Truth in Bariatric Surgery Advertising Among Academic and Non-academic Centers

J. Aaron Barnes¹, Sarah E Billmeier, MD, MPH², Gina L Adrales, MD, MPH². ¹Geisel School of Medicine, ²Dartmouth Hitchcock Medical Center

Introduction: Numerous advertisements for obesity treatments target a potentially vulnerable population. The purpose of this study is to evaluate the content of direct-to-patient consumer advertising by bariatric surgery programs.

Methods: Internet sites containing patient information regarding bariatric surgery were collected through a comprehensive internet search using terms associated with weight loss and weight loss surgery. Inclusion criteria included sources published by hospitals or practices offering bariatric surgery. Open forums, blogs, video interviews or news-related sites were excluded. Sources were assessed for accuracy of information and completeness of content provided along four areas: resolution of diabetes or hypertension, weight loss, and risk of complications for laparoscopic adjustable gastric banding (LAGB), gastric bypass (RYGB), and longitudinal sleeve gastrectomy (LSG) for both academic and non-academic bariatric surgery programs. Comparison of reporting by academic (AC) or non-academic centers (NAC) was performed by Fisher's exact test. 

Results: A total of 65 sites including 21 academic centers were identified. 62 sites (29% academic) advertised for LAGB with 27.4% claiming diabetes resolution or cure (including 16.7% of AC's and 31.8% of NAC's) and 22.5% of LAGB sites claiming resolution of hypertension (16.7% of AC's and 25.0% of NAC's). 62.9% of LAGB sites reported excess weight loss with ranges of 40-80% among AC's and 21-90% among NAC's. Of 52 RYGB sites,44.2% reported diabetes resolution (44.4% AC, 44.1%NAC), 40.4% listed hypertension resolution (27.8% AC, 47.1% NAC) and 75% reported weight-loss (72.2% AC, 27.0% NAC) ranging from 33-85% among AC's and 50-100% excess weight loss among NAC's. Of 53 LSG sites, 24.5% reported diabetes resolution (18.6% AC, 27.0% NAC), 26.4% reported hypertension resolution (8.6% AC, 29.7% NAC), and 50.9% reported weight loss (37.5% AC, 56.8% NAC) ranging 33-85% among AC's and 30-85% among NAC's. No risks were reported by 30.6% LAGB, 26.9% RYGB, and 45.3% LSG sites. Fewer sites quantified risk (22.3% LAGB, 17.3% RYGB, 5.7% LSG). There were no significant differences in reporting rates by academic versus non-academic programs.

Conclusions: There was consistency in effectiveness reporting among academic and nonacademic bariatric programs. Balanced patient information was not uniformly presented with a number of sites failing to report any risks. In an era when patients increasingly rely on the internet for health information, bariatric surgery programs should re-evaluate the content of their digital patient information.