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PODCAST

Weight and Healthcare

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

health & fitness medicine

All Episodes

8:39

Reader Question: How to Follow the Weight Loss...

Weight and Healthcare ·

2024/07/13

Reader Kellisa sent me the following question:I appreciate all the different things you write about, but some of my favorite newsletters are where you show how people and studies are paid for by the diet industry. I know this was a while ago, but I just found the newsletter you wrote about where you figured out that the person behind that “bill of rights” was actually a lobbyist for Novo Nordisk and I decided to ask this question. How do you find this stuff out? Are there any tips you can give to

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8:16

Unresearched GLP-1 Agonist Practices

Weight and Healthcare ·

2024/07/10

As I discuss the issues of GLP-1 agonist and GLP-1/GIP co-agonist weight loss drugs Semaglutide (Ozempic/Wegovy) and Tirzepatide (Mounjaro/Zepbound)I’ve been increasingly hearing from people who are engaged in practices with these drugs that are not remotely evidence based. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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7:20

Reader Question – What is the Body Roundness Index?

Weight and Healthcare ·

2024/07/03

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!Reader Shauna asked “I just saw an article about the Body Roundness Index, is that as silly as I think it is?”The Body Roundness Index seems to be the weight loss industry’s response to finally having to (at least begin to) admit that the Body Mass Index (BMI) is nonsense. The BMI is a ratio of weight and height that has been used to pathologize bodies based on their size alone

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6:13

Advocating for a higher-weight person at the doctor’s...

Weight and Healthcare ·

2024/06/26

This came up in our monthly Subscriber Ask Me Anything discussion and it’s something I get asked about a lot – how can you advocate for a fat* friend/family member in a healthcare appointment? Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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6:11

Your health program is not weight-neutral if…

Weight and Healthcare ·

2024/06/22

The co-opting of concepts from weight-neutral health community to sell weight loss (or obfuscate the harm it causes) is rampant. We’ve talked about this with the concept of weight stigma and fake anti weight stigma events, PR campaigns, and marketing. In today’s edition of “words mean things” we’re going to talk about the co-option of the concept of weight-neutral. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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11:09

The Need for Troncoconical Blood Pressure Cuffs

Weight and Healthcare ·

2024/06/15

In my recent quick guide to creating a size-inclusive office, I mentioned troncoconical blood pressure cuffs and I heard from a number of people in healthcare who said that they had never heard of them so I thought I’d write a follow-up piece. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:07

Case Study - GLP-1 Agonists and Medication Absorption...

Weight and Healthcare ·

2024/06/12

In part 1 we talked about the research (or lack thereof) around the ways in which GLP-1 drugs, taken in large doses for weight loss, might impact the absorption of other medications. Today, we’re going to hear from someone who was personally impacted by the issue. I received the following information from Jennifer Jonsson who gave me permission to publish it and use her name. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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6:21

GLP-1 Agonists and Medication Absorption - Part 1

Weight and Healthcare ·

2024/06/08

One of the questions I’ve been getting a lot is about how the new GLP-1 weight loss drugs (Novo’s Semaglutide Wegovy) and GLP-1/GIP co-agonist weight loss drugs (Lilly’s Tirzepatide/Zepbound) can interfere with the absorption of other medications. In part 1 we’ll look at the information around this and in part 2 we’ll have a personal story of someone who experienced it. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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9:35

We Need To Talk About P-Hacking

Weight and Healthcare ·

2024/06/05

Let’s start today with what P-hacking is, and then we can talk about why we needed to talk about it in the first place. Please note this is an overview, there are many more layers and complications to this, these are the basics. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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9:18

The Examination/WaPo Anti-Diet Hit Piece Methodology...

Weight and Healthcare ·

2024/05/29

In Part 1 I talked about the WaPo/Examination piece “As ob*sity rises, Big Food and dietitians push 'anti-diet' advice…General Mills warns of “food shaming"; dietitian influencers promote junk foods and discourage weight loss efforts.” I discussed my experience with being interviewed, as well as some basics about the piece. Today I’m going to talk about their methodology, such as it is. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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6:11

The Examination/Washington Post Anti-Diet Hit Piece -...

Weight and Healthcare ·

2024/05/25

The headline ran “As ob*sity rises, Big Food and dietitians push 'anti-diet' advice…General Mills warns of “food shaming"; dietitian influencers promote junk foods and discourage weight loss efforts.” (As is my policy, I don’t link to studies or articles that contain weight stigma, but I give enough information to Google.)Why am I calling it a hit piece? For two reasons, first because I know that the authors had every opportunity to provide a more balanced story, and second, because of their… let’s

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16:50

Does this Semaglutide (Wegovy) study really show...

Weight and Healthcare ·

2024/05/22

In part 1 we examined the massively misleading opening claim of the abstract of the new study “Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial” by Ryan et al, published in the journal naturemedicine, and we looked at the magnitude of the conflicts of the authors. Today I’ll dig into the rest of the study. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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11:33

Four-Year Outcomes of Wegovy (Semaglutide 2.4mg)...

Weight and Healthcare ·

2024/05/18

As you might imagine, I subscribe to a large number of medical publications and in the last couple of days I’ve been receiving updates from them falling all over themselves to breathlessly claim that weight loss was maintained for 4 years on Semaglutide 2.4mg (aka Wegovy) in the SELECT trial.The ways in which these claims are misleading are egregious and anti-science. In part 1 I’ll look at the initial claims and the people making them, in part 2 I’ll do a deeper analysis of the study. Get full

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4:07

Quick Guide – Creating a Size-Accommodating Office

Weight and Healthcare ·

2024/05/11

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!During the Q&A at a recent talk at a medical conference a healthcare provider at the end said “there is so much to do, what would you suggest is a good place to start?”There are plenty of places to start, but one that jumps to mind is in creating an accommodating office. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:58

The Myth of Kick-Starting Weight Loss - Part 2

Weight and Healthcare ·

2024/05/08

In part 1 we talked about the long-standing, evidence-free phenomenon of “jump-starting” weight loss using some kind of short-term extreme food/caloric restriction. Today we have another version straight from the doctor's office. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:38

Reader Question – What Should Disclosures in Weight...

Weight and Healthcare ·

2024/05/01

I received the following question from reader Deena:I love when you talk about the funding and other conflicts of interest of the people who write studies. It seems obvious that you don’t think disclosures are adequate, so I’m just wondering - what do you think that disclosures should include?Deena is exactly right, I do not think that disclosures as they are currently done are anywhere near adequate. So today I’ll talk about what I wish research disclosures included. Get full access to Weight and

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12:44

Wegovy for Cardiovascular Risk Reduction - Part 2

Weight and Healthcare ·

2024/04/17

In part one we looked at the staggering conflicts of interest and issues with the efficacy in the Semaglutide 2.4 (Wegovy) cardiovascular trial (Semaglutide and Cardiovascular Outcomes in Ob*sity* without Diabetes DOI: 10.1056/NEJMoa2307563) especially as compared to the deeply misleading claims in Novo Nordisk’s “company announcement” publicity stunt prior to publication.Today we’re going to dig deeper into the data, what there is of it, anyway. Get full access to Weight and Healthcare at

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8:41

The Worst Fitness Advice for Higher-Weight People?

Weight and Healthcare ·

2024/04/10

Today we’re going to talk about common advice that has long been a pet peeve of mine. It is advice that I, myself, have been given and that I’ve heard from countless people. It happens when someone (a fitness professional, a doctor, whomever) tells a higher-weight person that they should not lift weights/lift heavy weights/strength train etc. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:38

The Scientifically Shaky Definitions of "Obesity"

Weight and Healthcare ·

2024/03/27

In their zeal to medicalize and pathologize higher-weight bodies for profit, the weight loss industry (and the advocacy groups they fund, and the elements of healthcare they influence) have worked hard to claim that “ob*sity” is a disease and then manipulate the definitions of ob*sity to their best interest. Let’s look at some: Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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9:21

The Dangers of Medicare Coverage for Wegovy,...

Weight and Healthcare ·

2024/02/21

Moving forward I’m going to be writing about efforts on a number of fronts that are trying to recommend weight loss and, in particular, weight loss drugs to older adults. Much of this is part of the weight loss industry’s holy grail of getting their drugs approved by Medicare, so I wanted to provide some basics around this today. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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