Weight and Healthcare

When it comes to recommending weight loss, healthcare has always had what I call a Best Case Scenario Problem. I think the best way for patients to protect ourselves from this is to understand it so that we can spot it when it’s happening so in Part 1 I’ll examine how this works (in the past and currently) around behavior-based interventions and then in part 2 we’ll look at how GLP-1s are driving...

I’ve had a bunch of requests to write about this so here you go! Novo Nordisk has a long and sordid history of misdeeds, many of which I’ve written about previously. Now they have a new one to add to the list. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

This is the Weight and Healthcare newsletter ! If you like what you are reading, please consider subscribing and/or sharing! In Part 1 we started discussing the “Million Pound Challenge” created by Toby Cosgrove and Dr. Michael Roizen in which they are “challenging” an unknown number of people to collectively lose one million pounds. In part 2 we’ll discuss the program itself. (If you haven’t read...

Reader Shannon Roosma-Goldstein, MPH, BSN, RN, NPD-BC recently reached out to me because a professional healthcare organization she belongs to had sent her an email encouraging her, as a member, to participate with the organization in the “Million Pound Challenge.” In Part 1 we’ll look at the basic issues with the challenge and who is behind it. In part 2 we’ll look at the details of the program,...

Behavior-based interventions (sometimes under the auspices of lifestyle medicine) can be evidence-based, health-supporting, and weight-neutral. Unfortunately, when it comes to recommending behavior-based interventions to higher-weight people, there are common mistakes that providers make. We’ll talk about the mistakes and then what patients and providers can do to avoid and/or navigate them. Get f...

In part 1 we started looking at a study called Weight Regain after cessation of medication for weight management systemic review and meta-analysis by West et al. and in part 2 we looked at the findings. Today I thought it would be helpful to look at how the media is covering this study so we can see how these findings translate. If you haven’t read part 2 (or, at least, the summary) then I recomme...

In Part 1 we began discussing Weight Regain after cessation of medication for weight management systemic review and meta-analysis by West et al. Today we’ll discuss the findings. This is a long one so I’ve got a summary and then a deeper dive. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

I’ve received well over a hundred questions about this new study, all asking roughly the same thing - what does this mean? In Part 1 we’ll talk about the study authors and methodology Part 2 we’ll talk about the findings Part 3 we’ll talk about how the media is covering the study The study we are looking at is called Weight Regain after cessation of medication for weight management systematic revi...

I was recently advocating for a patient who needed an emergency head CT to rule out some potentially serious complications. (Luckily she was fine and her symptoms had the least concerning diagnosis.) Of course, I have her permission to write about this. A content note, this post is going to include medical weight stigma. After the imaging was done and the report completed the doctor came into the...

In part 1 we looked at the basics of the newly approved Wegovy pill for weight loss. In part 2 we began looking at the trial that was used for approval ( Oral Semaglutide at a Dose of 25 mg in Adults with Overw*ight or Ob*sity .) Today we’ll look at the findings of that trial. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

In Part 1 we looked at what Novo Nordisk’s page said about the new Wegovy Pill for weight loss. Today we’ll look at the trial. Now, Novo didn’t link to the trial (or even mention the name or the authors) on the webpage. They did say twice that it was a 64 week trial. That threw me off for a minute because it was actually written up as a 71 week trial, but we’ll get to that. Get full access to Weig...

Wow did I get a lot of requests to write about this! We’ll start with some basic information today and then break down the actual trial data in the rest of this series. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

I received the following question from reader Rebecca: This is my first New Years away from dieting and while I am happier (and healthier, though I know that’s complicated) than ever. Still I am struggling with New Years Resolution season, do you have any tips for making non-diet resolutions that focus on my health? I’m happy to help, you are definitely not alone in trying to navigate this time of...

In part 1 we talked about a trial of semaglutide for knee osteoarthritis. In part 2 we compared that trial to a trial that used metformin. Today we’re going to talk about research around behavioral (non-pharmacotherapy) weight-neutral interventions. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

In part 1 we looked at a study of the effect of semaglutide 2.4mg (Wegovy) on knee osteoarthritis. Today we’ll look at two studies that consider the effect of metformin and compare that with the semaglutide study. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

I've received a number of questions about GLP1s and knee pain/osteoarthritis and in this series we’ll look at what the research says. In part 1 we’ll look at the trial for semaglutide and knee osteoarthritis. In part 2 we’ll look at 2 studies that consider the effects of metformin on knee osteoarthritis. In part 3 we’ll look at a study of a weight-neutral intervention Get full access to Weight and...

I received a question from reader Brit who said “I see you and other people talking and writing about the weight-inclusive and weight-centric (and sometimes weight-neutral and weight-loss paradigm). I think I know what they mean but could you give a quick explanation? I’m happy to Brit, sometimes it’s good to go back to basics! Get full access to Weight and Healthcare at weightandhealthcare.substa...

In Part 1 we began discussing the article “Implications of a New Ob*sity Definition Among the All of Us Cohort” by Fourman et al. This is a study that took the recommendations of the (heavily financially entangled with the weight loss industry) Lancet Commission around increasing the methods by which “ob*sity” can be “diagnosed” (the massive issues with which I wrote about here ,) and applied it t...

I previously wrote about a Lancet Commission that published what I would describe as an opinion piece that they attempted to disguise as legitimate science. In it, they manipulated multiple research processes in order to create the largest possible market for the weight loss industry (in which the authors had massive financial entanglements) by wildly expanding the ways that someone might be “diag...

Today I’m taking a break from talking about weight and healthcare to write about navigating so much of the nonsense that happens during the holiday season. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

Today will be the first post in a short series discussing attempts to “calculate” the (supposed) “costs” of “ob*sity.” Before we get into any of this I want to say unequivocally that anytime we try to calculate the cost of a group of people, including and especially, to support a call for their eradication, we are going down a very bad, very wrong road. So while I will be discussing the specific i...

In Part 1 we looked at the basics and early research around GLP-1s for weight loss and muscle loss. In part 2 we looked at recent research around the newest GLP-1 weight loss drugs, tirzepatide (Zepbound) and semaglutide (Wegovy). In this final part of the series we are going to talk about the justifications/excuses/spin that are happening around the loss of lean muscle mass on GLP-1s. Get full ac...

In Part 1 we looked at an early study of GLP1 drugs and muscle loss. Today we’ll look at two more recent studies, one for Eli Lilly’s drug tirzepatide and one for Novo Nordisk’s drug semaglutide. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

As GLP-1 drugs get heavily marketed for weight loss, we know that when people stop taking the drugs they experience rapid weight regain. We also know that, while the claim is that if people stay on the drugs forever they’ll maintain the weight loss, there isn’t any research proving that and that in the longest study of these drugs for weight loss (4 years) they lost 89.5% of the sample . There is...

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.sub...