Posted on March 18, 2013 by admin
In a recent exchange about the relative merits of an expert commentary being made on a popular study; a highly respected individual in the health community, a scientist turned non-profit CEO, opened otherwise informed commentary on the article with this statement: “the ‘experts’ in this case are selling surgery so one might question their objectivity”
Despite well-informed and interesting commentary overall, the attack on the “experts” motivations with no evidence whatsoever immediately casts doubt on the value of the comments that follow. In the case in point, a wide range of non-surgical experts also found significant methodological fault with this study and its conclusions.
Personal attacks based on provider specialty or how we earn our livings in my opinion shows bias in the very individuals who are the first to point the finger at the biases of others. Furthermore, unless the actual data or design shows fundamental bias, these cheap-shot and unsubstantiated statements have no place in academic discussions of the scientific merits of various points of view.
Unfortunately these attitudes have plagued obesity treatment and research for decades. They do harm in my opinion to patients who feel that if they are seeking surgery, medications, or nutritional supplements, they are some sort of failure. As a result they often delay seeking appropriate, life saving intervention.
The more intensive medically managed treatments appear most stigmatized. Why is it in cardiology we don’t refer to doctors as “selling surgery’ or “selling” medication when the preponderance of data supports these interventions as viable and medically appropriate treatment options for the proper candidates? People who struggle with weight are often depicted even in medical and public health settings as “weak willed individuals who should just eat less and exercise more” and out-of-hand statements like the one mentioned here fuel that bias.
We need to be very careful what we say. I think it does a disservice both to patients and colleagues to attack the ‘experts’ based solely on their specialty as opposed to simply evaluating the scientific merits of their points of view. By the same token; if a dietitian suggests eating healthy balanced meals we don’t often attack them for “selling nutritional consultations” (yet it’s a business too)… We all get paid for what we do whether it is a lifestyle change approach, a surgical intervention, a medical management situation or a pharmaceutical intervention. It always amazes me that one person who earns a living utilizing evidence-based intervention in obesity management and prevention judges another who earns their living in the same way using different evidence-based interventions, based solely on the fact that they are earning a living.
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