the HAES files: How to Photoshop a Research Study

by Health At Every Size® Blog

[as demonstrated by Rock et al. (2010) on weight loss results of the Jenny Craig® program]

by Deb Burgard, PhD

1. Publish in a peer-reviewed, respectable journal like JAMA. The average person has no idea they are willing to publish research sponsored by industry, so the fact that Jenny Craig paid for this will stay buried in the fine print on page 1810.

2. You’re the researcher, so you get to choose who can be in the study. Forget the bother of a representative sample.  Make sure you eliminate at least 20% of your interested participants right off the bat, even though you don’t do that with your customers.  Who’s going to notice that you don’t have even a representative sample of your customers, let alone a representative sample of the “obese and overweight women” of your title?

3. Don’t bother to test your actual program−too many people would drop out.  Instead, pay your participants for showing up to clinic visits, and give away your diet food.  Readers won’t realize that you are not really testing your real-world program, which costs $100/week.  Don’t report on (or maybe even bother to track) the percentage of people who actually chose to eat the (free!) food−just track whether people showed up at the center or talked on the phone.  Don’t report on the percentage of people who would not eat Jenny Craig food even when it is given away.

4. Identify the study participants to your staff, for no discernible reason.  Could it be so they can be sure to work extra hard to get the desired results?  But report on how you told them to treat everyone the same, as if that is an accepted research procedure.

5. Say your study tests maintenance of weight loss, but don’t ever stop your intervention.  Who’s going to notice the difference between a two-year study of continuous dieting vs. a study that actually follows up, i.e., shows what happens two years after the intervention is over?

6. Report in BMI, kg, and means so that readers won’t do the math and translate into what is familiar to them.  Who’s going to go back and look at the average baseline weight of 92 kg and multiply by 2.2 then figure out what 5% of that would be (about 10 pounds) to understand that this statement, “By study end, more than half in either intervention group (62% [n=103] of center-based participants and 56% [n=91] of telephone-based participants) had a weight loss of at least 5% …” means that 59% of the people who showed up at clinic visits were at least 10 pounds lighter at two years out, going from an average of 203 pounds to 193 pounds?  Who’s going to subtract to figure out that even when they were getting paid and the food was given away for free, 41% of the participants could not maintain even a 10 pound average loss?

And really, who would actually divide to notice that it took an average of $6958 over two years to return an average weight loss of 15 pounds, or $463.87 per pound all while losing your sanity points being on a continuous diet for two years?

7. Count on no one noticing that even when you are paying people over $3000/year in food products and counseling rather than asking them to pay over $3000/year in the real world, the average weight trajectory is on the way back up after month 12.

8. Claim in the results section that the intervention groups reported better quality of life and reduced depression at 12 months; maybe people won’t notice that sure enough, at 24 months there were no significant changes from baseline in physical fitness or psychosocial measures.

9. Make sure to end your study at the point when you stop paying people, but describe the study in the abstract as “conducted over 2 years with follow-up between November 2007 and April 2010.”  Who reads the actual article anyway?

10. Make sure you publish your study side-by-side with an independently-conducted study but make sure that one stops at the 12-month point in the process where people tend to have maximum weight loss and benefits, even though studies consistently show this reverses over the next year.  That way your sponsoring company can send out its press release mashing everything together and imply all kinds of results no one found in either study, like you had a “two-year independent, multi-site clinical trial” (OK, the independent trial was a only a year and only one site) and “those who took part in the Jenny Craig program adopted healthier eating habits and meaningful health benefits for overall improved quality of life” (OK, the quality of life changes were not significant at 24 months) and “those following the program reduced risk factors that can lead to chronic disease including depression, diabetes, cancer and even stroke” (OK, there were no significant changes at 24 months in total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides, or step test fitness measures, or any psychosocial measures including depression).

Hey, if Vogue can get away with it, why not JAMA?

17 Responses to “the HAES files: How to Photoshop a Research Study”

  1. A number of ASDAH members asked to see this brilliant analysis by Deb Burgard as a blog post, so we were pleased and honored when Deb agreed to allow us to feature it here. In case you missed it, the CEO of Jenny Craig Australasia has been invited to speak at a conference for the Alliance of Girls’ Schools in Melbourne in May. This was brought to our attention last week by our Health At Every Size® colleague and ASDAH member Lydia Jade Turner. Many readers of this blog have already spoken out against this decision through letters and emails and by signing Lydia’s petition at https://www.chaange.org/petitions/stop-jenny-craig-presenting-at-conference-for-leaders-of-girls-schools. We encourage everyone to consider doing so.

    In the words of HAES(sm) public health expert Dr. Lily O’Hara, “It is just not possible to have a leader of the weight loss industry talking about stereotyping and the resulting inequalities, when they represent an industry that not only contributes significantly to these outcomes, but actually employs stereotyping as a fundamental sales tool.” This blog post is in honor of this type of hypocrisy.

    The ASDAH Blog Committee

  2. Wow. I’ll be sending this to just about everyone I know.

    One unexpected benefit of HAES(R) for me has been an increased skepticism about study outcomes – even when published in prestigious places like JAMA.

  3. Who’s going to subtract to figure out that even when they were getting paid and the food was given away for free, 41% of the participants could not maintain even a 10 pound average loss?

    WOW. Wow.

  4. This is amazing. Thank you. Sharing this on Twitter.

  5. Thank you, Dr. Bugard, for this study, and thank you for featuring it here at the HAES Files, ASDAH folks.

  6. Funny how when it’s broken down and all the weaselspeak is identified that the JC study shows virtually the same results as every other study of weight loss since the 1950’s.

    It’s almost like biology trumps diet plans! (/sarcasm)

  7. truly awesome. I’m going to be sharing this with some key folks on “the Hill” …continuing to educate decision makers about the many myths of obesity! ~ THANK YOU Deb!!!

  8. This is wonderful. Thank you so much

  9. Today is my favourite event of the year – the Melbourne International Flower and Garden Show, I’ve got my camera and lunch packed. But I just discovered its being sponsored by Jenny Craig who have an exhibit on ‘healthy living’ – arrggghh! I’m taking an industrial size texta and may do some graffiti :) Seriously however, I’m sitting here cramming all this information in the hope that the exhibitors have a question & answer session with the audience. I’m preparing questions right now. I’d also like to give thanks to Lydia Turner and her team at Body Matters Australasia for their protest against Jenny Craig CEO addressing the leaders of Melbourne Girls’ Schools. At least a poll result in our leading newspaper was encouraging with 55% of votes (out of 3200+) for NO, that she should not be at the event.

    http://www.melbflowershow.com.au/Show_Highlights

    http://www.theage.com.au/national/education/schools-jenny-craig-furore-20120326-1vups.html?rand=5949531

  10. Back from the Flower Show – no q & a session, their two exhibits were empty despite 10,000s of people in attendance. They also had a Jenny van selling pies and pasties (traditional Aussie junk food) – no one was buying that either. pic here: http://pinterest.com/pin/206602701625924996/

    I apologise if this is old (or irrelevant) news, however, this blurb from Jenny (the remarketed name for Jenny Craig) mentions another study:

    March 2012 – Don’t Judge Me, You’re Overweight Too! Why overweight Aussies are turning on each other

    A new study* of 4299 respondents by weight loss company Jenny Craig has revealed two out of every three (66%) overweight respondents and 58% of obese respondents negatively judge other overweight Aussies who eat unhealthy food in public. The results of the survey point to an emerging trend in Australia where people show prejudice against overweight people, even if they are overweight themselves.

    Of those respondents who are overweight or have been overweight, one in four are so scarred by public opinion; they limit themselves to eating healthy foods when in public in fear to being judged by others. The results went on to find 14% avoided eating anything in public, while 23% felt the public’s condemnation when they ate unhealthy foods, with the perception that this is how they got so overweight. Only 35% said they had a thick skin and did not feel others judged them.

    Leading psychologist, Sandy Rea, believes sizism is a contributing factor to the pressure being felt by overweight individuals eating out. “Sizism is a fairly new term which relates to both normal and overweight individuals who have a perception and prejudice directed against overweight people,” stated Sandy Rea. “This attitude is keenly felt by overweight people and of course exerts a social pressure.”

    “Underlying this social pressure linked to sizism is the perception that obesity symbolises an inability to be self-disciplined, demonstrate self-control and an inability to manage their personal health. By inference ‘fatness’ reflects negatively on personal character. Thus those respondents who do not eat in public or choose healthy foods so as not to be judged indicate a greater level of self-awareness,” concluded Sandy Rea.

    The same study found 58% of respondents felt restaurants around the country don’t offer enough healthy options for people trying to lose weight. Those surveyed said there were either no options to choose from or even the healthy options were sometimes laden with hidden kilojoules. A further 81% of respondents believe menus should have symbols to highlight healthy options, stating it would take the guesswork out of menus. Many respondents felt menu descriptions are misleading.

    For those wanting to lose weight, having a thorough knowledge of what you are eating and how it will affect your weight loss journey is imperative. Navigating restaurant menus can be a minefield. Weight loss programs, like Jenny, can assist in training dieters on how to make healther choices when faced with unfamiliar foods on restaurant menus. Jenny’s program couples every client with their own coach who helps devise a sensible eating plan that enables clients to reach their goal in a healthy, sustained approach.

    source: http://www.jennycraig.com.au/news-from-Jenny

  11. This is brilliant, Dr. Burgard! Engaging, detailed, compelling information and analysis.

    I will be copying the URL into my Facebook and sending it out, posting it to the Sonoma County HAES site, and forwarding it to the local and state chapters of NOW, the local Women’s Political Caucus, and Sonoma County Commission on the Status of Women.

    You have provided a wonderful opportunity for the public to learn that what is being passed off in reputable medical journals as credible research on weight and health is in fact funded by the weight loss industry, and designed via its methodology and presentation to doctors, public health officials, and the public to provide misleading information upon which to make personal and public health decisions.

    We *do* need to protect youth, especially girls, because they are so disproportionately valued and judged based on appearances, from this harmful industry, and from the lack of medical and political independence from it.

    Thank you again.

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