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A nervy approach to weight loss

Rating

3 Star

A nervy approach to weight loss

Our Review Summary

This was a story about an approach to augment weight loss involving manipulation of the vagus nerve that is currently under very limited investigation.  While containing cost estimates for the approaches discussed, the story was rather vague about the risks and benefits of these means to weight loss. The story provided little detail that would enable an interested reader to pursue more in depth information about these techniques.

  • While the story contained some discussion about historical precedent that suggested that disturbance of the vagal nerve could be utilized for the purpose of encouraging weight loss, the story did not include data about the efficacy of these approaches, whether such information had actually been compiled, or whether this approach to weight loss was entirely speculative.  This is an important oversight.
  • When comparing a medical device to disrupt neural signaling along the vagus nerve with surgical severing of the vagus nerve, the story did mention that surgical severing was irreversible and did discuss that implanting a device to disrupt the nerve involved having a foreign object within the body.  However beyond these two suggested problems, the story was lacking in discussion for the role of the vagus nerve in the body.  The vagus nerve is involved in far more than just mediating food intake; affecting it could have serious impacts on digestive system and on the cardiovascular system as well. 

  • There was insufficient comment from objective experts on weight loss who might have been able to provide some perspective for the relative merit or interest in this avenue of research. There was only a one line comment from Dr. Samuel Klein of the Washington University School of Medicine in St. Louis predicting that vagotomy may produce only temporary weight loss. Better balance in sources – or in space provided them – was needed.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story included cost estimates for the procedures mentioned.

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

Not Satisfactory

The story mentioned a study by a doctor of 30 people, involving a device that interfered with vagal nerve transmission in which 80% of the people lost 30% of their excess weight in the first six months.    As the story mentioned that this was done in 2005 and it is currently 2008. One wonders what the long term weight loss for these people was.  A query of the National Institutes of Health medical library database (PubMed) using the name of the doctor and vagus nerve failed to find any published report of this study.  Was the weight loss only temporary?

Beyond this information, there was no information on the amount of weight that might be lost using the techniques or procedures affecting the vagus nerve or whether weight loss with a method of this nature would be temporary or long term. 

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

Not Satisfactory

The discussion of harms was much too brief, and with only the presentation of glowing anecdotes, readers might walk away with an imbalanced and incomplete view of harms and benefits.

When comparing a medical device to disrupt neural signaling along the vagus nerve with surgical severing of the vagus nerve, the story did mention that surgical severing was irreversible and did discuss that implanting a device to disrupt the nerve involved having a foreign object within the body.  However beyond these two suggested problems, the story was lacking in discussion for the role of the vagus nerve in the body.  The vagus nerve is involved in far more than just mediating food intake; affecting it could have serious impacts on digestive system and on the cardiovascular system as well.  

An inadequate job was done exploring the ramifications of damaging the vagus nerve. 

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

Not Satisfactory

The story included anecdotes from several individuals who had had procedures that disrupt the signal from the vagus nerve; these people attested to their perception that the procedure had better enabled them to lose weight.  (One of the individuals interviewed claimed to have lost 20 pounds since December.  Interestingly, as this piece was written at the start of June, this works out to around 4 lbs per month.  There was no discussion about this magnitude of weight loss.)

While the story contained some discussion about historical precedent that suggested that disturbance of the vagal nerve could be utilized for the purpose of encouraging weight loss, the story did not include data about the efficacy of these approaches, whether such information had actually been compiled, or whether this approach to weight loss was entirely speculative.  This is an important oversight. 

Does the story commit disease-mongering?

Satisfactory

The story did not engage in disease mongering; in fact, the story was clear that these are treatments for obesity, not simply overweight.

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

Not Satisfactory

Several physicians involved in the use of devices to disrupt the vagal nerve for the purpose of weight loss and several individuals who had experienced weight loss using this type of methodology were interviewed for this story.  There was insufficient comment from objective experts on weight loss who might have been able to provide some perspective for the relative merit or interest in this avenue of research. There was only a one line comment from Dr. Samuel Klein of the Washington University School of Medicine in St. Louis predicting that vagotomy may produce only temporary weight loss. Better balance in sources – or in space provided them – was needed. 

Does the story compare the new approach with existing alternatives?

Not Applicable

Although this piece did not discuss other options, it was part of a series of reports by the paper that did discuss other options.

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

Satisfactory

The story made it clear that the newer (non-permanent) vagal nerve treatments are only available via clinical trials at this time.  And the availability of vagotomy surgery (and gastric bypass) was also clear.

Does the story establish the true novelty of the approach?

Satisfactory

It was clear from the story that the surgery was not new and which approaches were experimental.

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

Satisfactory

There are enough different sources used in this story that it is safe to assume that it did not rely on a news release.

Total Score: 5 of 9 Satisfactory

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