Double-Edged Sword:

The Positive and Negative Influence
of the Media on Obesity

Published in March 2014 Issue             

If you’ve been following the news over the last few months you would have heard that the obesity rate among young children has plummeted, the FDA has proposed a major update to food labels, Mississippi is the “fattest state,” Americans are not exercising, comedian Rosie O’Donnell had a sleeve gastrectomy and Governor Chris Christie is halfway toward his weight loss goal. Each of these stories have grabbed major headlines and Internet buzz, but are they actually helping Americans better understand the realities of fighting a disease that affects more than one-third (34.9%) adults? Are Americans getting a healthy diet of information about obesity and its treatments?

“The answer is yes and no,” said Jaime Ponce, MD, Immediate-Past President of the American Society for Metabolic and Bariatric Surgery (ASMBS). “The more information people have about obesity and its treatments, the better. However, the attention span of the media is quite short. What is news one day, may be forgotten the next. In addition, the things they choose to focus on might not be the important things people need to know.”

Last year, when New Jersey Governor Chris Christie revealed he had gastric band surgery, media from all over the world – from NBC to the BBC -- clamored for any detail they could find. Governor Christie was relatively tight lipped but said that when he turned 50 he was “confronted” by his own “mortality” and for the sake of his wife and children he “needed to take a more significant step to try to get my weight under control so that I could have a really active next half of my life.”

Jaime Ponce, MD

“The phone at ASMBS was ringing off the hook for comment,” said Dr. Ponce, who was president at the time. “And we did our best to respond because it was an opportunity to educate on the disease of obesity and the gastric band, as well as the other methods of surgery and what other not so famous people face in trying to obtain access
to treatment.”

Past ASMBS presidents Dr. Robin Blackstone, Dr. Philip Schauer and other ASMBS members were also featured in comments on media outlets including National Public Radio (NPR), USA Today, NBC News and others discussing the pros and cons of surgery, the importance of follow-up care and how Governor Christie could become a role model for others who have struggled for years with obesity, before seeking out effective treatment. “I think we were able to add important perspectives to the national conversation on Christie’s surgery,” said Dr. Ponce.

Ninh Nguyen, MD

Last month, on the first anniversary of Governor Christie’s surgery, the news media felt compelled to report on his progress. ran with the headline, “Still Not Skinny, Christie Cheered as a Weight-Loss Surgery Success.” ASMBS President Ninh Nguyen, MD, turned the discussion away from whether the governor was skinny or not to whether the governor was getting healthier or not. “We’re trying to get somebody into a healthy lifestyle and reduce their obesity-related conditions,” said Dr. Nguyen, “We’re not trying to make somebody skinny here.

At the end of February the federal government released a report in the Journal of the American Medical Association (JAMA) that found a 43 percent drop in the obesity rate among 2- to 5-year-old children over the past decade. Headlines roared the good news and characterized the decline as “offering the first clear evidence that America’s youngest children have turned a corner in the obesity epidemic” and provide a “glimmer of hope.”

There was little consensus on the reasons behind the decline, but many theories, including lower calorie counts, breast-feeding and government programs including Michelle Obama’s “push to change young children’s eating and exercise habits,” may have been responsible. However, lost in the headlines, and barely mentioned in most stories, was that fact that there were increases among those 12- to 19- year-olds (17.4% to 20.5%) and among women over 60, which rose from 31.5 percent to 38 percent. No comments or perspectives on these increases. Is it because rising obesity rates are not new so it doesn’t merit the attention of a decline of a smaller population?

A week later The Washington Post answered the question in an editorial entitled, “The U.S. Can’t Afford to get Complacent About Obesity.” The Post’s editorial board said “we’d suggest that the country should not be comfortable that the ravages of obesity – diabetes, heart disease, hypertension, cancer and more – will diminish the living standards of merely a third of our countrymen, even if some of their children and grandchildren end up better off.” Why was this in the editorial pages and nearly absent in the news coverage? Is it because the “ravages of obesity” of obesity are ‘old news?’ Is it up to the news media to keep reminding us of things we should already know? Or is it just their job to report what’s ‘new?’

“I think there needs to be a balance,” said Roger Kissin, president of Communication Partners & Associates, a health care communications firm based in New York City and a group that works with the ASMBS on media activities. “Just because something’s new doesn’t make it important and just because something’s important doesn’t make it news. Context and relevance are everything and it’s up to both journalists and the experts to provide it. When that happens, stories can advance issues and educate the public and policymakers.”

Recently, the Associated Press (AP), one of the largest and most important news organizations in the world, reported few eligible patients can get weight loss surgery. This is not a revelation, however, according to the AP, it is a “surprising trend: while the number of obese Americans persists at record levels, the number of weight loss surgeries hasn’t budged for a decade.” The story references statistics from the ASMBS that show only about 1 percent of eligible patients get surgery every year.

John Morton, MD

ASMBS president-elect John Morton, MD, commented in the story, “If we were talking about breast cancer, no one would be content with having only one percent of that population treated. Yet if you look at the impact of obesity on life expectancy, it’s by far one of the most dangerous conditions we have in public health.”

The story also cited new obesity guidelines that urge doctors to more aggressively address obesity, including referring patients for bariatric surgery and two groundbreaking 2012 studies that “suggest bypass surgery can reverse and possibly
cure diabetes.”

The story raises some real questions as to why insurers, employers and many state-run health insurance exchanges under the Affordable Care Act delay or deny bariatric surgery when the evidence shows such safety and effectiveness for most patients.

The AP profiled a mother from Texas whose insurer there, UnitedHealth, excludes coverage of bariatric surgery. Because of this, she and her family are trying to raise money “to pay for the surgery that she thinks will save her life.”

The AP concludes the story with a comment from the woman who takes 11 medications for obesity-related conditions. “I spend every day worrying about how much time I have left. Everything hurts and my health issues get worse all the time,” she said.

The ASMBS and many of its members find real value in responding to the media and providing context for stories that might otherwise go without.

Stacy Brethauer, MD

Stacy Brethauer, MD, FACS from Cleveland Clinic and member of the ASMBS Executive Council, says while some of the media tend to gravitate toward the sensational, he sees real value in providing context for stories that might otherwise go without and welcomes the media spotlight on issues and research that might otherwise go unnoticed.

“I see communicating to the media as an essential part of my job,” said Dr. Brethauer. “The media has an important role to play in educating the public and we have to do whatever we can to help them do that as accurately and responsibly as they can.”