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Weight and Healthcare: Daily Summaries Delivered
by with Ragen Chastain
Examining the intersections of weight science, weight stigma, and healthcare and what evidence, ethics, and lived experience teach us about healthcare and public health best practices for higher-weight people. weightandhealthcare.substack.com
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- 1 weeks ago9 min
Study Questions Associations Between Weight and Health in Metabolic Syndrome - Part 2
In Part 1 we looked at a study that questions common assumptions about weight and health. Today the lead author, Natasha Wiebe will share her reflections on her attendance and presentation of the paper at the Ob*sity Summit in Montreal, Quebec. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
- 2 weeks ago16 min
Study Questions Associations Between Weight and Health in Metabolic Syndrome - Part 1
I’ve previously written about research from Natasha Wiebe et al. that questions assumptions around weight and health. Today I’m back to discuss a new study “Associations of ob*sity, systemic inflammation, and hyperinsulinemia with the incidence of non-communicable chronic disease and mortality: A prospective cohort study” by Natasha Wiebe MMath, Stephanie Thompson MD, Peter Stenvinkel MD, Aminu Bello MD, Matthew T. James MD, and Marcello Tonelli MD.In part 1 we’ll discuss the study. In part 2 I’ll publish a piece written by Natasha about her experience attending a weight loss industry event to present her findings. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
- 2 weeks ago9 min
Reader Question - How to Stop the Weight Centric Backslide? Part 2
In Part 1 we started talking about emails that I’ve been receiving from readers about the weight centric backslide including some initial ways that we can identify the issue and push back. Today we’re going to dig deeper. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
- 3 weeks ago14 min
Reader Question - How to Stop the Weight Centric Backslide? Part 1
I’ve received a lot of reader emails like the one below from reader Jeannie.I feel like I’m seeing so many people, including dietitians and doctors, who used to be staunchly non diet getting back on the weight loss bandwagon. Suddenly they’re all “you can fight weight stigma and promote weight loss” and “o-word is a metabolic disease” - and “use people first language” and it’s like they were claiming to be non diet but it was only because they didn’t think they could shrink us but now they think these drugs can and they are showing their true (anti fat) colors and people (including doctors) I thought respected me and believed in non diet care are showing me that they’ve always thought I would be better thin, or that my fatness is a disease, they just didn’t think they could make me thin (or not “diseased”) and now they do. Is there anything we can do to fight against this? Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
- May 6, 20269 min
New Study Questions Weight Loss Claims in Diabetes Prevention Programs - Part 2 Findings
In part 1 we began discussing the study “Potential mechanisms for change in diabetes prevention programs: A systematic review” including the authors and the premise. Today we’ll look at the methodology and the findings. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
- May 2, 20269 min
New Study Questions Weight Loss Claims in Diabetes Prevention Programs - Part 1 Authors and Premise
This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!Diabetes Prevention Programs are a group of programs that are created to prevent the onset of Type 2 Diabetes, often in people who have been identified as at-risk. Most include behavior changes, social support, and include weight loss as a metric and/or the primary outcome. The assumption is typically that any health changes and/or reductions in the development of T2D are because of any weight loss. In discussing these programs previously I’ve expressed the concern that any differences in health/T2D development were more likely due to behavior changes/support than any weight loss and that, because of their insistence on a weight-loss focus, the programs likely included much more restriction than is necessary to create any health changes, which could create harms including weight cycling (which can actually drive T2D,) weight stigma (which can actually drive T2D,) and disengagement from behaviors that might actually support health and make T2D less likely (with the clear and critical understanding that whether or not someone develops T2D involves myriad factors, many of which are completely outside of their control, including genetics.)Enter the new systematic review “Potential mechanisms for change in diabetes prevention programs” which sought “to investigate potential mechanisms for change in diabetes prevention programs (DPPs), and assess the strength of associations.” Their hypothesis was that “ Weight loss would be less strongly associated with improved health than other mechanisms.” SummaryA group of researchers, several of whom work in weight inclusive Type 2 Diabetes preventions and management, sought to fill a gap in research around Diabetes Prevention Programs (DPPs). These program seek to delay/prevent onset of Type 2 Diabetes and typically include multiple interventions but often target an end goal of weight loss. There is a significant lack of research that even attempts to determine which aspects of DPPs might actually be responsible for any benefits and which might be unhelpful or cause harm. These researchers undertook a systematic review to attempt to determine just that. The AuthorsWe’ll begin, as we always do, with the authors. Spoiler alert, this is going to be much shorter than these typically are. The study received no funding and the authors disclosed no conflicts of interest. I’ll do my usual deeper dive into their work and, as a reminder, working in the space in which you are researching is not considered a conflict of interest that requires disclosure but is something that always makes me give extra scrutiny to methodology. As usual, if you want to skip this part you can scroll down to where it says “The Study.”Margit I. Berman is an Associate Professor at the Graduate School of Professional Psychology at the University of St. Thomas. Dr. Berman is the author of a “A Clinician’s Guide to Acceptance-Based Approaches for Weight Concerns: The Accept Yourself! Framework” This is not a DPP program but does have a section on Health at Every Size™ approaches to Diabetes and Cardiovascular Health. [Note: that Health at Every Size is the trademarked brand of the Association for Size Diversity and Health) Martha Burla - per LinkedIn currently works at the Feinberg School of Medicine in the Department of Medical Social Sciences where she supports research on patient reported outcomes and shared decision making. She is also pursuing a PhD in Health Sciences from Rush University with the hope of continuing to research patient decision making and autonomy.Hannah Martin - per her Linkedin she is a PhD candidate at the University of Otago, Dunedin New Zealand. Her research focuses on Intuitive EatingMegrette Fletcher - is the owner of Inclusive Diabetes Care, LLC which offers free and paid resources for weight-inclusive diabetes care. Full disclosure, Megrette and I have worked together including speaking on the same panel and on a w
- Apr 18, 202610 min
GLP-1s and Nutritional Deficiencies - Follow-up
Recently I wrote about research around GLP-1s and nutritional deficiencies. In summary, we looked at a study that showed that most of the clinical trials aren’t studying this at all, and that when studies do consider this there are concerning findings, and, finally, the implications of all this.I was recently contacted by a Chicago-area private practice dietitian (MS, RDN, LDN) who had, in fact, written a letter to the editor of the journal that published one of the articles I looked at in Part 2, Malnutrition is Common in Patients Utilizing Glucagon-Like Peptide-1 Agonists Prior to Total Joint Arthroplasty, published in the journal Arthroplasty Today. The letter made important points about the study itself (including the lack of a Registered Dietitian among the authors) as well as issues with the measures chosen and more.This is where I would link to the published letter, except that it’s not published. It was rejected, not on the merits of its arguments, but with a single sentence:“We appreciate your letter to the editor but I am not sure that we typically have registered dietician [sic] comment or collaborate on our research." Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
- Apr 11, 202614 min
Novo Nordisk In Trouble For Not Reporting Serious Adverse Events to the FDA
Remember when I wrote about the FDA Averse Events Reporting System and how the drug companies are required to report adverse events? Novo Nordisk just got a warning from the FDA for…not doing that. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
About Weight and Healthcare
Examining the intersections of weight science, weight stigma, and healthcare and what evidence, ethics, and lived experience teach us about healthcare and public health best practices for higher-weight people. weightandhealthcare.substack.com
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