There were some bright spots in the coverage — the discussion of costs was particularly welcome — but overall this story provides the reader with an incomplete picture of the value of TORe surgery. A single patient anecdote is used as the basis for the majority of the claims. And while a link to a supporting study abstract is provided, the story gives no analysis of the findings and lacks key details such as the study design, the number of patients, and the true burden of the side effects of the procedure.
Obesity is a significant health problem in the United States, affecting about one third of all adults. While diet, exercise and behavioral changes are the mainstays of weight reduction, surgical options including gastric bypass have been shown to be very effective at treating obesity and related conditions such as diabetes. (Here’s an example.) As we are now learning, the weight reductions seen in people who have undergone gastric bypass surgery may be temporary in a significant minority of patients. A simple procedure getting weight reduction and maintenance back on track would be welcome.
The story clearly provides the reader with an estimate of the costs of the procedure and highlights issues related to insurance coverage. A strong point in this story.
Although the story links to an abstract from a randomized trial of the procedure, the story is almost purely dependent on the experience of one person and the comments of an expert: “After the surgery, Watson says, patients report feeling fuller and less hungry and they ultimately gain greater control over what they are eating. And research conducted over the past decade suggests it works.” The story does not provide any additional details. How well did TORe work in the research? Did it work for everyone? How long did the researchers follow the subjects?
It would have been especially useful, in our opinion, to point out that the weight loss was modest in the intervention group (3.5% from baseline) and that most everyone in the study (including 78% of the control group that received a sham procedure) achieved weight loss or stabilization.
The side effects should be clearly stated. The randomized study notes that the majority of people who had the surgery (including, interestingly, those who underwent a sham procedure) had side effects including nausea and vomiting. The story states simply that there were “no significant side effects.”
The story did provide a link to the study abstract mentioned previously. But we don’t think that is really sufficient. All of the evidence for the TORe procedure comes from a single patient anecdote and an expert who merely provides an assurance without any quantification or analysis.
Given the high incidence of obesity in the United States, exaggerating the seriousness of the problem is unnecessary. No disease mongering here.
The story quotes an independent expert who provides useful context about this type of surgery. While it clearly meets our standard, the story could have offered a few more details about this source. Is he a bariatric surgeon? Has he used this device? That would give readers a better perspective from which to evaluate his comments about the procedure.
We are told the there are other procedures available to help maintain the benefits of bariatric surgery, but they are not described. And while the story states that the patient is recommitting herself to lifestyle changes, exercise and diet after receiving the TORe procedure, it would have been useful to describe the role of these measures in preventing the initial weight regain. The authors of the research stated; “TORe is one approach to avoid weight regain; a longitudinal multidisciplinary approach with dietary counseling and behavioral changes are required for long term results.”
Although not explicitly stated, it is apparent that the TORe procedure is available since cost and insurance coverage are noted. It would have been useful to include additional details on how widely the procedure is used, whether it’s used by both gastroenterologists and bariatric surgeons, and whether patients should look for doctors who have special training or credentials for performing this procedure.
Although the story does not make any inappropriate claims about the novelty of the procedure, it does not really address the issue. If the procedure is not new, why is it being written about now?
The story includes an independent expert comment and does not appear to rely solely or mainly 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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