This smartly written blog post manages to pack more information into a tight space than many longer pieces. We wish it had spent a little more time with the evidence behind this study on weight loss programs. For example, a MedPageToday story explained:
Each of those is important points – and limitations that readers should have been told about – somehow – even in a short blog piece.
As the story points out, the majority of Americans are either overweight or obese, and losing that weight can prove very difficult. Anyone who has picked up a lifestyle magazine knows how fat-fighting fads catch fire and then disappear. Solid research into what motivates people to lose weight and to keep it off is necessary to help guide public policy on a number of fronts.
The story excels in this criteria where so many others fail. The story says, "The program costs about $1,600 for 12 weeks," and then it goes on to make an important comparison. "Compare that to the $19,000 to $29,000 cost of bariatric surgery, which is often reimbursed by insurers." This helps readers understand that dieting is a far cheaper approach to weight loss, and that the burden of expensive weight-loss surgeries is actually passed onto all of us in the form of higher insurance premiums. We wish the story had driven home the point more emphatically – as it alluded to in the headline and in one line in the story – that people in the trial got the intervention for free. That’s a big leap from reality.
The story does quantify the benefits of each of the plans studied. We would have liked to have seen the total number of people in each group and the highest and lowest amount of weight lost. This would have shown, for example, whether anyone in the control group lost more weight than people in the Jenny Craig face-to-face group.
This story does not quantify the harms of either the diet plans or of obesity.
The story missed an opportunity here to explore some of the limitations of the study, even though it does make note of a few of them. The study was funded by Jenny Craig, as the story points out, and it compared three different groups of people. There were so many factors going on in this study, though — counseling, the diet itself, cash payments — that it would have been nice to see some acknowledgment of the difficulty in teasing out the real triggers for the weight loss. The story talks about the program being 12 weeks long but then also says that "average weight loss was greater at one year than at the end of the study." Are we to take this to mean that people stuck with the program for a year and lost more weight? Were there people from different income groups in this study? A $25 incentive might not mean much to a high earner.
For comparison, a MedPageToday story did a far better job explaining limitations of this research.
The story repeats the commonly cited CDC statistics on people who are obese and overweight. It does not engage in disease-mongering.
The story does not quote any "live" sources, but it does make good use of an editorial that accompanied the study. It also points out that the study was finded by diet giant Jenny Craig and that the editorial writer, Rena Wing, a professor of psychiatry at Brown University called for "cost-effectiveness studies, conducted by researchers without any financial ties to the companies involved, that compare different commercial programs with each other."
The story says up high that "there’s not much clinical evidence on the best way to lose weight, outside of research on bariatric surgery. (True, “Eat less and exercise more” is great advice if you can manage to follow it, but public-health authorities have repeated that line until they’re blue in the face and as a population we’ve only gotten fatter.)" The study itself compared three different approaches, and the story also makes this important note: "The countervailing theory is that people value things more when they pay for them, and that the mere act of ponying up $1,600 for three months of a diet program may make you take it more seriously."
This is a tricky one. Because the study was funded by Jenny Craig, it seems some mention of how widespread Jenny Criag programs are would have been warranted. Absent that, the story could have said how easy it might be for the typical person to find a diet program of any sourt that would provide people once-weekly face-to-face counseling, which was the regimen that had the best results – and for free! It might seem obvious that these programs are popping up all over the place, but they are not uniformly available, especially in rural and poor areas in counties that have high concentrations of obesity. If the story had even mentioned how many Jenny Craig centers (according to the company’s website it is 565) we would have given this one a passing grade.
The story could have put this study into the larger context of cash payments for health incentives. This has been demonstrated to work on a number of fronts, including encouraging mothers to give birth in health centers, discouraging risky sex, and smoking cessation.
This story does not rely on a news 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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