A Tale of Two Headlines

As a writer and science journalist, one of the things I find most interesting and revealing is looking at how different media outlets cover the same story. Some places simply reprint the press release, word for word. (This is neither news or reporting...it's called laziness) Other places will have varying degrees of coverage and quality. Naturally, some media have a different focus and will emphasize different parts of a study.

That's not what I'm talking about.

What I find most interesting is looking at everything from the headlines to the content to see how science can be used and misused in the popular media. Case in point is this study by Guido Frank et al recently published in the journal Neuropsychopharmacology:  Anorexia Nervosa and Obesity are Associated with Opposite Brain Reward Response.

It received a flurry of news coverage, under headlines including

Brain Reward Systems Of Obese Women Different From Those Of Women With Anorexia: Study (Huffington Post)
Brain Circuits Differ in Women with Anorexia vs. Obesity (PsychCentral)
Brain wiring makes women anorexic or obese (NY Daily News)

The PsychCentral news story opened with this zinger: "Why does one person become anorexic and another obese? Blame the brain." The problem is that this has nothing to do with what the actual study found. The researchers examined the brain activity in women who were already anorexic or obese.* It didn't track them over time. No one watched brain activity before the women became ill and tracked how it changed through the course of illness. Was it the brain that caused these disorders? No one knows. The brain changes could just as likely have been a result of the disorders instead of a cause.

Not to mention that "blame the brain" is pretty big oversimplification. I think that different neural wiring makes one more or less likely to develop an eating disorder, and I think that all of the crap (good and bad) that happens to us in life increases or decreases that likelihood. The brain is a big player in EDs, no doubt. I think it plays a major role in who gets sick and why. But it's not the only factor. So blame the brain if you really want, but be sure to blame a lot of other stuff, too.

What the study actually said was pretty significantly less profound than what you might think by the news coverage. Basically what the researchers found was that the brains of women with anorexia or obesity had different reward responses to sugar water. The women with anorexia showed a much greater dopamine response to the sugar water, and the obese women much lower, when compared to controls. Um, ya think?!? I'm not saying this isn't important to establish, but the idea that the food reward systems in anorexia are whacked is hardly rocket science.

The problem I have with the study's conclusions is that the control groups were kind of sucky. Could the women with anorexia have shown an increased reward response because they were malnourished? What about tracking the anorexic women over time and seeing how these reward pathways changed with re-nutrition and weight restoration? What about in women who considered themselves fully recovered and had no psychological, behavioral, or emotional signs of an eating disorder?

Neuroscience is hard to report, and hard to get right. It's also disturbingly easy to sensationalize. I don't always get it right. But I do find it both fascinating and revealing to track how these studies are reported to the general public. The title of the press release was much less interesting than the other headlines. The press release read: Brain circuitry is different for women with anorexia and obesity

In the end, the author's conclusions (stated in the press release and dutifully rehashed by every news story out there) were a lot more limited than the headlines would suggest. "It is clear that in humans the brain's reward system helps to regulate food intake" said Frank. "The specific role of these networks in eating disorders such as anorexia nervosa and, conversely, obesity, remains unclear."

*I'm not sure why the powers that be haven't received the memo, but, uh, anorexia isn't the opposite of obesity.  Underweight/malnourished might be the opposite of someone who is routinely taking in too many calories, but obesity isn't an eating disorder. It's not a good comparison group.

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extralongtail said...

I love, love, love this post. Neuroscience studies (like many research studies) are frequently poorly (and sensationally) reported in the mass media.

'Blame it on the brain' is an absolute 'cop out', IMO. It doesn't surprise me for one moment that people who are starved with AN exhibit very different patterns of brain activity and cerebral perfusion than people who are well fed. But how such findings can be extrapolated to the suggestion that the person's brain was always that way, or developed in such a way that the person developed AN, is far too big a leap in 'logic'.

What is needed to address neurodevelopmental hypotheses of AN are longitudinal studies that track changes in brain physiology over time, and starting from a young age. Of course this would hold huge ethical dilemmas and such studies would be extortionate, costwise. Very large sample sizes would be required to confer adequate statistical power.

And then there is the 'so what' factor... So what if the brains of people with AN respond differently to sensory cues than the brains of well-nourished, non-ED individuals? Does this make EDs more easy to treat?

IrishUp said...

I can't wait to use "... kind of sucky" the next time I review a paper....

Excellent post.

Heather Peterson said...
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Blog MidnightCosmostar said...

Greetings! Do you happen to have any blogging experience or it is a completely natural talent of yours? Can't wait to hear from you.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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