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.

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.

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

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!

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 to the All of Us population. So what did they find?

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 “diagnosed” as “ob*se.” You can read about the whole sordid affair here. This has been a longtime goal of the weight loss industry and this group of financially entangled authors made it real, at least in their article.

Now another group of authors have shown the reality if these ideas are applied in the real world.

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.

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 issues with these calculations, please always remember that the calculations shouldn’t be undertaken in the first place.

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.

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.