The Unpacking Weight Science Podcast has two parts: the audio podcast, and the Supporting Materials.
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Episode 1: Stuck in a Weight-Centric Operating System
Why is it that everyone seems to be pushing a weight-centric agenda? Weight centrism is a cultural norm, medical behemoth, and capitalist bonanza. This podcast delves into the forces that bind us externally and internally, to weight centrism.
Episode 2: Demystifying Definitions, De-myth-defying Assumptions
This episode discusses the two main myths that perpetuate weight loss encouragement as well as the terms, weight centric, weight neutral, lifestyle intervention and concern troll.
Episode 3: How We Got Here: BMI Meets Death
A history of the development of the BMI (including how 'obesity' ended up on child growth charts), how we discovered there was a relationship with weight and death, and how a few powerful men gifted us the weight-centrism we have today.
Episode 4: Weight Bias, Stigma and Discrimination
This episode is an introduction and defines the terms, discusses their impact on healthcare, society and the lives of the people who are impacted by weight-centrism.
Episode 5: The Anatomy of a Weight Loss Paper
A research paper is a piece of persuasive writing. This episode breaks down how all the pieces fit together, the expected rhetoric of weight loss research, common research methods that guarantee statistical significance at the cost of clinical practicalities, how to spot hyperbole, and how the way we usually read research papers leaves us at the mercy of the authors biases.
Episode 6: The Science of Self-Compassion
In this podcast I take you through the research and academic operationalisation of self compassion, some of it’s associations and effects on individuals and their self care as well as on health practitioners with compassion fatigue and burnout. I talk about how to weave language that models a self compassionate attitude into your counselling and encounters with others and yourself. These supplementary materials contain exercises shown in experimental studies to induce self compassion.
Episode 7: Weight-Neutral, Health-Enhancing Habits
This episode looks at behaviours associated with longevity, delay and avoidance of disease, as well as behaviours which enhance health outcomes at any weight and health status. Key research papers are discussed as well as strategies for how to use them in your work.
Episode 8: Theoretical vs Actual Weight Change: Industrialised Wishful Thinking
In this podcast I compare and contrast what our mathematical formulas about energy requirements and weight loss say should be possible (ie the theoretical) versus what actually happens in real life. I also talk about the history of this energy requirement belief system, who continues to use it and why.
Episode 9: Morality vs Ethics: why Fat is Fraught
This episode delves into theories of human morality and medical ethics and their role in fat-phobia. I unpick the concepts and meaning of fatness through these two lenses in order for you to be able to identify which meaning system is at play in those who force their weight-centrism upon others, and select a line of discussion that is more likely to hit its mark.
Episode 10: The Non-Diet Approach Model
This episode explains the development process, underlying theoretical framework and principles of the Non-Diet Approach, a clinical model that I’ve developed during my PhD research. This model is a weight-neutral, size inclusive, body acceptance practice framework for clinicians who work one-on-one but can be adapted for working with groups and populations too.
Episode 11: Unboxing Wellness Marketing
This episode I take you through some components of the science of human persuasion with ‘unboxing wellness marketing’. As my following on Instagram grew I started getting approached by ‘health and wellness’ brands to spruik their products, and one lot even sent me some samples of their product (apple cider vinegar!) to try – without asking if I wanted them! They came with a lovely letter and some product information, filled to the brim with reasons why their product should be in every home across the country. So I’m going to dissect their arguments for your listening pleasure and highlight the tricks used in wellness-food marketing to persuade us to open our wallets and our mouths for just about anything.
Episode 12: What the 5percent?!? Type 2 diabetes and weight loss recommendations
We continually hear this magical 5% weight loss goal for people with type 2 diabetes, that losing 5% of your body weight is going to result in protecting you from all sorts of terrible diabetes related things…. So in this episode I talk about where this figure has come from, why it misconstrues its own science, and weight neutral ways to manage diabetes and the diabetes healthcare environment.
Episode 13: Size Inclusive Approaches and Diffusion of Innovations Theory
One of my favourite theories of social science is the Diffusion of Innovations theory. It so beautifully explains how new ideas spread through social groups and populations. The adoption of size inclusive approaches (eg Intuitive Eating and Health at Every Size) by individuals and by health and counselling professionals has followed the predictable patterns laid out in this theory. This episode I’ll be running through these characteristics and importantly, showing you how you can recognise where someone is on their path towards size inclusive approach adoption and how you can most effectively nudge them towards decision-making.
Episode 14: Measuring Intuitive Eating: Why, How and When
This episode covers the development of the Intuitive Eating Scale, and it’s follow-up, the Intuitive eating Scale 2. I talk about the different aspects of eating behaviour that it captures, research that it’s been used in and how you might like to use it in your clinical practice or research.
Episode 15: When is a diet not a diet? Health at Every Size and Medical Nutrition Therapy
Dietitians and nutrition professionals can feel like the ‘nutrition baby’ is being thrown out with the ‘diet bathwater’ when learning about the Non-Diet Approach, HAES and Intuitive Eating. Many wonder, if I can’t tell people what to eat, what is left? Is there any point to dietitians? Do I just forget all my medical nutrition therapy knowledge? This existential crisis is a consequence of nutrition-related professions identifying with their key expertise being in weight management. This episode sorts the ‘therapeutic wheat’ from the ‘fatphobic chaff’ to offer an alternative perspective on your professional identity.
Episode 16: Diet Quality: Measurement, Magnitude and Meaning
In recent years nutrition research has moved from a focus on nutrients to a focus on foods and eating patterns. Dietary quality broadly refers to the variety of foods in someone’s usual eating habits. In this episode I’ll be bringing you up to date on the current state of play with this kind of research, how impactful dietary quality is on health outcomes, and how you can use it and measure it in your practice.
Episode 17: Dieting, Illness and Malnutrition at Every Size
Malnutrition is a condition that has both short-term and long lasting consequences. In this episode I unpack the science of malnutrition, it’s signs and symptoms and as always, how our intentional weight loss focus results in dangerous malnutrition invisibility.
Episode 18: 'Obesity': Unpacking 'risk' vs 'disease'
This episode delves into the definition(s) of 'disease' and 'risk factor' and how body size has come to be understood by various 'body size stakeholders'. At its core, the question is, is being fat the same as being sick? And can telling someone that they’re sick, even when they’re not, actually make them sick?
Episode 19: Defining Diet Culture
Diet culture is something that we talk about as toxic a lot in the eating disorder treatment and Health at Every Size worlds, but what is it? In this episode I unpack what constitutes body and diet culture, what we can do to dismantle it and how it contrasts with the subculture of the fat acceptance movement.
Episode 20: Evidence Based Practice: more than just a literature search!
The reliance on PICO and GRADE frameworks to make clinical decisions has meant that we now seamlessly step from ‘what does the evidence say’ to clinical recommendations without stopping to consider the other critical components of evidence based practice – hint: the client and clinician are involved too!
Episode 21: Dodgy Definitions: Overeating', 'Cravings' and 'Bingeing
The pathologization of body weight and eating behaviours spills out into well-known, often-used but ultimately meaningless terms. This episode takes you on a trip into the research involving and shaky ground of ‘overeating’, ‘cravings’ and bingeing’.
Episode 22: Deep dive into the Look AHEAD Study: face-saving through shifting goalposts
The Look AHEAD study included over 5000 people with diabetes and aimed to see whether intentional weight loss resulted in reduced chance of death. After 9 years they found it didn’t but that hasn’t stopped them singing the praises of weight loss. This episode unpacks why.
Episode 23: HAES Intervention Research Update
This episode looks at the components and outcomes of interventions for individuals based on the Health at Every Size principles. I take a look at the randomised controlled trials by Bacon, Mensinger and Ulian in order to highlight intervention themes and outcomes as well as describe the characteristics and usage of quantitative and qualitative research in this field.
Episode 24: Starving in the Intensive Care Unit
People of all sizes end up in intensive care, with their life hanging in the balance. Without modern medicine they’d be dead already. Despite this cutting edge of science setting, larger patients are often arbitrarily underfed. This episode discusses why this is, what the implications for larger patients are, and what we can do about it.
Episode 25: Weight Loss is Not a Fertility Time Machine
In this episode I take a look at weight loss recommendations for fertility, the research they’re based on, and the gaping holes in it, to find what’s real and what isn’t when it comes to weight and fertility.
Episode 26: A Good Fit: Size Inclusive Practice and Dietetics
I’m just about to finish writing my PhD thesis about the suitability of approaches that endorse size inclusivity (eg health-focussed size acceptance frameworks like Health at Every Size and Intuitive Eating- in one on one nutrition and dietetics counselling. So while it’s all fresh in my head I've given you a wrap up of what I wanted to find out, how I went about it, and what I found.
Episode 27: Weight Loss Before Joint Replacement Surgery: The Cutting Truth
This is something that comes up constantly for people – both health professional and people who own troublesome joints. In this episode I take look at things from the surgeon’s perspective, the anaesthetist’s perspective, the patient’s perspective and the allied health professionals perspective, and provide you with both the science, and ideas for ways you can advocate for yourself and your clients to get the joint you need.
Episode 28: Leave Them Kids Alone! The Problems with Weight Loss Programs for Teens
The past year or so has seen the re-emergence of commercial programs and research studies that aim to make larger-bodied kids smaller in the name of ‘health’. In this episode I’ll be looking at the growth trajectories of larger-bodied kids, the links between weight loss efforts and height and weight growth, and psychological factors that need consideration in this vulnerable group of people.
Episode 29: The Deal with Weight Loss Drugs: Big Pharma, Physiology and The Hard Sell
This episode takes a look at the current weight loss drugs on the market (AKA 'Fat Shat', 'Brain Zap', Zombie Speed', 'Narcotics R Us' and 'Expensive Diabetes'), the way they function, side effects and long term outcomes as well as the wheeling and dealing that takes place behind the scenes by ‘obesity inc’ in the approval and promotion of these drugs.
Episode 30: Transplant Trouble: Kidney Transplants and Weight
BMI cut-offs are frequently used to deny larger-bodied people from attaining a kidney transplant when they need it most. This episode delves into the validity and ethics of transplant weight restrictions and weight loss advice for people with end stage renal disease.
Episode 31 & 32: Adopting Health at Every Size After Weight Loss Surgery
Part 1: Almost all learning materials about weight loss surgery are written from a weight-centric viewpoint, where weight loss is seen as good and higher weight is seen as a problem. This episode takes a weight-neutral view and explores the anatomical, physiological and nutritional consequences of the four most popular weight loss surgeries – the bypass, the band, the sleeve, and the switch.
Part 2: Weight loss surgery has many physical and psychological consequences and means that people who have had this surgery have had protracted experience with weight centric medical and health professionals. Where does that leave people who now wish to pursue health without weight concern? Part 2 of the Unpacking Weight Loss Surgery series looks at factors to support body acceptance, nourishment and health after weight loss surgery using the Health at Every Size framework.
Episode 33: Biohack or Balderdash: BMI, Energy Balance and Blood Tests
‘Healthy’ reference ranges for routine blood tests are usually derived from effortlessly weight stable populations. In this episode I reveal how blood test results can be influenced during periods of weight loss and weight gain, and what that means to the validity of how we interpret these health risk markers.
Episode 34: Fatty Liver: Facts and Follies
Non-alcoholic fatty liver disease, NAFLD, is an increasingly frequently-made diagnosis. Weight loss is lauded as the central treatment for it. But are those weight loss recommendations valid? This episode investigates the phenomena, the diagnosis, and the consequences of NAFLD and unpacks the weight bias within.
Episode 35: COVID-19 and BMI: A Tale of Three Papers
The handwringing about body size and covid-19 began almost immediately after the pandemic did. But now, well into the first year of the pandemic, does the data actually stack up? In this episode three papers are examined for outcomes and bias, highlighting yet again the deeply held assumption that higher weight is a problem and the unfortunate truth that negative narratives about weight win headlines.
Episode 36: Inflammation Information Inflation: the deal with inflammation in larger bodies
Larger bodies have been subject to endless examinations to try to pin down the multitude of ways they must be damaged and diseased. In this episode I unpack the concept and science of ‘inflammation’ and how it relates to body size. As usual, the science is not always as it seems.
Episode 37 & 38: Medication Mayhem
This two-part series looks at the most widely prescribed medications in the world and interrogates which of them has been properly trialled in larger bodied people and the possible consequences of under-dosing, delaying medications due to weigh-based gatekeeping and medicating while underfed.
Part 1 (Ep 37): Pharmaceutical trials, statins and birth control
Part 2 (Ep 38): Chemo, antibiotics, blood pressure medications and antidepressants. [COMING SOON]
Purchase Supporting Materials
If you were not a subscriber to the Unpacking Weight Science Podcast on Patreon when an episode was released, you can purchase the Supporting Materials below to complete your professional development activities. Supporting materials for more recent episodes are only available by subscribing to the podcast here.