In this issue:
Featured MSSI Community Artwork
THREE NEW MSSI Resources!
Evidence-Based Archives
MSSI Community Artwork
Call for Art Submissions
We are excited to announce a new initiative aimed at celebrating the beauty and diversity of all bodies through art. MSSI invites you to submit your creative works—whether visual art, poems, reflective stories, or any other form of expression—that capture the essence of living in and caring for diverse bodies.
Our goal is to highlight the experiences and triumphs of individuals within the body liberation movement, and the unique perspectives of medical providers dedicated to inclusive and compassionate care. This is an opportunity to showcase the beauty, strength, and resilience found in all body types, and to inspire others within our community and beyond.
Submission guidelines:
Who can submit their art: MSSI members and advisors
Accepted formats: Visual art (paintings, drawings, photography), poetry, short stories, personal reflections and any other creative expressions!
Selected pieces will be featured in our upcoming newsletters, shared on our social media platforms, and potentially included in a special online gallery. We believe that your art can spark important conversations and bring a deeper understanding of the importance of size inclusivity in healthcare 🙂
Please submit your work to the Google Form below. We look forward to seeing your beautiful and powerful contributions!
Three NEW MSSI Resources!
Our members have been hard at work over the last few months finalizing some resources for advocacy for size-inclusive healthcare. Take a look at the three new tools our teams have created:
**NEW** Mini-Guide: What If a Patient Expresses a Desire to Discuss Weight/Weight Loss?
MSSI Mini-Guides are brief informational sheets centered around specific topics within the realm of size inclusive medicine! We hope you find them useful to your learning and/or advocacy work. Please let us know if there are additional topics you would like to see us cover.
**NEW** Bariatric Surgery Informed Consent Resource
For years we have seen referrals being made out to bariatric surgery programs specifically aimed at promoting weight loss. We are concerned that patients may receive misleading or insufficient information from their healthcare providers before undergoing these major operations.
While MSSI does not believe weight & BMI are accurate measures of health, or that weight loss improves health outcomes, we also champion patient autonomy. Weight discrimination permeates so many aspects of society, and the physical and mental harm it directly causes fat people is immeasurable and far-reaching.
Our goal is to give patients desiring to pursue bariatric surgery a more comprehensive understanding of the risks and benefits associated. Knowing what alternatives are available is part of full informed consent, so we also include evidence-based options for improving health that do not require weight loss.
Link to the bariatric surgery resource
MSSI Student Contributors: Rachel Stefaniuk, Sophie Lalonde-Bester, Jackie Liu, AsiaLuna Patlis, Marisa Langton
**NEW** Weight-Centric vs. Weight-Inclusive Comparative Chart
Utilize the table below to learn more about the Weight-Centric and Weight-Inclusive models of healthcare. This table is meant to be used as a guide to start conversations. We recognize that this is a nuanced topic that encompasses a spectrum, rather than two clear-cut categories. You may find you fall somewhere in between these two models of care.
Additionally, the Weight-Inclusive column may feel aspirational due to larger systemic issues. It is okay if what you’ve practiced in the past or present does not always reflect this approach. Our intention is not to call out, but to shed light on how personal beliefs about body weight and health impact patient care and outcomes, and how these beliefs can be shaped by medical training and healthcare systems.
Main Authors: Abigail Faust, Samantha Temucin, Hannah Wisniewski, Sarah Leonard Main Reviewers: Ragen Chastain, Dr. Katarina Wind, Dr. Lisa Erlanger
Evidence-Based Archives
MSSI is excited to present our fourth installment of “Evidence-Based Archives,” our monthly column highlighting and summarizing seminal research in the field of size-inclusive healthcare. In this section, we hope to celebrate our scholars, empower each other with knowledge, and stock up on citations for the next time we’re called upon to justify size-inclusive healthcare in the classroom, clinic or wards!
Content warning: Medicalized fatphobia, ob*sity, anti-fat language
Disclaimer: We use the term “ob*sity” in our summaries when it is otherwise impossible to accurately describe findings from certain studies, due to the language and descriptors chosen by researchers. We acknowledge the inaccuracies and harms that this label has perpetuated in medicine and society. Please keep your mental health in mind when reading, and feel free to reach out to us with any feedback or suggestions at any time!
This month’s highlight:
DOI: 10.1111/obr.12949
The aim of this systematic review was to answer the question: Is substantial, stable, and long-term weight loss through dieting a viable goal for adults with obesity?
Methods:
To answer the research question, this team conducted a broad systematic search of non-surgical and non-pharmacological obesity treatment studies with the following strict criteria:
minimum 3-year follow-up,
5% body mass lost,
no continued interventions in the follow-up- period,
prospective design, and
less than 30% attrition from the start of the follow-up period.
The review only included studies of intentional weight loss attempts through very low energy diets, exercise, CBT, and/or behavioral therapy. This review did NOT examine weight loss attempts due to bariatric surgery or pharmacological intervention.
Participant demographics:
Adults only
Results:
The research team states that their search revealed a very large number of published articles, but only eight studies met their inclusion criteria. While some of the excluded studies report that participants were able to achieve satisfactory weight loss and little regain, these studies also continued interventions into the follow-up period, limiting their value as unbiased reports of true outcomes in the absence of structured intervention. This goes to show that research efforts are abundant in the field of “lifestyle interventions” for the “treatment” of obesity, but few high-quality studies are actually published! Among excluded studies, the two most common limitations were lack of true prospective design and lack of follow-up.
The eight high-quality studies included in this study unanimously demonstrate a trend of weight regain towards the pretreatment baseline. This review concludes that high-quality prospective studies offer no evidence that weight loss can be maintained over time in the absence of structured intervention, likely due to the metabolic and psychiatric changes that significant caloric restriction triggers in the human body. For the majority of participants, body weight may be lost at first, but is gradually regained over time (see figure below).
Mean weight loss was 7.4 % across all studies after the treatment phase. The average rate of weight regain in the follow-up phase was 0.14 % of body weight each month, reaching pre-intervention weight at roughly 4.1-years post-intervention.
Limitations:
As a systematic review, this study was unable to comment on whether participants personally attempted to maintain restrictive diets or other behavioral changes in the post-intervention follow-up period. Additionally, weight loss was the only metric followed in this study. Other, potentially more revealing measures of overall metabolic health and wellbeing in the patient sample were not assessed.
Closing thoughts:
This study synthesizes available medical research on the effects of diets on weight loss and suggests that substantial, stable, and long-term weight loss through dieting doesn’t work.
Have thoughts?
We are open to feedback and interested in the lived experiences of our MSSI members. Have you referenced this article in your clinical work, used it to guide patient counseling, or used it to communicate with your colleagues? How did it go?
Feel free to share your stories, reflections, expertise, and advice using the link below. With your permission, we may publish reflections in future installments of this column.
If you have a favorite article you’d like us to highlight in our next installment, feel free to submit it for consideration, also by using the link below! We look forward to hearing from you.
This newsletter was authored by Jay Liu and Sophie Lalonde-Bester, MSSI members and medical students (Stanford University and University of Alberta, respectively).