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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

5:06

Quick Guide: Diet Drugs and Surgeries for Children

Weight and Healthcare ·

2025/10/29

Several months ago I was asked to complete an interview over email for online publication The Quo. I was recently told that the writer fell ill and that the piece won’t be published. The interview was, essentially, a quick guide to the issues with diet drugs and surgeries for children so I thought I would publish the answers here. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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8:25

Questions about the claimed benefits of weight loss

Weight and Healthcare ·

2025/10/25

I write a lot here about the fallacy of blaming health issues on body size. Today I want to talk about the tendency to credit weight loss for physical, psychological, and social benefits. For example, someone will (at least short term) lose weight and offer a testimonial about how much better they feel, how much more they are doing in the world etc. Or a study will determine that Health Related Quality of Life (HRQoL) has improved after weight loss.Just like a weight-centric healthcare system (and

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18:59

What Going On With the Obesity Action Coalition

Weight and Healthcare ·

2025/10/22

I last wrote about the Ob*sity Action Coalition (OAC) in 2022 and you can read about their history in that post here. It’s time for an update. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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3:47

Quick Guide - Expanding Thinking About Weight And Health

Weight and Healthcare ·

2025/10/18

I got the following question from reader Katrina:“You spoke to my doctoral program recently and in the Q&A you said something about poking holes into people’s thinking where better ideas could fall in. In the past I’ve talked to my doctor about research. I love the research posts you make but I know my doctor isn’t going to read or listen to something that long (he really should he just won’t!) Do you have some quick questions I could ask to poke some holes in his thinking that better ideas could

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10:41

New Drug to Tolerate Weight Loss Drugs?

Weight and Healthcare ·

2025/10/15

One of the things I’m seeing with the rise of GLP-1 weight loss drugs is other companies trying to use these drugs as a profit center. Today we’ll look at a drug that is seeking approval to help those who take GLP-1s avoid some of the adverse events. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

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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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235 results

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