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Weighing risk for obese youth

Rating

3 Star

Weighing risk for obese youth

Our Review Summary

This is a story about a study of the use of one particular weight loss surgery (gastric banding) for the treatment of children who are obese. 

This story did accurately report the results of the story, though selectively so.  Further, the title of the research study mentioned that the results were 'short-term'.  This is important because the surgeons promoting the use of the surgery make the claim that it would have an effect on the chronic diabetes and cardiovascular disease that these kids would be facing.  There is no evidence that inserting a gastric band in children will decrease the risk of these diseases in adulthood because there is no evidence that the band will decrease the risk of obesity in these children as they become adults.  While participants of the study lost about 63% of their excess weight by one year after surgery, they had already started to regain weight by 18 months.

Thus while the story did contain accurate information about the increasing prevalence of obesity, it did not contain information about treatment options, costs of weight loss surgery or adequate information about the potential for weight regain.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story did not discuss costs of these treatments – a significant oversight.

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

Satisfactory

The benefits of the treatment (weight loss at 18 months) was accurately reported.  It should have been clarified that this amount of weight loss did not represent the maximum weight loss, which was seen at 1 year. The fact that the children in the study were seen to have started to gain weight by 18 months after surgery should have been mentioned.  Nonetheless, we'll again give the story the benefit of the doubt. 

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

Satisfactory

The story did quantify the complications seen in the trial.  But it let a study co-author get away with saying that these were  "minor compared to the chronic diabetes and cardiovascular disease teens would face….".  He failed to point out that the complications they experienced were concrete as opposed to hypothetical. It might be better to let patients dexcribe whether these were "minor" or not.

The fact that the children in the study were seen to have started to gain weight by 18 months after surgery should have been mentioned.

Nonetheless, because of the listing of complications at the end of story, we'll give it the benefit of the doubt.  

 

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

Satisfactory

The evidence presented in this story come from a study of 53 children, which was accurately reflected. 

The story explained that the study participants had lost "nearly half of their weight over 18 months…"    But more importantly, they had lost about 63% of their excess weight at 12 months, which means that they had already started to regain some lost weight by a year and half.  This is an important point that could have been presented.  Nonetheless, we'll give the story the benefit of the doubt on this criterion.

Does the story commit disease-mongering?

Not Satisfactory

"…huge increases in the number of dangerously obese children….." is disease mongering.  A real estimate of prevalence would have been helpful.  (About 5% of children nationwide have a BMI greater than 40).  Although it is true that the number of children with a BMI > 40 has been increasing, and that children who are obese are commonly found to become obese adults, it could have easily been described as an increasing proportion of kids who are obese.  It is true that health problems typically seen in older individuals can be seen in obese kids, it is extremely rare for these  health problems to be 'dangerous' in the short term.

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

Satisfactory

One patient was interviewed for this story as was one of the authors of the research study.  One surgeon at one of the hospitals with FDA approval for using this surgical procedure on children was interviewed. And one nutritionist who was not associated with the study and had a rather dim view of this mode of treatment of obesity was also interviewed.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

This story mentioned dieting only in passing (as in the one patient quoted as saying "Dieting didn't work") and failed to mention counseling or weight loss drugs that might be used to better enable children to reduce their weight.

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

Not Satisfactory

The story provides only a limited view on availability of these procedures. It does mention that four hospitals are testing various forms of weight loss surgery in children and that only three are approved for the laparoscopic gastric banding procedure detailed in the article.  But the FDA does not regulate gastric bypass and can only decide on whether the gastric band is officially "approved" for use in kids. Many other treatments for kids do not have FDA approval for that age range, but some clinicians feel comfortable with "off-label" prescribing.

So, in short. Both procedures may be available to kids all over the U.S. What people need to know is that the use of both procedures in kids is still very much experimental. There isn' t much evidence of efficacy and safety in this population.

 

Does the story establish the true novelty of the approach?

Satisfactory

This story was about the use of an established treatment of morbid obesity in adults in a new population, children.

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

Satisfactory

This article does not appear to rely exclusively on a press release.

Total Score: 6 of 10 Satisfactory

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