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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

6:06

Weight and Inflammation Part 1

Weight and Healthcare ·

2025/01/11

In discussions around weight and health, the concept of “inflammation” almost always arises. This is a complex discussion and so I am thrilled and honored to share a four-part series in which Zed Zha, MD, FAAFP (Fellow of the American Academy of Family Physicians) and I explore assumptions around weight, weight loss, and inflammation.Here now, Part 1 - Patient Story - as told by Dr. Zha Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:04

Fight Weight Stigma - Not Higher-Weight Patients

Weight and Healthcare ·

2025/01/08

On Saturday I posted a piece helping patients navigate weight stigma in healthcare, today I want to offer some support to healthcare providers to avoid creating weight stigma. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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7:48

Three Options When Your Healthcare is Compromised by...

Weight and Healthcare ·

2025/01/04

Higher-weight people too often find themselves in healthcare situations where they are being treated poorly/unequally because of weight stigma. These situations are, sadly, too numerous to count and in some cases need to be addressed in very specific ways. In many cases though, there are some standard responses that higher-weight patients and/or those advocating for them can use to try to get appropriate care. Get full access to Weight and Healthcare at

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4:13

Reader Question - What Is Number Needed to Treat?

Weight and Healthcare ·

2024/12/21

This came up in our monthly subscriber Ask Me Anything. When I break down research I often talk about using absolute risk reduction and statistical significance to determine the efficacy of an intervention. Another number that helps determine efficacy is the Number Needed to Treat (NNT). This number helps us understand how many patients need to be treated with an intervention in order to avoid a single negative outcome. Get full access to Weight and Healthcare at

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5:10

Intentional Weight Loss and Lottery Logic

Weight and Healthcare ·

2024/12/11

You can’t win if you don’t play.That’s what the PowerBall ad said. I could pay $2 for a ticket and possibly win a $20 million jackpot. Of course, I have a 99.9999997 percent chance of losing which may be why my stats teacher used to say that the lottery was a tax on people who didn’t pay attention in her class.So why am I going on about the lottery in a newsletter about the intersections of weight science, weight stigma, and healthcare?Because I hear a similar type of “logic” all the time from the

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9:37

Reader Question: What’s With the New Child Growth...

Weight and Healthcare ·

2024/12/07

I got the following question from reader Naomi“Thanks for the information on the CDC growth charts. I wonder if you could talk about how to understand them. My pediatrician said that my child is more than 120 percent of the 95th percentile. What the h e double hockey sticks does that even mean? Help!” I’m happy to try to explain. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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11:42

New Study Supports Weight-Neutral Health

Weight and Healthcare ·

2024/12/04

Today we’re going to talk about a new study called whose goal was to assess the “relationship of cardiorespiratory fitness (CRF) and Body Mass Index (BMI) on both cardiovascular disease (CVD) and all- cause mortality risk” by Nathan R Weeldreyer, Jeison C De Guzman, Craig Paterson, Jason D Allen, Glenn A Gaesser, and Siddhartha S Angadi. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:18

We Must Stop Blaming Higher-Weight Bodies for...

Weight and Healthcare ·

2024/11/27

There are many ways that weight stigma occurs in healthcare. One that is harmful on multiple levels happens when higher-weight people are blamed for the ways in which healthcare fails them. This occurs when a patient is blamed for being “too big” for something they need. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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11:34

What Is Clinical Obesity?

Weight and Healthcare ·

2024/11/23

I’ve now had eleven different doctors ask me about this article, so let’s talk about it! Here is one of the emails:“I’m an MD and I just read this article in Medscape about “clinical ob*sity.” Should I be worried? I feel like I should be worried. I understand it hasn’t happened yet, but it seems like one of those things that will happen all at once without any chance to pushback. Any ideas on how to handle this?” Get full access to Weight and Healthcare at

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5:25

How NOT to handle a patient weigh-in (and what to do...

Weight and Healthcare ·

2024/11/16

Regular readers may know that while speaking and writing are my primary work, I’m also a Board Certified Patient Advocate and I sometimes work directly with patients, typically in emergency or complex medical situations. Recently I was advocating for a patient at a cardiology appointment (who has given me permission to share this.) I was waiting outside the treatment room while my patient got settled, near the area where the scale that is used for weigh-ins was located. In this practice each

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4:24

A Diet By Any Other Name

Weight and Healthcare ·

2024/11/13

I received the following question from reader Jin,I’m a pharmacist and one of the things I’ve learned from following you over the years is the importance of language. I wanted to ask you about language like “anti-ob*sity” medication and “ob*sity treatment.” I notice that you still use terms like weight loss drugs and I imagine that is on purpose. I’d love to understand more about this. Feel free to make it a Substack post if you’d like.Thanks for noticing and thanks for asking Jin! Get full access

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6:31

The Problem With People-First Language for...

Weight and Healthcare ·

2024/11/06

I received the following question from reader Alina:I’m a family med doctor and I’ve started seeing lots of publications, even research, using the terms “person with ob*sity” and “person with overw*ight.” I took some CME [Continuing Medical Education] where they said that it was for weight stigma reduction. I’m not sure why, but it just doesn’t feel right at all (Does person with overw*ight even make sense?) I would love to see a newsletter about this.Thanks for asking Alina, your feeling that

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6:18

How Medical Research Fails Higher-Weight Patients

Weight and Healthcare ·

2024/11/02

There are many aspects of weight stigma within the healthcare system that harm higher-weight people. There is an issue that isn't often discussed that underpins many of the harms that the healthcare system does to higher-weight people.Research. Or a lack thereof. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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17:30

More Problems With Obesity First Medicine - Part 2

Weight and Healthcare ·

2024/10/30

In part 1 we discussed a New York Times article about so-called “Ob*sity First Medicine” (OFM) which suggests that higher weight people with health issues should be targeted for weight loss treatment (in this case specifically the new GLP-1 diet drugs) treating them differently than thinner people with the same symptoms/presentations/diagnoses.Today we’re going to look at an opinion piece in WaPo that discusses the same phenomenon. Get full access to Weight and Healthcare at

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10:20

The Dangers of "Obesity First" Medicine - Part 1

Weight and Healthcare ·

2024/10/26

Many of you reached out to me about two articles. One in the New York Times by Gina Kolata about so-called “Ob*sity First Medicine” - OFM (you may remember Kolata from a different article I wrote about that essentially lobbied for insurance coverage for weight loss drugs and failed to disclose that each person interviewed was on the payroll of the drug companies.) Another an opinion piece in the Washington Post by Leana S. Wen. We’ll discuss the NYT article in part 1, along with some general issues

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8:42

RIP to the AspireAssist

Weight and Healthcare ·

2024/10/23

I received a reader question from Annilyn who said:“My doctor just suggested that I try the AspireAssist to lose weight. I didn’t want to Google it because I think it will be really triggering but based on what he described, I just don’t think this thing can be real, can it? Will you write about it?”I’m happy to write about this weight loss device Annilyn, and mostly I’m happy because it seems to be off the market, but we’ll get to that. I think it’s worth looking at the history and research around

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7:18

Weight Loss Drug Manufacturers Sued - Part 2

Weight and Healthcare ·

2024/10/19

In part one we looked at a lawsuit being brought by Jaclyn Bjorklund against Novo Nordisk (maker of Semaglutide - brand names Ozempic/Rybelsus/Wegovy) and Eli Lilly (maker of Tirzepatide - brand names Mounjaro/Zepbound) for the severe gastrointestinal side effects she experienced after taking Ozempic and then Mounjaro for type 2 diabetes. At the end I made the point that, for some people, the negative side effects don’t end when they stop taking the medications and for others, the damage has been

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7:58

Lawsuit highlights the dangers of GLP-1 Drugs - Part 1

Weight and Healthcare ·

2024/10/16

I received requests from a number of you to write about this situation. Jaclyn Bjorklund, a 44 year old woman from Louisiana is suing both Novo Nordisk and Eli Lilly.Content note: this piece will include details of severe gastrointestinal symptoms and conditions. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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11:52

Diets, Eating Disorders, and Dubious Research...

Weight and Healthcare ·

2024/10/12

This is the final part of the series about the study “Eating disorder risk during behavioral weight management in adults with overw*ight or ob*sity: A systematic review with meta-analysis” by Jebeile et al, 2023. In part 1 we talked about overarching issues with the science, in part 2 we talked about general issues with this specific study, and in part 3 we’ll discuss the specific claims made. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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5:33

Study's Questionable Claims About Diets and Eating...

Weight and Healthcare ·

2024/10/09

In part 1 we discussed the overarching issues with “Eating disorder risk during behavioral weight management in adults with overw*ight or ob*sity: A systematic review with meta-analysis” by Jebeile et al, 2023. Today we’ll begin to dig into the specific issues with this study.Content note: in this piece I’ll be talking about eating disorders, including specific behaviors, and weight loss methods that include eating disorder behaviors. Get full access to Weight and Healthcare at

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