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Gastric Bypass Best for Weight Loss, Study Finds

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4 Star

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Gastric Bypass Best for Weight Loss, Study Finds

Our Review Summary

This story also was better than the LA Times story in other small but tangible ways, including its handling of the statistics on benefits and harms and its discussion of costs. More context on the previous research that has been conducted in this field — and particularly the well-established differences in surgical mortality associated with the different operations — would have been valuable.

 

Why This Matters

Most Americans today are either overweight or obese, and all that fat is taking a serious toll on our health and our economy. With manyt of us seemingly unable or unwilling to change our diets and exercise more, surgery remains one of the few options that can produce substantial long-term weight loss. The emergence of the gastric banding procedure in recent years provides an alternative to the more widely used and more invasive gastric bypass operation. Studies like those covered in this story can help us determine which procedure is a better fit for different types of patients.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story notes that the average cost of weight loss surgery is about $30,000. It would have been helpful to include a comparison of the different procedures discussed in the story, but this is good enough.

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

Satisfactory

A little bit better job with the numbers than the LA Times. The same weight loss data are provided in absolute terms, but this story also attaches a figure to the number of patients whose diabetes resolved after bypass compared with the band procedure. The LA Times called the results here “far better” for gastric bypass, but HealthDay notes that improvement or resolutions was seen in three-fourths of bypass patients and half of band patients — a more precise characterization.

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

Satisfactory

Unlike the LA Times, this story attached a number to the risk of complications observed during the study. It would have been interesting to see some discussion of the seriousness of these problems, as some data suggest that short-term complications with gastric bypass are more grave than those with the band, while longer-term complications with the band may be more frequent and serious. This story mentioned that there were no deaths in either group in the bypass vs. band study, but as with the competing coverage, it didn’t explain that there are well established differences in mortality risk associated with each procedure. We’ll award a passing grade, but the story could have done better here.

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

Satisfactory

There were some differences between this story and the competing LA Times piece on this criterion. Notably, this story injected some caution into the discussion in the second paragraph, where it noted that bypass outcomes are better with more experienced surgeons like the ones who conducted the study comparing bypass to the gastric band. Patients with different surgeons at a different institution might not fare as well with bypass as the patients in this study. It also included comments from an expert who noted that the band may be a better choice for certain patients, such as those with a lower BMI or who don’t have related medical conditions such as type 2 diabetes. Although it included a closing caveat about the relatively short-term follow-up of these patients, which is an important limitation to point out, it could have done a bit better job of explaining why this is important. Previous studies suggest that some band patients continue to lose weight for years and may approach the weight loss seen with bypass patients, whereas bypass patients may gain back some of the weight they lose initially. There may also be differences in the risk of very long-term complications (e.g. neurological disorders resulting from nutritional deficiencies after 5-10 years in bypass patients, versus failure of the device and need for reoperation with the band).

Does the story commit disease-mongering?

Satisfactory

No disease-mongering here.

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

Satisfactory

The story quotes an independent expert source and weaves his comments into the coverage nicely. Remarks from a second source would have been even better.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

As with the LA Times, there was no mention of the effectiveness of diet or lifestyle interventions for weight loss. Even a line would have helped.

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

Not Satisfactory

This story did not fully explain who might be a candidate for these procedures – which is a matter of availability. A brief explanation of the criteria for weight loss surgery would have dispelled any confusion.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story didn’t mention that many other studies have examined these procedures or establish what, if anything, is novel about these new findings. It should have.

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

Satisfactory

The reporter seems to have contacted two expert sources, although only one is quoted directly. There’s no evidence that anything was taken directly from a press release. A close call, but we’re fairly confident in the level of independent reporting done here, so we’ll award a satisfactory.

Total Score: 7 of 10 Satisfactory

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