In part one we looked at the 2022 article by Sierżantowicz et al., “Quality of Life after Bariatric Surgery A Systematic Review.” I do recommend reading that to understand the issues with the way “Health Related Quality of Life or HRQOL” is used in the studies we’ll examine today as we take a deeper diver into two of the studies Sierżantowicz et al. included. Content note for discussion of suicide and self-harm. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscri...
Apr 16, 2025•7 min
As I mentioned in part 2, when I teach research analysis, I recommend checking something I call “The Do-Do’s” which encompasses two questions: Do the citations support the claims? Do the study data support the results? In part two we looked at the first question, today we’ll look at the second question. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Mar 29, 2025•17 min
This is the Weight and Healthcare newsletter . If you like what you are reading, please consider subscribing and/or sharing! Content note: this piece will discuss research around binge eating, including behaviors and frequency. In part 1 , we looked at the authors and methodology of a 2024 study called “Evaluating dietary restriction as a maintaining factor in binge-eating disorder” by Bartholomay et al., whose authors claim that the findings “challenge the assumption that dietary restriction ma...
Mar 25, 2025•13 min
Recently a reader reaching out asking me to analyze a 2024 study called “Evaluating dietary restriction as a maintaining factor in binge-eating disorder” The authors claims that their findings: “challenge the assumption that dietary restriction maintains BE [binge eating] among all individuals with BED [Binge Eating Disorder]. Rather, results suggest that dietary restriction may be largely unrelated to BE maintenance in this population, and that reducing dietary restriction generally does not ha...
Mar 22, 2025•10 min
It can be difficult to tease apart what is real anti-weight stigma work and what is weight stigma in sheep’s clothing. Here are some quick tricks to tell the difference. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
Mar 15, 2025•6 min
I’ve written here many times about the ways that the weight loss industry has been attempting to co-opt the work of weight stigma/weight-neutral/weight inclusive experts and activists. More than 40 of you asked me to write about a piece by Amanda Velazquez, MD called “Promoting a Weight-Inclusive Approach to Treat Ob*sity” carried in both Medscape and MDEdge/Endocrinology that gives us a perfect example. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Mar 12, 2025•16 min
One of the most vulnerable times for higher-weight patients in healthcare can be when they are in a healthcare facility. Recently I worked with an incredible woman with a complex health history who was scheduled for a surgery followed by a hospital stay. I was available to help remotely and she had a group of friends and family who would be on-site. One of the things I did to help prepare was create scripts for her family and friends to use. She kindly agreed that I could share them with readers...
Mar 08, 2025•11 min
During the Q&A a physician raised her hand and asked me a question that I’ve been asked many times over the years. “I don’t disagree with the information you presented about the failure rate of behavior-based weight loss attempts, but I do disagree with what you said about informed consent. If I tell patients that there is about a 95% chance that they will lose weight and gain it back then they will never try, what good does that do?” Get full access to Weight and Healthcare at weightandheal...
Mar 05, 2025•6 min
The study “The Physiological Effects of Weight-Cycling: A Review of Current Evidence” published January 3, 2025 is making broad claims that “healthy individuals who struggle with overw*ight or ob*sity should not be discouraged from repeated attempts to lose the excess weight.” In part 1 we looked at the issues with the authors and the premise. In part 2 we looked at the issues with the studies they included, in this final part we’ll discuss the issues with their interpretation and conclusions. G...
Mar 01, 2025•12 min
We are back discussing the article “The Physiological Effects of Weight-Cycling: A Review of Current Evidence” published January 3, 2025. In part 1 we looked at the authors and the introduction, in part 2 we’ll be looking at the studies they included. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Feb 26, 2025•18 min
As more data has come out about the realities of GLP-1s for weight loss (including some people regaining weight while still taking the drug , and research showing that those who go off the drugs regain weight quickly , paired with their own research showing that by year four, 8 9.5% of patients were no longer on the drug ,) there has been talk about the dangers posed by drug-induced weight cycling. As we’ve seen with other concerns around these drugs and intentional weight loss in general ( like...
Feb 22, 2025•10 min
In part 1 , the amazing Leslie Jordan Garcia and I wrote about creating size-inclusive fitness spaces. Today, Leslie has created an audit that you can use to determine the size inclusivity of your fitness space and make changes! Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Feb 19, 2025•3 min
Today I am thrilled to bring you the first of a two-part series about creating safe fitness spaces that I had the honor of co-writing with Leslie Jordan Garcia. You may remember Leslie from her 5 Questions With… feature, and you may know her as the incredible passionate multi-certified Anti-diet Ed Recovery, wellness practitioner, and fitness professional behind Liberati Wellness ! Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Feb 15, 2025•10 min
In part 1 of this series, Dr. Zed Zha shared a patient story of the harm that can happen when assumptions are made about the relationships between weight and inflammation. In parts 2 and 3 , Dr. Zha examined common beliefs around inflammation, weight, and weight loss. In the final installment of this series, I’ll look at two possible confounding variables that may be at the root of associations between weight and inflammation. Get full access to Weight and Healthcare at weightandhealthcare.subst...
Jan 25, 2025•9 min
In part 1 Dr. Zed Zha discussed a patient experience that elucidated the issues that happen when assumptions are made about the relationships between weight and health. In part 2 she began a discussion of four conditions that must be met to rigorously prove the theorem that weight loss lowers inflammation - “ weight ↓ → inflammation ↓ ”. In part 3 of this 4-part series, she’ll discuss the third and fourth conditions. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/su...
Jan 22, 2025•9 min
In November I responded to readers’ questions about a paper that was being teased to the media suggesting a new definition for “ob*sity.” The paper is now out, and it’s even worse than I thought. I’ve had a lot of requests to write about it and there is a ton of media on it right now (though, sadly, not a ton of any kind of critical/investigative journalism.) As regular readers know, I am in the middle of a four-part series with Dr. Zed Zha about weight and inflammation. I’m pausing that today t...
Jan 18, 2025•8 min
In Part 1, Dr. Zed Zha (M.D. and Fellow of the American Academy of Family Physicians) discussed a patient experience that illuminated the need to look beyond simple assumptions about weight and inflammation. In part 2 she will begin a deep dive into the research around weight, weight loss, and inflammation. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Jan 15, 2025•15 min
In discussions around weight and health, the concept of “inflammation” almost always arises. This is a complex discussion and so I am thrilled and honored to share a four-part series in which Zed Zha, MD, FAAFP (Fellow of the American Academy of Family Physicians) and I explore assumptions around weight, weight loss, and inflammation. Here now, Part 1 - Patient Story - as told by Dr. Zha Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Jan 11, 2025•6 min
On Saturday I posted a piece helping patients navigate weight stigma in healthcare, today I want to offer some support to healthcare providers to avoid creating weight stigma. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
Jan 08, 2025•5 min
Higher-weight people too often find themselves in healthcare situations where they are being treated poorly/unequally because of weight stigma. These situations are, sadly, too numerous to count and in some cases need to be addressed in very specific ways. In many cases though, there are some standard responses that higher-weight patients and/or those advocating for them can use to try to get appropriate care. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Jan 04, 2025•8 min
This came up in our monthly subscriber Ask Me Anything. When I break down research I often talk about using absolute risk reduction and statistical significance to determine the efficacy of an intervention. Another number that helps determine efficacy is the Number Needed to Treat (NNT). This number helps us understand how many patients need to be treated with an intervention in order to avoid a single negative outcome. Get full access to Weight and Healthcare at weightandhealthcare.substack.com...
Dec 21, 2024•4 min
You can’t win if you don’t play. That’s what the PowerBall ad said. I could pay $2 for a ticket and possibly win a $20 million jackpot. Of course, I have a 99.9999997 percent chance of losing which may be why my stats teacher used to say that the lottery was a tax on people who didn’t pay attention in her class. So why am I going on about the lottery in a newsletter about the intersections of weight science, weight stigma, and healthcare? Because I hear a similar type of “logic” all the time fro...
Dec 11, 2024•5 min
I got the following question from reader Naomi “Thanks for the information on the CDC growth charts. I wonder if you could talk about how to understand them. My pediatrician said that my child is more than 120 percent of the 95th percentile. What the h e double hockey sticks does that even mean? Help!” I’m happy to try to explain. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Dec 07, 2024•10 min
Today we’re going to talk about a new study called whose goal was to assess the “relationship of cardiorespiratory fitness (CRF) and Body Mass Index (BMI) on both cardiovascular disease (CVD) and all- cause mortality risk” by Nathan R Weeldreyer, Jeison C De Guzman, Craig Paterson, Jason D Allen, Glenn A Gaesser, and Siddhartha S Angadi. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Dec 04, 2024•12 min
There are many ways that weight stigma occurs in healthcare . One that is harmful on multiple levels happens when higher-weight people are blamed for the ways in which healthcare fails them. This occurs when a patient is blamed for being “too big” for something they need. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
Nov 27, 2024•5 min
I’ve now had eleven different doctors ask me about this article, so let’s talk about it! Here is one of the emails: “I’m an MD and I just read this article in Medscape about “clinical ob*sity.” Should I be worried? I feel like I should be worried. I understand it hasn’t happened yet, but it seems like one of those things that will happen all at once without any chance to pushback. Any ideas on how to handle this?” Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subsc...
Nov 23, 2024•12 min
Regular readers may know that while speaking and writing are my primary work, I’m also a Board Certified Patient Advocate and I sometimes work directly with patients, typically in emergency or complex medical situations. Recently I was advocating for a patient at a cardiology appointment (who has given me permission to share this.) I was waiting outside the treatment room while my patient got settled, near the area where the scale that is used for weigh-ins was located. In this practice each car...
Nov 16, 2024•5 min
I received the following question from reader Jin, I’m a pharmacist and one of the things I’ve learned from following you over the years is the importance of language. I wanted to ask you about language like “anti-ob*sity” medication and “ob*sity treatment.” I notice that you still use terms like weight loss drugs and I imagine that is on purpose. I’d love to understand more about this. Feel free to make it a Substack post if you’d like. Thanks for noticing and thanks for asking Jin! Get full ac...
Nov 13, 2024•4 min
I received the following question from reader Alina: I’m a family med doctor and I’ve started seeing lots of publications, even research, using the terms “person with ob*sity” and “person with overw*ight.” I took some CME [Continuing Medical Education] where they said that it was for weight stigma reduction. I’m not sure why, but it just doesn’t feel right at all (Does person with overw*ight even make sense?) I would love to see a newsletter about this. Thanks for asking Alina, your feeling that...
Nov 06, 2024•7 min
There are many aspects of weight stigma within the healthcare system that harm higher-weight people. There is an issue that isn't often discussed that underpins many of the harms that the healthcare system does to higher-weight people. Research. Or a lack thereof. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
Nov 02, 2024•6 min
