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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

10:34

Options to Deal With BMI-Based Healthcare Denials -...

Weight and Healthcare ·

2023/02/18

Transcript:In part one we talked about the issues with BMI-based denials. Today we’ll talk about your options if you are facing a BMI-based healthcare denial. Part three will be the story of someone who successfully fought these denials.First of all, if your healthcare is being held hostage unless/until you reach a certain BMI (or lose a specific amount of weight etc.), please know that this is not your fault, even though it’s becoming your problem. Your options include finding different

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7:36

BMI Limits - Healthcare Held Hostage For A Weight...

Weight and Healthcare ·

2023/02/15

One of the ways that weight stigma harms fat people is through Body Mass Index BMI (and other weight-based) limits. BMI is a ratio of weight and height, and its use is deeply problematic in multiple ways. BMI and weight-based healthcare denials occur when people above a certain BMI or weight are refused medical procedures unless or until they meet the BMI or weight requirement. In part 1 of this three-part series, I’ll offer a general discussion of these limits, in part two I’ll provide some options

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7:42

The Validation and Frustration of Stunkard et al.

Weight and Healthcare ·

2023/02/11

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!Stunkard et al.’s 1959 study “The Results of Treatment for Ob*sity: A Review of the Literature and Report of a Series” is one of the earliest studies that really sought to determine the success of weight loss interventions. As someone who works full-time pointing out that weight loss interventions almost never succeed at creating significant, long-term weight loss and often do

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10:42

When Doctors' Education Is The Best That Pharma Money...

Weight and Healthcare ·

2023/02/08

In part 1 I talked about information that was brought to me by two senior residents who wanted people to know that they are being invited to “educational summits” that are actually being run by doctors with massive undisclosed ties to the pharmaceutical companies that make the drugs that are recommended in the summits. I did some digging around the company that is behind this to try to get some information about what’s going on.The company that created both of these summits is PCMG, Primary Care

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4:32

When Doctors' Education Is Really Pharmaceutical...

Weight and Healthcare ·

2023/02/04

In discussing weight stigma and diet culture in medicine in general and, recently, the new AAP guidelines that recommend “intensive” weight loss attempts to toddlers, a common question I get is - How did we get here? How did doctors get so totally invested in this paradigm that they can’t see past it? I think that a huge part of this is how enmeshed the weight loss industry is in every aspect of the healthcare system, including (and perhaps especially) provider education.Recently I was contacted by

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6:01

Asking for Accommodations as a Higher-Weight Person -...

Weight and Healthcare ·

2023/02/01

In Part 1 we talked about some general information about asking for accommodations as a higher-weight person. To get more insight into the legalities of this, I reached out to the brilliant folks at The Fat Legal Advocacy, Rights, and Education (FLARE) Project to write this guest column. The rest of this newsletter is their wise words.FLARE’s approach to health care access: Fat people deserve access to health care. Due to high rates of anti-fat attitudes, lack of universal design in medical

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7:28

Asking for Accommodations as a Higher-Weight Person...

Weight and Healthcare ·

2023/01/28

While places that serve the public (from transportation, to food service, to entertainment and especially healthcare) should be set up to accommodate everyone in the public, unfortunately, that is not always the case. This can create a situation where we may want/need to ask for access/accommodations. This can happen to people for any number of reasons - size, disability, neurodivergence and more. For those with multiple marginalized identities, this can occur more often and asking can be more

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10:14

Things to Stop Saying/Doing To Fat Patients At The...

Weight and Healthcare ·

2023/01/25

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!Higher-weight patients can face tremendous weight stigma, including intrinsic, extrinsic, and structural stigma, within the healthcare system, with those at the highest weights and those who are multiply marginalized being the most impacted. Some of that isn’t something that can be solved by individual providers, but some of it is.The part of the appointment from the time we

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27:55

Testing The Claim That Pediatric Weight Management...

Weight and Healthcare ·

2023/01/21

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!I think that one of the more dangerous and disingenuous parts of the new American Academy of Pediatrics guidelines is their claims about eating disorders. These are claims that I am hearing echoed in other spaces as well, so I wanted to write about them in depth. In terms of the guidelines themselves, I wrote a deep dive about their three main recommendations around “Intensive

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6:42

The Problem With Weight Stigma Research

Weight and Healthcare ·

2023/01/18

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!I spend a massive amount of time digging into weight stigma research and much of it is incredibly frustrating because of how often research around weight stigma still takes (and supports) views that are, in and of themselves, rooted in weight stigma.The overarching problem is that much of this research is still predicated on the idea that fatness* is bad and should be

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37:52

Serious Issues With the American Academy of...

Weight and Healthcare ·

2023/01/14

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!The American Academy of Pediatrics has put out a new Clinical Guideline for the care of higher-weight children. This document is 100 pages long including references and there are so many things that are concerning and dangerous in it that I had trouble deciding how to divide it up to write about it. I began on Thursday with a piece about the undisclosed conflicts of interest

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13:24

Special Edition: Dangerous New American Academy of...

Weight and Healthcare ·

2023/01/12

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!At their base, the guidelines recommend intentional weight loss for higher-weight children via “Intensive Health Behavior and Lifestyle Training” starting as early as age two (2) with drugs as young as twelve (12) and surgeries starting as early as age thirteen (13).There is a lot to unpack here, and this will be a multi-part series but I have had a flood of requests to write

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4:08

Study Finds Doctors’ Weight Loss Advice Is Rarely...

Weight and Healthcare ·

2023/01/11

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!In findings that will likely not surprise anyone who has been on the receiving end of it, a recent study (What advice do general practitioners give to people living with ob*sity to lose weight? A qualitative content analysis of recorded interactions) found that doctor’s weight loss advice is rarely effectiveExamples of unhelpful general advice included· Eat less and do

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4:01

Novo Nordisk Marketing Diet Drug to Adolescents

Weight and Healthcare ·

2023/01/04

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!Novo Nordisk (the same company that made a literal fortune by price gouging with insulin,) has taken another step to follow through with their promise to shareholders to generate massive profit from their new weight loss drug Wegovy by getting FDA approval to market the drug to adolescents ages 12 and up.This approval is based on a 68-week trial. They started with 210

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3:02

Ghosts of Diet Culture Yet to Come

Weight and Healthcare ·

2022/12/31

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!This is the third part of a three-part series looking at diet culture past, present, and future. In this week’s subscriber discussion we talked about what we wanted to see and do in the coming year to continue to move away from diet culture and weight stigma. I think that one of the most important things that we can do right now is to push back against the diet industry’s work

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3:51

Ghosts of Diet Culture Present

Weight and Healthcare ·

2022/12/28

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!In part one we talked about the Ghosts of Diet Culture Past, today we’re going to talk about, well, today.Diet culture is working overtime right now because this time of year contains two of its triumvirate of evil marketing seasons (the holidays are coming, News Years Resolution season, and swimsuit season).The diet industry made $72.6 Billion in 2021, and they use a lot of

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6:27

Ghosts of Diet Culture Past

Weight and Healthcare ·

2022/12/24

This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing!This is part of a three-part end of the year series that will discuss the past, present, and future of diet culture. A common refrain is that being higher-weight is “linked” to health issues. We have discussed before how, even if higher-weight people do experience health issues(s) more frequently, that doesn’t mean that being higher-weight causes

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6:45

How To Solve The So-Called "Obesity Epidemic" Today

Weight and Healthcare ·

2022/12/21

This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing!Every day I see something about how this diet, or that activity, or this federally funded program will help “solve the ob*sity* epidemic.” In truth, this “epidemic” could be solved today.Just stop talking about the “ob*sity epidemic”. There, problem solved. But perhaps in our current society this bears some explanation – here’s why we should

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6:53

Does this Study Really Say You Can't Be Fat and Fit?

Weight and Healthcare ·

2022/12/17

This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing!This study came out almost two years ago, but it came up in a talk I gave this week, so I thought I’d post about it. CNN ran a headline that said “Fat but fit’ is a myth when it comes to heart health, new study shows.” The study is Joint Association of Physical Activity and Body Mass Index with Cardiovascular Risk: A Nationwide Population-Based

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6:54

How to Tell If A "Weight Bias" Training Is Diet...

Weight and Healthcare ·

2022/12/10

This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing!As the diet industry works hard to co-opt the language of weight-neutral health and fat liberation and misuse it to sell weight loss interventions, I’m seeing more and more “anti-weight bias” trainings that are actually just diet industry marketing in disguise.Sometimes the trainers are very aware of what they are doing, sometimes they are actually

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