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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

6:29

Identifying Two Dangerous Lies in Weight and Healthcare

Weight and Healthcare ·

2025/10/11

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

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11:27

Reader Question - What’s in it for Novo Nordisk?

Weight and Healthcare ·

2025/10/08

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) discount

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8:33

Analyzing ADCES Conversation Guide for Weight and...

Weight and Healthcare ·

2025/10/01

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

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13:36

Analyzing ADCES Conversation Guide for Weight and...

Weight and Healthcare ·

2025/09/27

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 Healthcare

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7:30

Analyzing ADCES Conversation Guide for Weight and...

Weight and Healthcare ·

2025/09/24

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 and

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25:05

GLP-1s and Kidney Function - Part 3

Weight and Healthcare ·

2025/09/20

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

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19:54

GLP-1s and Kidney Function - Part 2

Weight and Healthcare ·

2025/09/17

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

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22:03

GLP-1s and Kidney Function Part 1

Weight and Healthcare ·

2025/09/13

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

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10:37

Reader Question - Weight and Healthcare Basics

Weight and Healthcare ·

2025/09/06

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

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5:40

What if they tell you that you have to weigh-in?

Weight and Healthcare ·

2025/09/03

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

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8:31

Reader Question - All These Other GLP-1 Uses

Weight and Healthcare ·

2025/08/30

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

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12:36

New Study of Harms of Weight Cycling - Part 2 Discussion

Weight and Healthcare ·

2025/08/27

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

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13:46

WaPo Article Claims Food Causes "obesity" Part 2 -...

Weight and Healthcare ·

2025/08/20

In part 1 we discussed the issues with the study “Energy expenditure and ob*sity across the economic spectrum” by McGrosky et al. Literally hundreds of people reached out to me to write about it and most of them were asking about the article from the Washington Post “What causes ob*sity? A major new study is upending common wisdom.” Today I’m going to talk about that article. If you haven’t read part 1, I recommend checking that out first, because I’m going to be referring to it a lot. Get full

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15:45

WaPo Article Claims Food Causes "obesity" Part 1 -...

Weight and Healthcare ·

2025/08/16

Wow did a lot of you ask me to write about the article “What causes ob*sity? A major new study is upending common wisdom” from The Washington Post.The article is about a study called “Energy expenditure and ob*sity across the economic spectrum” by McGrosky et al.We’ll talk about the study in part 1 and the reporting of it in part 2. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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8:03

Questions About Weight and Surgical Complications...

Weight and Healthcare ·

2025/08/13

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!In part 1 we discussed general issues with claims about higher-weight patients and surgical outcomes. Today, we’ll talk about three important questions I think we need to be asking about the idea of higher-weight people having higher complication rates and/or worse outcomes. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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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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