This is a story reporting on a study detailing the long-term outcomes observed in a group of patients more than a decade after having gastric banding to help with weight management. The story provided some useful insight about how gastric banding and gastric bypass compare in terms of rates and magnitude of weight loss. It also informed readers about the fact that outcomes following banding surgery are highly variable.
Obesity is an increasingly common and increasingly serious risk factor for disease and early death. Providing readers with realistic expectations about the benefits of gastric banding is useful for those making decisions about what approach to take to help manage their weight. While gastric banding may be less invasive and appealing in the short term, the long term outcomes of the approach are in question, especially for morbidly obese patients. This new study adds to our understanding of the limitations of this minimally invasive procedure.
Although not discussed in the study precipitating the story, the costs for gastric banding and appropriate follow-up care are readily available.
The story reported the average long term loss of excess weight that was observed in the study along with an insight from a clinician indicating that there is some variability observed among practices.
The story provided quantitative information about the harms observed in the study population who had had gastric banding surgery. It says, “However, 39 percent of the patients had experienced serious complications, including abnormal pouch expansion (9), band erosion (23) and band infection (1). Another 22 percent experienced relatively minor complications. Almost 50 percent had to have the bands entirely removed, while 60 percent needed to undergo subsequent surgery. The procedure “appears to result in relatively poor long-term outcomes,” the researchers concluded.”
The story provided only hints about the study on which it was reporting. It should have provided better context and asked tougher questions about the study. The timeline in the story also may confuse readers. It says that gastric banding has been an alternative to gastric bypass since 2001, but then it says the study followed patients who received operations from 1994 to 1997. This appears to be before the band was approved. The story should have said that the 2001 date was when the FDA approved banding for use in the US and that the study population was in Belgium. It also should have mentioned that the pool of patients studied were treated at a single clinic.
The story did not engage in overt disease-mongering.
The story quoted an author of the study, the author of a critique on that study, and a surgeon who did not appear to have ties with the study. But the story missed a key fact that WebMD found in the study and reported, which is the conflicts of interest for the study’s lead author, who, as WebMD pointed out, “reports consultant work for Ethicon Endosurgery, which makes another gastric band, Realize, and for Covidien, a health care products company.” Not pointing out that the author has worked for a competing gastric band maker is a significant drawback to the story.
The story relied on a critique published alongside the study from Dr. Clifford W. Deveney, a professor of surgery in the department of surgery at Oregon Health and Science University in Portland, to provide readers some good comparison information between gastric bypass surgery and gastric banding. We would have liked to have seen a more detailed discussion of the evidence for both and also at lesat some mention of diet and exercise.
The gastric banding procedure was appropriately described as an available treatment.
It is clear from the story that the procedure is not new.
The story does not appear to rely solely 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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