Weight and Healthcare

This Substack explores the intersections of weight science, healthcare, and public health with a focus on evidence, ethics, and the impact of weight stigma on higher-weight individuals. It critiques weight-based healthcare practices, diet culture, and pharmaceutical interventions, advocating for weight-neutral healthcare approaches and challenging prevailing narratives around weight and health.

Weight Stigma in Healthcare Weight Loss Industry Critique Ethical Issues in Weight Management Health at Every Size (HAES) Weight-Neutral Healthcare Practices Impact of Diet Culture Medical Bias and Discrimination Evidence-Based Approaches to Health Public Health and Obesity Narratives Weight Loss Drugs and Interventions

The hottest Substack posts of Weight and Healthcare

And their main takeaways

Issues with Terminology and Statistics in Weight Science - Part 1

459 implied HN points • 13 Dec 23
🏥 Health & Wellness Terminology Statistics Weight loss industry
  1. The weight loss industry manipulates terminology to market weight loss as a treatment for obesity, leading to misconceptions and ineffective interventions.
  2. The term 'weight-related conditions' is often used inaccurately to imply causation, ignoring confounding variables like weight stigma and healthcare disparities.
  3. The concept of 'sustained weight loss' is sometimes misrepresented by the weight loss industry to imply success, when in reality, it often refers to temporary weight loss followed by regain.

Study Questions Supposed Link Between Being Higher-Weight and Cognitive Ability

639 implied HN points • 26 Aug 23
🏥 Health & Wellness Weight Stigma Cognitive ability BMI Research
  1. The concept of 'cognitive ability' has been historically used to promote discrimination against various groups.
  2. BMI and definitions of 'obesity' are shaky concepts without clear health implications.
  3. Research questioning the link between higher weight and cognitive ability often still operates under the assumption that weight is a preventable health issue.

Reader Question: What is Relapsing Remitting Obesity

639 implied HN points • 13 Sep 23
🏥 Health & Wellness Obesity Weight Loss Diet Industry Health Issues Body positivity
  1. Relapsing Remitting Obesity is a term used in the context of repeated weight loss attempts followed by long-term weight gain.
  2. This concept of weight cycling has been shown to have serious negative impacts on health outcomes, which may be wrongly attributed to body size.
  3. The re-branding of weight cycling as Relapsing Remitting Obesity by the weight loss industry serves as a marketing tactic to perpetuate the cycle of failed products and interventions.

Three Common Statistics Snafus in Weight Science

718 implied HN points • 19 Apr 23
🏥 Health & Wellness Weight Science Statistics Research Body Weight
  1. Repeated attempts at intentional weight loss can have decreasing odds of success, and weight cycling can lead to significant harm.
  2. Just because a study result is statistically significant doesn't necessarily mean the effect is important or impactful.
  3. Understanding the actual increase in risk percentage versus the absolute risk percentage is crucial in healthcare decision-making.

ObesityWeek and The Obesity Society - Part 1

579 implied HN points • 25 Oct 23
🏥 Health Politics Weight Obesity Research Profit Advertising
  1. ObesityWeek is organized by The Obesity Society, serving the weight loss industry rather than focusing on supporting the health of higher-weight individuals
  2. The Obesity Society uses its research journal, Obesity, to publish articles that align with its weight-centric paradigm
  3. ObesityWeek is a lucrative event for The Obesity Society, with significant revenue coming from sponsors and exhibitors
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Weight Loss Industry Big Think - Expanding the Market -Part 2

459 implied HN points • 02 Dec 23
🏥 Health & Wellness Weight Loss Weight Stigma Research Methods Insurance Coverage
  1. The weight loss industry strategically turns existing higher body weights into disease diagnoses to expand its market.
  2. They aim to exploit insurance coverage and exaggerate risks associated with higher weights to increase profits.
  3. The industry targets all age groups and sizes, pushing for wider definitions of overweight and obesity to sell interventions and expand its customer base.

Large study shows high BMI not associated with serious top-surgery complications

479 implied HN points • 15 Nov 23
🏥 Health & Wellness Healthcare Studies Weight Surgery BMI
  1. A large study indicated that a high BMI is not linked to serious complications in top surgery.
  2. The study suggested reevaluation of BMI cutoffs for patients undergoing chest masculinization surgery.
  3. Surgeons and patients should engage in shared decision-making conversations to discuss potential risks with higher BMI, without holding healthcare hostage for weight loss.

A First Step to Solving Weight Stigma in Healthcare Interactions

678 implied HN points • 05 Apr 23
🏥 Health & Wellness Weight Stigma
  1. Bias in healthcare can negatively impact higher-weight patients, including provider and structural biases.
  2. Healthcare providers often blame the patient's body for lack of accommodation, adding insult to injury.
  3. Addressing weight stigma in healthcare starts with providers acknowledging that patients are not the problem, and accessibility is essential for everyone.

Serious Issues With the American Academy of Pediatrics Guidelines For Higher-Weight Children and Adolescents

938 implied HN points • 14 Jan 23
🏥 Health & Wellness Guidelines Interventions Surgery Health Issues
  1. The American Academy of Pediatrics guidelines for higher-weight children and adolescents focus on intensive behavioral interventions, drugs, and surgeries, which may not have long-term benefits and can have serious side effects.
  2. The guidelines pathologize higher-weight bodies and promote weight loss as a solution, without enough evidence to support the efficacy or safety of these interventions on a long-term basis.
  3. There are ethical concerns about recommending weight loss surgeries for adolescents as young as 13, considering the significant risks, lack of long-term follow-up, and potential impact on the mental and physical health of the individuals.

Weight Watchers Expands Their Harmful Model - Adding Prescription Drugs

738 implied HN points • 15 Mar 23
🏥 Health & Wellness Weight Loss Prescription drugs Medical Industry Body positivity Pharmaceuticals
  1. Weight Watchers is expanding their model by adding prescription drugs, showing a pattern of prioritizing profits over people's well-being.
  2. Weight Watchers acquired Sequence, a telehealth company prescribing weight loss drugs with risky side effects and questionable efficacy.
  3. The company's approach includes misleading weight loss claims, lack of transparency, and a focus on short-term financial gains rather than long-term health.

Study Shows Lack of Link Between High BMI and COVID Deaths

698 implied HN points • 22 Mar 23
🏥 Health & Wellness COVID-19 Research Body Weight Health Inequality Fat Activism
  1. Some studies rushed during the pandemic suggested a link between high BMI and COVID deaths, but a recent umbrella review found serious quality concerns with these conclusions.
  2. The study focused on the quality and certainty of the evidence regarding the association between high BMI and COVID mortality.
  3. Healthcare inequalities can impact outcomes for higher-weight individuals, and research often pathologizes body size without fully considering all confounding factors.

The Problem with the Edmonton Obesity Staging System – Part 1

539 implied HN points • 27 Sep 23
🏥 Health & Wellness Obesity Healthcare Weight Stigma Mental health
  1. The Edmonton Obesity Staging System focuses on categorizing fat people based on weight-related health issues, despite lacking evidence of the benefits of aggressive weight management.
  2. Critics argue that the system pathologizes bodies solely based on size and overlooks other factors like weight stigma, healthcare inequalities, and weight cycling.
  3. The system's stages imply that health issues are directly tied to obesity but fail to address the fact that these issues affect people of all sizes, suggesting a need for a shift in focus toward holistic health support.

Key Words That Have a Different Meaning In Weight Science Research

539 implied HN points • 17 May 23
🏥 Health & Wellness Weight Science Research
  1. The concept of 'long term' in weight science research can be misleading, with studies claiming 'long-term' follow-ups that are actually quite short.
  2. The term 'significant' in weight science research can be manipulated to make small weight losses seem important, leading to misleading conclusions.
  3. The idea of 'success' in weight science research is often based on short-term weight loss without considering long-term health outcomes, contributing to the perpetuation of flawed weight loss paradigms.

Subscriber Bonus - A Little Good News

1258 implied HN points • 26 Sep 22
🏥 Health & Wellness
  1. The post is a subscriber bonus and shares some good news with the audience.
  2. The author initially felt hesitant to share positive experiences due to worries about how it might be perceived.
  3. The post is directed towards paid subscribers only, emphasizing exclusivity.

Do Small Pharmaceutical Industry Payments Really Influence Doctors?

519 implied HN points • 16 Aug 23
🏥 Health & Wellness Medical Ethics Health Research
  1. Studies suggest that even small pharmaceutical industry payments can influence doctors' prescribing patterns
  2. The amount of money received from pharmaceutical companies correlates with increased rates of prescribing brand-name drugs
  3. Research shows that receiving payments from the industry is linked to higher prescribing costs and a greater proportion of branded medication prescribing

Steps for Practitioners to Advocate for Higher-Weight Patients/Clients

519 implied HN points • 28 Jun 23
🏥 Health & Wellness Advocacy Weight Stigma Healthcare access Body positivity
  1. Recognize that higher-weight individuals deserve respect and healthcare, regardless of their size.
  2. Shift to a weight-neutral paradigm to support patients in the bodies they have, focusing on health rather than weight loss.
  3. Identify gaps in caring for higher-weight patients, work towards a healthcare system accessible to people of all sizes, and advocate for systemic change.

Weight Loss Surgery and Kids Part 1

519 implied HN points • 29 Jul 23
🏥 Health & Wellness Weight Loss Children Surgery Healthcare Obesity
  1. The study questions the effectiveness of nonsurgical weight management programs in children and emphasizes the need for long-term outcome data, especially regarding weight loss surgery.
  2. The conflict of interest with the authors, who have significant ties to weight loss companies and surgery programs, raises concerns about the objectivity of the study's findings.
  3. Lack of control groups, short follow-up periods, and small sample sizes in the research undermine the conclusions supporting weight loss surgery for children.

Fighting Weight Stigma by Ending Weight Pathologization - Part 2

519 implied HN points • 15 Jul 23
🏥 Health & Wellness Weight Stigma Fat Activism Body positivity
  1. The study focused on using qualitative methods to understand weight stigma by involving medical students and fat community members in narrative workshops.
  2. Participants in the study recognized the complexities of weight stigma in healthcare, including the impact of assumptions, power dynamics, and lack of trust in fat patients' stories.
  3. The intervention helped create depathologizing and empathetic interactions, undermining the power dynamic in medical authority and emphasizing the importance of humanizing interactions to combat weight stigma.

Beachbody's Pseudo Rebrand – I Tried It So You Don’t Have To Part 2

519 implied HN points • 24 Jun 23
🏥 Health & Wellness Fitness Body Image Nutrition Weight Loss
  1. Beachbody's rebrand to 'Bodi' still heavily focuses on weight loss rather than health.
  2. The programs offered by Beachbody continue to emphasize slimming, sculpting, and weight loss, lacking representation for diverse body types.
  3. Beachbody's MLM structure and 'wellness coaches' perpetuate the narrative of weight loss over true health and fitness goals.

What To Do When Weight Stigma Makes You Want To Avoid The Doctor

519 implied HN points • 07 Jun 23
🏥 Health & Wellness Weight Stigma Healthcare Mental health Advocacy Self-care
  1. Weight stigma in healthcare can lead to higher-weight individuals avoiding going to the doctor altogether.
  2. It's important to advocate for yourself when facing weight stigma in medical settings and not let it deter you from seeking care.
  3. Bringing along an advocate and practicing how to deal with weight stigma in advance can help improve the healthcare experience.

Novo Nordisk (Finally) Faces Some Consequences for Their Deceptive Marketing Tactics - Part 1

639 implied HN points • 29 Mar 23
🏥 Health & Wellness Pharmaceuticals Marketing Deception Regulations
  1. Novo Nordisk faced consequences for deceptive marketing tactics such as using astroturf organizations and promoting their drugs without disclosing ties.
  2. The Association of the British Pharmaceutical Industry suspended Novo Nordisk for breaching their code of practice related to a promotional course and inducing healthcare professionals to prescribe their drug.
  3. Novo Nordisk's appeal for the breach was unsuccessful, leading to public reprimand for failings and suspension for two years from ABPI membership.

Special Edition: Dangerous New American Academy of Pediatrics Guidelines for Higher-Weight Children

858 implied HN points • 12 Jan 23
🏥 Health & Wellness Body Weight Medical Guidelines Conflicts of Interest Children's Health
  1. The American Academy of Pediatrics released guidelines recommending weight-loss strategies for higher-weight children, including pharmaceuticals and surgeries from a young age.
  2. There are concerns about conflicts of interest among the guideline authors, with several having financial relationships with companies that develop weight-loss products benefiting from these recommendations.
  3. The guidelines' promotion of weight loss for children has raised questions about biases, especially since disclosures of conflicts of interest were limited and did not cover authors' ties to the 'higher-weight as lifelong chronic illness' model.

Study Looks at Higher-Weight People and Nursing Practice

499 implied HN points • 23 Sep 23
🏥 Health & Wellness Obesity Weight Stigma Patient Care
  1. The nursing care of higher-weight individuals (Class III ob*sity) lacks high-quality evidence and requires better equipment and education for improved outcomes.
  2. Healthcare facilities often lack proper equipment to accommodate higher-weight patients, leading to patient harm and blaming of the patients instead of acknowledging the lack of accommodation.
  3. There is a need for more research and evidence-based practices in wound management for higher-weight patients, without using weight stigma as an excuse to deny care.

Study Misleads About Efficacy of Weight Loss Interventions in Children

499 implied HN points • 20 May 23
🏥 Health & Wellness Efficacy Interventions Weight Loss Children
  1. The study discussed how weight loss interventions in children might not be as effective as previously thought. The research highlighted issues with how body size changes are linked to health outcomes.
  2. The study pointed out flaws in assuming that weight loss directly improves health outcomes. It emphasized the importance of considering the impact of behaviors on health, rather than just focusing on weight change.
  3. The study recommended being cautious about interpreting weight loss as the main driver for health improvements. It highlighted the need to question biases and assumptions about the relationship between weight loss and health outcomes.

The Harm of Weight Stigma

678 implied HN points • 08 Mar 23
🏥 Health & Wellness Weight Stigma Physical health Mental health Research
  1. Weight stigma can have significant negative impacts on physical and mental health, including increased risk for conditions like high blood pressure, diabetes, and poor health behaviors.
  2. Perceived weight discrimination is linked to psychiatric disorders, risk of suicidality, and even an increase in mortality risk, demonstrating the serious harm caused by weight stigma.
  3. Healthcare practitioners, including doctors and nurses, may exhibit weight bias which can lead to barriers in accessing healthcare and biased treatment, affecting the well-being of higher-weight individuals.

December 2023 AMA Answers!

279 implied HN points • 14 Jan 24
🏥 Health & Wellness Health
  1. This post discusses the December 2023 AMA answers by Ragen Chastain on weight and healthcare.
  2. One question related to studying the relationship between prolonged high cortisol levels was mentioned.
  3. Access to the full AMA answers is available for paid subscribers.

Why You Shouldn’t Put Your Kids On Diets – Full Interview

539 implied HN points • 22 Apr 23
🏥 Health & Wellness Children's Health Dieting Body positivity Mental health Medical Ethics Weight Stigma
  1. Body Mass Index is not a reliable measure of health as people at the same weight can have vastly different health statuses.
  2. Factors like genetics, social determinants, and health-supporting behaviors matter more to overall health than weight.
  3. Research shows that diets are ineffective, especially for kids, and can lead to negative outcomes like eating disorders and weight gain.

The Truth About ObesityWeek - Part 2

439 implied HN points • 28 Oct 23
🏥 Health & Wellness Obesity Weight Loss Healthcare Research Mental health
  1. ObsityWeek focuses on promoting the weight-centric paradigm in healthcare by connecting weight with health and disease, potentially leading to harmful practices.
  2. Corporate influence is prevalent at ObsityWeek through sponsored symposia and key lectures, where pharmaceutical companies push for weight-centric treatments like medications and surgeries.
  3. There is a disconnect at ObsityWeek between celebrating weight loss industry figures and the lack of progress in reducing the population of higher-weight individuals, highlighting the profit-driven nature of the field.

Study's Questionable Claims About Eating Disorders and Dieting

399 implied HN points • 11 Nov 23
🏥 Health & Wellness Eating Disorders Dieting Weight Stigma Health Impacts
  1. Study utilizes questionable research to support the idea that weight loss interventions for children won't increase eating disorder risk.
  2. Authors of the study have conflicts of interest as they receive payments from or are associated with the weight loss industry.
  3. The study fails to provide concrete evidence that weight management leads to long-term weight loss or health benefits.

Subscriber Bonus - My Favorite Comment

359 implied HN points • 27 Nov 23
🏥 Health & Wellness Health
  1. The post includes a bonus for subscribers as a token of thanks for their support.
  2. The feedback received from a recent talk with Dr. Jeffrey Hunger is shared with subscribers, uplifting their spirits.
  3. Access to the full post is only available to paid subscribers of the newsletter.

A New HAES™ Friendly Disordered Eating, Exercise and Body Image Screening Tool

659 implied HN points • 25 Feb 23
🏥 Health & Wellness Body Image Weight Stigma
  1. The screening tool aims to identify individuals struggling with disordered eating, body image issues, unhealthy exercise patterns, and weight stigma beyond traditional diagnostic tools.
  2. The tool underwent review by HAES-aligned providers to ensure inclusivity and effectiveness in identifying those in need of support.
  3. The challenge faced during development was maintaining conciseness while addressing the pervasive impact of weight stigma and diet culture on individuals' thoughts and behaviors.

The Truth About The Obesity Action Coalition

639 implied HN points • 04 Mar 23
🏥 Health & Wellness Obesity Advocacy Weight loss industry Non-profit organization Pharmaceutical industry
  1. The Obesity Action Coalition (OAC) is not an advocacy group for higher-weight people, but predominantly funded by and lobbies for the priorities of the weight loss industry.
  2. OAC's priorities aim to expand Medicare coverage for weight loss interventions, revealing ties to the weight loss industry such as funding from companies producing weight loss drugs and surgical equipment.
  3. There are parallels between OAC's actions and the tactics used by pharmaceutical companies in the past, like Purdue Pharma, to influence healthcare organizations and profit from weight loss interventions.

Study Looks At Ways To Protect Ourselves from Weight Stigma

619 implied HN points • 11 Mar 23
🏥 Health & Wellness Weight Stigma Health Impact Research Analysis Body positivity
  1. The study highlights the detrimental impact of internalizing weight stigma on physical and mental health.
  2. Factors like alignment with the group 'Fat' and beliefs about weight controllability can predict resistance to weight stigma.
  3. Recognizing and challenging weight stigma, reframing self-identity as a fat person, and fighting against stigma messages are crucial steps to protect against weight stigma.

Study examines at connections between weight loss programs and depression and anxiety in adolescents

439 implied HN points • 07 Oct 23
🏥 Health & Wellness Mental health Adolescents Weight Loss Anxiety Depression
  1. Professionally run weight loss programs for adolescents may not increase depression or anxiety and could even lead to a slight reduction in symptoms, based on the study findings.
  2. The study's short follow-up period of up to 15 months raises concerns about the long-term effects of weight loss programs on mental health, especially considering weight regain patterns.
  3. Authors of the study have potential conflicts of interest, raising questions about their motivations and the credibility of their recommendations.

Options to Deal With BMI-Based Healthcare Denials - Part 2

639 implied HN points • 18 Feb 23
🏥 Health & Wellness Healthcare BMI Weight Stigma Fat Activism
  1. Understanding the reasons behind BMI-based healthcare denials is crucial to decide how to proceed.
  2. Options for dealing with BMI-based healthcare denials include finding different circumstances, fighting the denial, or trying to reach the BMI requirement.
  3. Fighting BMI-based healthcare denials may involve challenging the decision, seeking support, and exploring counterarguments to address the reasons given for denial.

Dangerous USPSTF Guidelines for Higher-Weight Children Are Open for Public Comment - Part 1

299 implied HN points • 16 Dec 23
🏥 Health Politics Public Health Child Health Health recommendations
  1. The US Preventive Services Task Force draft recommendation for higher-weight children is open for public comment until January 16.
  2. Good news: They aren't suggesting intensive dieting for toddlers and recognize the need for research on weight-neutral interventions.
  3. Bad news: They recommend intensive diet programs for children aged 6 or older based on outdated charts, using predominantly fair quality studies with limited long-term follow-up.

Comment on Harmful USPSTF Kids Weight Loss Recommendation - Part 2

279 implied HN points • 20 Dec 23
🏥 Health Politics Recommendations Health Impacts Weight Stigma
  1. The US Preventive Services Task Force has put forth draft guidelines for higher-weight children, open for public comment until January 16, but the evidence does not support their conclusions.
  2. The recommendation for weight loss interventions for children 6 and older is based on short-term data and studies with significant flaws, posing the risk of harm without clear long-term benefits.
  3. Structural inequalities, financial insecurity, and weight bias play significant roles in influencing diet, physical activity, and access to healthcare, complicating the effectiveness and ethics of weight loss interventions.

The Validation and Frustration of Stunkard et al.

619 implied HN points • 11 Feb 23
🏥 Health & Wellness Weight Loss Research Body positivity Medical Science Healthcare systems
  1. Stunkard et al.'s 1959 study on weight loss interventions revealed the ineffectiveness and harmfulness of most programs from as early as the 1950s.
  2. The study highlighted common flaws in weight loss research, such as short-duration studies, lack of specific data on individual outcomes, and the exclusion of unsuccessful participants.
  3. It's frustrating to see that the failure of weight loss interventions has been consistently validated since the 1950s, yet the weight loss industry continues to grow, offering dangerous and expensive solutions.