Wow did I get a lot of requests to write about this! We’ll start with some basic information today and then break down the actual trial data in the rest of this series. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
I received the following question from reader Rebecca: This is my first New Years away from dieting and while I am happier (and healthier, though I know that’s complicated) than ever. Still I am struggling with New Years Resolution season, do you have any tips for making non-diet resolutions that focus on my health? I’m happy to help, you are definitely not alone in trying to navigate this time of year in weight-neutral, non-diet ways! Get full access to Weight and Healthcare at weightandhealthc...
In part 1 we talked about a trial of semaglutide for knee osteoarthritis. In part 2 we compared that trial to a trial that used metformin. Today we’re going to talk about research around behavioral (non-pharmacotherapy) weight-neutral interventions. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
In part 1 we looked at a study of the effect of semaglutide 2.4mg (Wegovy) on knee osteoarthritis. Today we’ll look at two studies that consider the effect of metformin and compare that with the semaglutide study. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
I've received a number of questions about GLP1s and knee pain/osteoarthritis and in this series we’ll look at what the research says. In part 1 we’ll look at the trial for semaglutide and knee osteoarthritis. In part 2 we’ll look at 2 studies that consider the effects of metformin on knee osteoarthritis. In part 3 we’ll look at a study of a weight-neutral intervention Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
I received a question from reader Brit who said “I see you and other people talking and writing about the weight-inclusive and weight-centric (and sometimes weight-neutral and weight-loss paradigm). I think I know what they mean but could you give a quick explanation? I’m happy to Brit, sometimes it’s good to go back to basics! Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
In Part 1 we began discussing the article “Implications of a New Ob*sity Definition Among the All of Us Cohort” by Fourman et al. This is a study that took the recommendations of the (heavily financially entangled with the weight loss industry) Lancet Commission around increasing the methods by which “ob*sity” can be “diagnosed” (the massive issues with which I wrote about here ,) and applied it to the All of Us population. So what did they find? Get full access to Weight and Healthcare at weigh...
I previously wrote about a Lancet Commission that published what I would describe as an opinion piece that they attempted to disguise as legitimate science. In it, they manipulated multiple research processes in order to create the largest possible market for the weight loss industry (in which the authors had massive financial entanglements) by wildly expanding the ways that someone might be “diagnosed” as “ob*se.” You can read about the whole sordid affair here . This has been a longtime goal o...
Today I’m taking a break from talking about weight and healthcare to write about navigating so much of the nonsense that happens during the holiday season. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
Today will be the first post in a short series discussing attempts to “calculate” the (supposed) “costs” of “ob*sity.” Before we get into any of this I want to say unequivocally that anytime we try to calculate the cost of a group of people, including and especially, to support a call for their eradication, we are going down a very bad, very wrong road. So while I will be discussing the specific issues with these calculations, please always remember that the calculations shouldn’t be undertaken ...
In Part 1 we looked at the basics and early research around GLP-1s for weight loss and muscle loss. In part 2 we looked at recent research around the newest GLP-1 weight loss drugs, tirzepatide (Zepbound) and semaglutide (Wegovy). In this final part of the series we are going to talk about the justifications/excuses/spin that are happening around the loss of lean muscle mass on GLP-1s. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
In Part 1 we looked at an early study of GLP1 drugs and muscle loss. Today we’ll look at two more recent studies, one for Eli Lilly’s drug tirzepatide and one for Novo Nordisk’s drug semaglutide. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
As GLP-1 drugs get heavily marketed for weight loss, we know that when people stop taking the drugs they experience rapid weight regain. We also know that, while the claim is that if people stay on the drugs forever they’ll maintain the weight loss, there isn’t any research proving that and that in the longest study of these drugs for weight loss (4 years) they lost 89.5% of the sample . There is another aspect that I think is not being discussed nearly enough and that is the subject of how much...
Several months ago I was asked to complete an interview over email for online publication The Quo. I was recently told that the writer fell ill and that the piece won’t be published. The interview was, essentially, a quick guide to the issues with diet drugs and surgeries for children so I thought I would publish the answers here. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
I write a lot here about the fallacy of blaming health issues on body size. Today I want to talk about the tendency to credit weight loss for physical, psychological, and social benefits. For example, someone will (at least short term) lose weight and offer a testimonial about how much better they feel, how much more they are doing in the world etc. Or a study will determine that Health Related Quality of Life (HRQoL) has improved after weight loss. Just like a weight-centric healthcare system (...
I last wrote about the Ob*sity Action Coalition (OAC) in 2022 and you can read about their history in that post here . It’s time for an update. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
I got the following question from reader Katrina: “You spoke to my doctoral program recently and in the Q&A you said something about poking holes into people’s thinking where better ideas could fall in. In the past I’ve talked to my doctor about research. I love the research posts you make but I know my doctor isn’t going to read or listen to something that long (he really should he just won’t!) Do you have some quick questions I could ask to poke some holes in his thinking that better ideas...
One of the things I’m seeing with the rise of GLP-1 weight loss drugs is other companies trying to use these drugs as a profit center. Today we’ll look at a drug that is seeking approval to help those who take GLP-1s avoid some of the adverse events. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
I write a lot here about the specific lies, obfuscations, and shenanigans done by the weight loss industry. But there are two overarching lies that I think may do the most harm in weight and healthcare sometimes consciously and sometimes subconsciously - as part of the unstated background of decisions around purchasing, care, and accommodation. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
After I posted the final part of my 3-part series on GLP-1s and kidney function, I got a question from reader Liza:“I appreciate how you always talk about how the authors get money from the drug company, I think it’s important to know. As I read this newsletter [ GLP-1 and Kidney Function Part 3 ] I was wondering if it is possible to calculate how much the drug company themself would make?” This is an interesting question. I think it’s tough to figure out because (at least here in the US) discou...
In part 1 and 2 we explored the document “Person-Centered Conversations: Weight Management and Type 2 Diabetes” that was put out by the Association of Diabetes Care and Education Specialists (ADCES) as a “framework” document. Reader Emily wrote in to ask if I would analyze it as she has recently been told to use it in her work as a diabetes educator. In Part 1 we looked at the basics, in part 2 the conversation recommendations. Today we’re going to look at what they are calling “Continuing the c...
In part 1 we started to explore the document “Person-Centered Conversations: Weight Management and Type 2 Diabetes” that was put out by the Association of Diabetes Care and Education Specialists (ADCES) as a “framework” document based on a request from reader Emily who is a diabetes educator who was recently told to use this document in the care of her higher-weight clients. Today we’re going to look at their specific recommendations for these conversations. Get full access to Weight and Healthc...
I recently got this question from reader Emily: I work as a diabetes educator and the place where I work just sent this document to everyone and told us that we should use it when talking to “o-word” patients. It doesn’t seem right to me at all can you do some analysis so I can push back? Thanks for asking Emily, I will do my best. The document she is referring to is called “Person-Centered Conversations: Weight Management and Type 2 Diabetes” and was put out by the Association of Diabetes Care ...
In parts 1 and 2 we looked at studies that sought to determine the effects of semaglutide on kidney function. Today, in the final part of the series, we are going to discuss another such study called Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes by Perkovic et al., 2024. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
This is part 2 of my series on the research around GLP-1 drugs for supporting kidney function. In part 1 we looked at Long-term kidney outcomes of semaglutide in ob*sity and cardiovascular disease in the SELECT trial, today we’ll look at “Semaglutide in patients with overw*ight or ob*sity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial” Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
As I promised, I’m doing some deep dives into the research and claims around GLP-1 agonist drugs for actual health uses other than their use in managing Type 2 Diabetes. For this series, I’ll be doing the deep dives as well as analyzing the studies using the framework that I discussed here . Kidney-related health is one of the claimed uses I’m most often asked about with GLP1s, that providers have told me they feel is one of the most promising, and which recently received FDA approval (for semag...
I’ve been meaning to write a piece about “the basics” of weight and healthcare and a question from a reader gave me the perfect chance. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
This came up during a monthly Subscriber Ask Me Anything . Many patients, of all sizes, choose to opt-out of routine weigh-ins for a lot of reasons. But what happens when you decline a routine clinical weigh-in (again, not a medically necessary weigh-in that has a specific medical purpose like dosing medication,) but one that is just being done because you are at a doctor’s office) and they tell you that you aren’t allowed to decline? Get full access to Weight and Healthcare at weightandhealthca...
I recently heard from reader Evelynn who asked : It seems like every other day I see a new supposed use for the GLP drugs. This just seems fishy to me. Are they really some kind of all purpose wonder drug? Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
In Part 1 we began discussing the 2025 study “Weight Trajectory Impacts Risk for Ten Distinct Cardiometabolic Diseases” by Swartz et al. that tested for possible harms of weight cycling. In part 1 I offered a quick summary of the study as well as looking into the methodology. Today we’re going to break down their discussion section. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe...
