Weight and Healthcare

In part 1 we discussed the basics of substituting weight loss for healthcare and accommodation. In part 2 we discussed issues with the likelihood of achieving weight loss, even if it was appropriate to insist that higher-weight patients become thinner before accessing care (and I don’t believe it is.). In part 3 , we discussed the issues with weight loss being promoted as a solution to accessibili...

In part 1 we discussed the basics of substituting weight loss for healthcare and accommodation. In part 2 we discussed issues with the likelihood of achieving weight loss, even if it was appropriate to insist that higher-weight patients become thinner before accessing care. Today we’re going to discuss the issues with delaying care for weight loss. Get full access to Weight and Healthcare at weigh...

In part 1 of this series we looked at the basic issues of a healthcare system that is allowed to demand weight loss before patients are able to access healthcare. In this section, we’ll look at BMI-based denials of care. These occur when a patient is denied care unless or until they reach a certain BMI. It is often justified by the idea that higher-weight patients have more complications/worse out...

Substituting weight loss for health and/or healthcare accommodation is a primary source of harm enacted on higher-weight people by the healthcare industry. I’ve had a bunch of requests asking me to write about it from a macro perspective . This is complicated and there is a lot to discuss so I’m breaking it up into five parts. (I’m thrilled that you are reading this whether you stumbled onto it or...

In Part 1 we looked at the basics of a study that compared the two newest GLP-1 weight loss drugs against each other - Novo Nordisk’s Semaglutide (Wegovy) and Eli Lilly’s Tirzepatide (Zepbound) The trial was funded by Eli Lilly and while many of the authors took money from the makers of both drugs, the only authors (some of whom were statisticians) who were employed by and owned stock in a drug co...

On May 11, 2025, the study “Tirzepatide as Compared with Semaglutide for the Treatment of Ob*sity” was published in the New England Journal of Medicine. This study was, essentially, a cage match between the two newest weight loss drugs to see which one created more weight loss. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

The way that higher-weight patients are discussed (in research, in medical/healthcare education and training, and even in interventions meant to increase accessibility in healthcare) can vastly increase weight stigma among healthcare providers. Today I want to talk about three terms that are often used that create this issue. Get full access to Weight and Healthcare at weightandhealthcare.substack...

I recently wrote about a study that questioned the assumption that higher-weight causes health issues . Today I’m writing about a study that questions the assumption that weight loss improves health issues in higher-weight people. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

Weight stigma does untold harm and, especially in healthcare, it can be deadly. One of the most important things that each of us can do to reduce weight stigma and the harm it causes is to act (when we can) when we find ourselves in situations where weight stigma is happening. Today I have an example of quick push-back and a more in-depth example. Get full access to Weight and Healthcare at weight...

In the past we’ve talked about how the health issues that get blamed on being higher-weight may actually be due to weight stigma and/or weight cycling and/or healthcare inequalities . Recently reader Conner let me know what this 2021 study whose bottom line finding was “adverse consequences currently attributed to ob*sity could be attributed to hyperinsulinemia (or another proximate factor.” Get f...

I got the following question from reader Jill who attended a recent talk that I gave at her medical center: ”During the question and answer part you mentioned a contest to win weight loss surgery. Did that really happen? I hope you’ll write about it on your newsletter.” Yeah, it did and yes, I will Jill, thanks for asking. Get full access to Weight and Healthcare at weightandhealthcare.substack.co...

In part 1 we talked about the general issues with giving the weight loss industry the benefit of the doubt. In part 2 we talked about the specifics of this for the GLP-1 weight loss meds. That brings us back to our original question from family doctor Elena: I’m a weight-neutral family doctor. I was talking to a colleague about my issues with the GLP-1s and how there is no evidence that supports t...

In part 1 we discussed the general issues with giving the weight loss industry the benefit of the doubt. Today we are going to talk about this as it applies to GLP-1s. This started with an email I got from Elena: ” I’m a weight-neutral family doctor. I was talking to a colleague about my issues with the GLP-1s and how there is no evidence that supports that taking them for life will lead to sustai...

I got this email from reader Elena: I’m a weight-neutral family doctor. I was talking to a colleague about my issues with the GLP-1s and how there is no evidence that supports that taking them for life will lead to sustained weight loss or health benefits. He said “There’s no evidence that they won’t.” It strikes me as wrong, but how do I argue with that This same question came up in our monthly s...

We are going to start out today with the story of Dr Thomas Kraut and then talk about what it that story demonstrates and what we can do about it. Content note that this story is tragic. This was originally brought to my attention by reader Suzanne. I read every account I could about the situation and pieced them together. Get full access to Weight and Healthcare at weightandhealthcare.substack.co...

I got a question from reader Giana who asked: I feel like I’ve seen a hundred news reports claiming that the GLP1 drugs will cure anything and everything…joint pain, heart attacks, addiction, on and on and on. Is it possible that they can do all of these amazing things or is this just the new snake oil? I’ve also seen a bunch of claims about the healing powers of GLP-1 drugs. It is possible that G...

In parts 1 and 2 we looked into a 2018 journal article called Management of osteoarthritis of the knee in younger patients by Khan, Adili, Winemaker, and Bhandari. It turns out we aren’t the only ones looking into it. As I was finishing up this piece, I was googling to make sure I had a list of all the links I used in the piece (while I don’t include links to pieces with weight stigma here, I alwa...

In part 1 we began discussing the article Management of osteoarthritis of the knee in younger patients by Khan, Adili, Winemaker, and Bhandari and their claim that weight loss is an appropriate treatment for osteoarthritis. We examined one of their citations and today we’ll look at the other. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

Recently I received an email from a physician who had just attended a talk I gave. She asked what I thought about a study that “shows that weight loss is an evidence-based treatment for OA” (osteoarthritis). I started investigating the issues with the study and, in the course of researching and writing about it, I came across an absolute gem by Ilona Hale. In parts 1 and 2 we’ll look at my analysi...

I frequently write about types of weight stigma and bias . Today I want to talk about a specific form called Surveillance Bias, I’ve also heard it called Detection Bias or Testing Bias. I want to talk about how this kind of bias can lead to claims that a health issue is more likely to be found in a group of people when actually the difference is/may be because of the way that group of people were...

In part 1 we looked at the 2022 article by Sierżantowicz et al., “Quality of Life after Bariatric Surgery A Systematic Review.” In part 2 we took a deeper look into two of the studies they included. In part 3 we’ll examine their conclusions. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

In part one we looked at the 2022 article by Sierżantowicz et al., “Quality of Life after Bariatric Surgery A Systematic Review.” I do recommend reading that to understand the issues with the way “Health Related Quality of Life or HRQOL” is used in the studies we’ll examine today as we take a deeper diver into two of the studies Sierżantowicz et al. included. Content note for discussion of suicide...

As I mentioned in part 2, when I teach research analysis, I recommend checking something I call “The Do-Do’s” which encompasses two questions: Do the citations support the claims? Do the study data support the results? In part two we looked at the first question, today we’ll look at the second question. 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! Content note: this piece will discuss research around binge eating, including behaviors and frequency. In part 1 , we looked at the authors and methodology of a 2024 study called “Evaluating dietary restriction as a maintaining factor in binge-eating disorder” by Bartholomay...

Recently a reader reaching out asking me to analyze a 2024 study called “Evaluating dietary restriction as a maintaining factor in binge-eating disorder” The authors claims that their findings: “challenge the assumption that dietary restriction maintains BE [binge eating] among all individuals with BED [Binge Eating Disorder]. Rather, results suggest that dietary restriction may be largely unrelat...