Teacher:Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
Teacher: Now, understand the problem? Solve this instance: Paragraph: There's no mention of the cost of these procedures or whether they are covered by insurance. The average cost of gastric bypass surgery is $23,000, the average cost of lap band is $14,500, and the average cost of sleeve gastrectomy surgery $14,900, according to the web site ObesityCoverage. The story states: "Before surgery, only 3 percent of the teens had no cardiac risk factors at all, but three years later, just over half of them (52 percent) had no risk factors. Just 5 percent had all four cardiac risk factors before their surgeries, but none had all of them three years later. In fact, the majority of the participants 83 percent had only one or no risk factors three years after their surgeries. The proportion of participants with two or three risk factors also dropped substantially." This is a useful start,but the story needed to remind readers: Changes in risk factors predicated on lab values are surrogate markers, so they may not actually lead to improved "heart health" as the story states. The story states that the weight-reduction procedures "carry the same risks as any surgical procedure, such as infections, blood clots and bleeding" as well as nutritional and vitamin deficiencies. It also states that gastric banding "has low effectiveness and a risk of the band slipping down the stomach." Note: The most risky complications (problems arising from general anesthesia) were not mentioned. The story describes how the study was conducted and provides important caveats, stating: "The study's biggest limitation is its very selective population. Most of the participants were female, most were white, and most received the gastric bypass. Children of color have the greatest risk of obesity, heart disease and type 2 diabetes, but it's not clear if they would see the same improvement with these procedures." It also mentions that the study included "only teens with the greatest obesity who were also unsuccessful trying other weight loss methods. Further, it points out the need for longer-term data of 10 or 15 years. The story does not mention one inherent weakness of this study: The lack of a comparison group that did not receive surgery. [Editor's note: We updated the final sentence in this criterion to strike the phrase "observational studies" and replace it with "this study."] The story does not engage in disease-mongering. It states that an estimated 4 to 7 percent of teens have severe obesity. The story includes two sources who were not part of the study. The story does a good job here, quoting Geetha Raghuveer, a pediatric cardiologist at Children's Mercy Kansas City in Missouri who, it reports, was not involved in the study. Raghuveer is quoted saying surgery "would be considered for the highly obese and those not responding to any behavioral modifications, physical activity or calorie restriction." Further, the story says, Raghuveer endorses public health efforts that "aim for better obesity prevention, including parent education and interventions when children are toddlers and preschoolers." "The big question is, how do we prevent obese kids from getting to this point where they would need an invasive surgical procedure?" Raghuveer says in the story. The story mentions that 1,600 teens undergo stomach reduction surgeries each year, which suggests that they are widely available. It also mentions the need to seek counseling and "detailed information from well-established bariatric surgery centers that are specifically dedicated to treating adolescents." However, one big key to availability is insurance coverageand this was not mentioned. The story mentions that this study includes more patients than some previous studies that looked at the impact of surgery on teens with severe obesity, and it quotes the study's author saying it "serves to reinforce the benefits of bariatric surgery as a safe and effective treatment strategy that should be considered sooner rather than later." Also, the the study of cardiac risk factors and how they are affected is novel, as well, and that's clear in the story. The story does not appear to rely on a news release. Claim: Bariatric Surgery Helps Teens With Severe Obesity Reduce Heart Disease Risk
Student:
This story covers an observational study showing cardiovascular risk factors improved after three years for teens who underwent weight-loss surgery. The story does a good job describing the study, the potential harms of the intervention, and limitations to the findings. One area with room for improvement: it doesn't mention how much these procedures cost or whether they are covered by insurance. Also, it's always a good idea to point out when surrogate markers are being used as stand-ins for heart health. Lastly, some readers of the story might have found the photo stigmatizinghere's our tips for communicating about obesity without promoting stigma. This isn't the first research to suggest that bariatric surgery might help teens with severe obesity, who are at risk of developing health problems in their 30s and 40s. Yet one recent review asserted that while weight-loss surgeries are increasingly being offered to teens, there's no data to show what impact these involved procedures will have in the long term. News coverage should remain cautious, stressing the risks and extreme lifestyle changes they entail and the fact that the jury is still out on their ultimate impact.