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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

6:21

Questions About Weight and Surgical Complications...

Weight and Healthcare ·

2025/08/09

BMI-based denials of care are devastating and can have serious negative impacts on people’s health, lives, and quality of life. In some cases they are, in fact, life or death. I have a series here that talks about this in detail, including options if you are dealing with a BMI-based denial of care and resources if you want to fight them. Today I want to talk about a common reason that is used to (attempt to) “justify” BMI-based denials of care. Get full access to Weight and Healthcare at

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13:08

ABC News' Love Letter to Diet Drugs - Part 2 Sell the...

Weight and Healthcare ·

2025/08/06

In part 1 I started discussing the ABC News article “GLP-1s work but when they're stopped, the effects stop too: Expert” We discussed the fact that in order to buy the claims their “expert” makes, you first have to buy the dubious claim that simply existing in a higher-weight body, regardless of actual health status, is a health condition requiring treatment (which I wrote about in detail here and here.) We also learned about Dr. Louis Aronne, the “expert” they are quoting who, prior to taking over

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8:35

ABC News' Love Letter to Diet Drugs - Part 1 Buy the...

Weight and Healthcare ·

2025/08/02

There are a couple of online articles floating around that literally hundred of you have asked me to write about. One is the Washington Post “reporting” on the study about eating and body size. That study is…a lot, so while I’m slogging through that article and the study it references, today I’m going to write about the other article. Published by ABC News and called “GLP-1s work but when they're stopped, the effects stop too: Expert” Get full access to Weight and Healthcare at

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8:09

The dangers of giving unsolicited health advice to...

Weight and Healthcare ·

2025/07/30

In part 1, I offered a framework of questions for healthcare providers (or others) to ask themselves before they offer unsolicited health advice to a higher-weight person (or, really, any person.) Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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7:39

4 Questions to Ask Before Making Health...

Weight and Healthcare ·

2025/07/26

A couple years ago I wrote a piece about what to think about before offering unsolicited advice to higher-weight friends/family/strangers about their health. Today’s piece extends from that. While it can apply to family/friends/randos at the drug store, this is intended for healthcare providers and other health/public health professionals and educators whether you are one yourself, or you want to share this with healthcare providers and educators you know.I’ve written extensively about the research

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9:46

Weight Loss Is Not a Substitute for Healthcare: Part...

Weight and Healthcare ·

2025/07/23

In part 1 we discussed the basics of substituting weight loss for healthcare and accommodation. In part 2 we discussed issues with the likelihood of achieving weight loss, even if it was appropriate to insist that higher-weight patients become thinner before accessing care (and I do not think it is). In part 3, we discussed the issues of weight loss being promoted as a solution to accessibility. In part 4, we looked at a case study.Today, we’re going to talk about what can be done to stop the

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5:04

Weight Loss Is Not a Substitute for Healthcare: Part...

Weight and Healthcare ·

2025/07/19

In part 1 we discussed the basics of substituting weight loss for healthcare and accommodation. In part 2 we discussed issues with the likelihood of achieving weight loss, even if it was appropriate to insist that higher-weight patients become thinner before accessing care (and I don’t believe it is.). In part 3, we discussed the issues with weight loss being promoted as a solution to accessibility. Today we’ll look at a real experience with this. Many facilities, including physical and mental

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3:56

Weight Loss Is Not a Substitute for Healthcare: Part...

Weight and Healthcare ·

2025/07/16

In part 1 we discussed the basics of substituting weight loss for healthcare and accommodation. In part 2 we discussed issues with the likelihood of achieving weight loss, even if it was appropriate to insist that higher-weight patients become thinner before accessing care.Today we’re going to discuss the issues with delaying care for weight loss. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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8:15

Weight Loss Is Not a Substitute for Healthcare: Part...

Weight and Healthcare ·

2025/07/12

In part 1 of this series we looked at the basic issues of a healthcare system that is allowed to demand weight loss before patients are able to access healthcare. In this section, we’ll look at BMI-based denials of care. These occur when a patient is denied care unless or until they reach a certain BMI. It is often justified by the idea that higher-weight patients have more complications/worse outcomes and that weight loss will improve this. But it’s far from being that simple. Get full access to

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6:49

Weight Loss Is Not a Substitute for Healthcare: Part...

Weight and Healthcare ·

2025/07/09

Substituting weight loss for health and/or healthcare accommodation is a primary source of harm enacted on higher-weight people by the healthcare industry. I’ve had a bunch of requests asking me to write about it from a macro perspective .This is complicated and there is a lot to discuss so I’m breaking it up into five parts. (I’m thrilled that you are reading this whether you stumbled onto it or are a free or paid subscriber and today I want to offer some extra gratitude to my paid subscribers - a

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16:29

Weight Loss Drug Cage Match - Part 2 Study Insights

Weight and Healthcare ·

2025/07/05

In Part 1 we looked at the basics of a study that compared the two newest GLP-1 weight loss drugs against each other - Novo Nordisk’s Semaglutide (Wegovy) and Eli Lilly’s Tirzepatide (Zepbound) The trial was funded by Eli Lilly and while many of the authors took money from the makers of both drugs, the only authors (some of whom were statisticians) who were employed by and owned stock in a drug company were from Eli Lilly. While that isn’t proof of bias, it’s certainly a red flag.Today we’ll look at

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7:31

Weight Loss Drug Cage Match Study - Part 1 The Basics

Weight and Healthcare ·

2025/07/02

On May 11, 2025, the study “Tirzepatide as Compared with Semaglutide for the Treatment of Ob*sity” was published in the New England Journal of Medicine.This study was, essentially, a cage match between the two newest weight loss drugs to see which one created more weight loss. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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7:14

3 Things to Stop Calling Higher-Weight Patients Right...

Weight and Healthcare ·

2025/06/28

The way that higher-weight patients are discussed (in research, in medical/healthcare education and training, and even in interventions meant to increase accessibility in healthcare) can vastly increase weight stigma among healthcare providers. Today I want to talk about three terms that are often used that create this issue. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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10:54

Study questions the claimed health benefits of weight...

Weight and Healthcare ·

2025/06/14

I recently wrote about a study that questioned the assumption that higher-weight causes health issues. Today I’m writing about a study that questions the assumption that weight loss improves health issues in higher-weight people. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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6:03

Letter Pushes Back Against Weight Stigma in Research

Weight and Healthcare ·

2025/06/11

Weight stigma does untold harm and, especially in healthcare, it can be deadly. One of the most important things that each of us can do to reduce weight stigma and the harm it causes is to act (when we can) when we find ourselves in situations where weight stigma is happening.Today I have an example of quick push-back and a more in-depth example. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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4:55

Research questions the relationship between weight...

Weight and Healthcare ·

2025/06/07

In the past we’ve talked about how the health issues that get blamed on being higher-weight may actually be due to weight stigma and/or weight cycling and/or healthcare inequalities. Recently reader Conner let me know what this 2021 study whose bottom line finding was “adverse consequences currently attributed to ob*sity could be attributed to hyperinsulinemia (or another proximate factor.” Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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7:03

Reader Question - Was there really a contest to win...

Weight and Healthcare ·

2025/06/04

I got the following question from reader Jill who attended a recent talk that I gave at her medical center:”During the question and answer part you mentioned a contest to win weight loss surgery. Did that really happen? I hope you’ll write about it on your newsletter.”Yeah, it did and yes, I will Jill, thanks for asking. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:21

Why Not Give The Weight Loss Industry the Benefit of...

Weight and Healthcare ·

2025/05/28

In part 1 we talked about the general issues with giving the weight loss industry the benefit of the doubt. In part 2 we talked about the specifics of this for the GLP-1 weight loss meds. That brings us back to our original question from family doctor Elena:I’m a weight-neutral family doctor. I was talking to a colleague about my issues with the GLP-1s and how there is no evidence that supports that taking them for life will lead to sustained weight loss or health benefits. He said “There’s no

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5:55

Why Not Give The Weight Loss Industry the Benefit of...

Weight and Healthcare ·

2025/05/24

In part 1 we discussed the general issues with giving the weight loss industry the benefit of the doubt. Today we are going to talk about this as it applies to GLP-1s. This started with an email I got from Elena:”I’m a weight-neutral family doctor. I was talking to a colleague about my issues with the GLP-1s and how there is no evidence that supports that taking them for life will lead to sustained weight loss or health benefits. He said “There’s no evidence that they won’t.” It strikes me as wrong,

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5:56

Why Not Give The Weight Loss Industry the Benefit of...

Weight and Healthcare ·

2025/05/21

I got this email from reader Elena:I’m a weight-neutral family doctor. I was talking to a colleague about my issues with the GLP-1s and how there is no evidence that supports that taking them for life will lead to sustained weight loss or health benefits. He said “There’s no evidence that they won’t.” It strikes me as wrong, but how do I argue with thatThis same question came up in our monthly subscriber Ask Me Anything as well. I’ll address it specifically but first I want to talk about how this is

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