Initially we “killed” the story.
I came across the article “Myths, Presumptions and Facts about Obesity” in a press release for studies that would be printed in the New England Journal of Medicine the next week. It was a newsworthy title, but in reviewing the article, it had some questionable science. Running it by Nancy Snyderman, she said if it wasn’t solid science, then it wasn’t worth reporting. We were done. For us the story was dead.
But then the next week rolled around and there it was in the health section of the New York Times. As I looked through other news sources it showed up in many places. A couple days later, it was still being talked about.
In some ways I understood. I mean, how could you not report on “myths about obesity?” With two thirds of the United States either overweight or obese, everyone wants to know what we are doing wrong! Truthfully, I loved the premise of the article. There are so many old wives tales about weight and how to lose it. But reading the original article, I did not find it helpful for my patients.
As a young doctor, I had to admit I was tentative about disagreeing with my superiors. Finding fault with parts of this article made me nervous because the list of authors was impressive—all experts in the field of obesity, and the journal was one of the best.
But it was also my job as a physician to read every article critically to see if the science added up. So I read each myth the article’s authors cited and the reason they could say this was untrue. For every myth, presumption, or so-called fact I did a quick literature search to look at the largest body of research I could access. And the more I read, the more I disagreed with the authors.
One example was the “myth” of breast-feeding. The authors claimed that breast-feeding’s protective effect against obesity was actually a myth. In the article they cite a proponent of breast-feeding, and say even he didn’t think breast-feeding was protective against obesity. Yet, the conclusion of the paper they cite clearly states that breast-feeding is protective against obesity. The article even admits that the World Health Organization states that breast-feeding is one of the few proven things we know that helps to prevent obesity. The World Health Organization cites decades of studies showing this.
Which begs the question, if I had such problems with this study, why report on it at all?
Mostly, people were talking. Even I kept talking about it. Just reading the article, I’d get frustrated, and say something out loud at my desk. Then I’d end up in a half hour conversation with my coworkers sitting near by. The title of the article was interesting, and that I was disagreeing with the article made it even more interesting.
As a news show we could ignore the article and not be a part of the conversation. But part of the role of news is to explain what is out there. We needed to explain the article and its context, not just reiterate the authors’ ideas without fact checking them.
This was already in the news, shouldn’t we try to tell people what it really means?
So the story was on. But then came the real challenge: How to make a one-minute, thirty-second TV spot for something this complicated?
We started by figuring out what we could truthfully say about the article, then moved to what parts were questionable. We also wanted to close with a take home message. You be the judge of whether or not we succeeded.
One thing that got cut—the authors’ conflicts of interest. The producer and I debated about that one for a bit. It is important for scientists and doctors to know about conflicts of interest, and arguably for the public to know as well. But we had to decide what was more important: the conflict of interest or the actual take home messages about what you can do for your health.
We had to consider our platform and our audience. We felt that the conflict of interest story was better told in newspapers, which would have more space to explain those relationships. While television news reaches into everyone’s home, a long TV news story is still only 2 minutes which makes it difficult to cover more than one point in a story. Rather than trying to cover everything and doing so poorly, we felt the better option was to give the general public specific news they could use.
I worked with the producer to do the best job I could. I read the article as critically as I was able, and looked at the literature to provide context. We reached out to experts in the field and doctors seeing patients to get various expert opinions.
And there you go.
Was that the right choice? I think so, but in the week following, I did see several articles on the authors’ conflicts of interest. I welcome your comments below.