriate as the one she followed.
To address the harms associated with treatment, this segment should have had some discussion about the problems associated with ‘fad’ diets and why they are problematic, especially for individuals, such as the one featured in this segment, with type I diabetes.
There was actually no discussion about the evidence demonstrating the increased health risks associated with obesity.
The clinician on this segment directly contradicted the health claim made on the first of the three segments. (On that segment, the nutritionist said that "for every 5% of weight you lose, there is about a 50% reduction in certain risk factors"… where as in this last segment, the doctors stated that "if people just lose weight, and they lose an equal amount of fat and muscle, they’re not getting healthier. They’re still fat. They’re still at risk for everything.")
The opening of this segment talked about the proportion of Americans that are overweight. While the information presented is in agreement with the data from the CDC, overweight should not be conflated with medical obesity. Overweight and obesity are not the same thing; an individual who is 5-10-20 pounds beyond the normal weight range for their height does not have have the same health risks as an individual of the same height who has a body mass index (BMI) that is 30 or higher.
Obesity was never defined (or mentioned) in this segment.
The two clinicians featured in this segment were not objective experts in the field. They had designed and helped the woman execute the lifestyle modification plan she followed and so can not be considered impartial sources of information.
They really should have had an objective expert commenting on why it is particularly important for someone with a complicating medical condition, in this case, type 1 diabetes, to have some medical oversight when attempting to lose weight.
This segment mentioned two other dietary approaches to weight loss and there was brief mention of medications that may be helpful for weight loss. There was, however, no discussion about weight loss surgery.
This segment focused on the use of regular sessions with a nutritionist as a weight loss aid; it was mentioned in passing that the cost of such services varied greatly depending on whether the nutritionist was available through a community center, hospital, or private practice. This provides some insight about where it might be possible to find a nutritionist to work with.
It would have been much better to include some information that would help viewers find appropriate nutritionists to assist with weight loss, perhaps including something about professional credentials to look for.
The segment appropriately did not portray a limitation on caloric intake coupled with increased physical activity as a novel approach to weight loss.
Does not appear to rely on a press release.
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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