Yoni Freedhoff

2 plots showing distributions of ww signal by year and by VOC.

@yonifreedhoff.com Here are violin plots showing distribution of the ww signal in Ottawa by year and by VOC. "wwlast30d" represents signal sampled over past 30 days.

A 5-year, continuous public health dataset unaffected by policy changes--unlike clinical indicators--is a beautiful thing.

Amazing

They were offering financial assistance only for those prescribed tirzepatide for diabetes

Lilly Cancels Its Tirzepatide Fat Tax Lilly announces the pending launch of their MyZepbound.ca financial assistance program for patients prescribed tirzepatide for obesity

You might remember my blog on how Lilly effectively levied a fat tax on obesity whereby they were charging more for tirzepatide prescribed for obesity than for diabetes in 🇨🇦. Well they've cancelled that and launched a financial assistance program for Zepbound open.substack.com/pub/yonifree...

Are we at the lowest levels of the entire pandemic? Looks like maybe. Or at least very close. Pre-delta.

How do Front-of-Package Warnings Influence People? A recent study found that different front-of-package labels were effective in decreasing purchases, but can it be a long-term solution?

impact because when we shop hungry we buy and want all the things! For more details can click through to the story medscape.com/viewarticle/...

it would be valuable to compare the impact labels have on people with markedly decreased levels of hunger and cravings (GLP1 users) vs. those whose hunger and craving levels are not medically reduced. My bet of course is that the latter group will see a markedly diminished /3

nutrient only warnings were nearly as effective as those that tied warning to diseases like obesity - but only in an artificial study setting. In the real world, if the hope is that front of package warnings protect against weight gain/help with weight loss /2

Do front-of-package food warnings change behaviour? Do they increase stigma vs. obesity? How about if the warnings don't reference obesity at all but simply, as they should, reference nutrients? My latest for @medscape.com explores new research that found /1

Good news for Canadians looking to start Zepbound (tirzepatide) for obesity. Lilly will be introducing a program to help defray costs. Medication should be on shelves mid summer. I'll blog about this in more detail but wanted to briefly mention

The Wegovy effect: A new drug reshapes the lives of teens wih obesity Reuters delves into the experiences of four American teenagers with obesity who were among the first wave to take Novo Nordisk’s weight-loss drug.

But overall, even with what sounds like care shortcomings, it's heartening to see this sort of reporting. These drugs change lives and are remarkable. Worth the click
www.reuters.com/investigates...

And it certainly doesn't sound like any of the teens or their families received any real nutritional support or counselling that might have helped them maximize medication efficacy. Even sounded like one MD involved explicitly avoids providing same. /4

At least 2 of the teens had what sound like fairly severe side effects that they soldiered through - but with careful follow up I'd venture they could have been either avoided by slower dose titration, mitigated by way of dietary tweaking, or treated by way of concomitant Rx /3

Also striking though was that at least from the article, which of course may not have shared all of the details, the teens and their families received minimal or no ongoing support around the drug's prescription /2

Just read a rare piece that rather than demonize weight loss drugs, instead highlighted the use of Wegovy in teens by emphasizing the teens' joy for the benefits the drug provided them with /1

Cancer Prevention Bias: Not Mentioning Obesity Interventions Cancer prevention guidelines and studies fail to mention weight loss medications and surgeries, and their ability to decrease risk. Is this another form of weight bias?

If you'd like to read more, here's the link, and a reminder, registration is free and you need not be a healthcare provider to do so www.medscape.com/viewarticle/...

and not even one suggested a discussion with one's MD about weight loss medications or surgery. Difficult to reconcile that with the data except as an extension of the pervasive bias that obesity is a disease of willpower alone and as such, meds and surgery are somehow wrong /6

And there's no reason not to expect sustained pharmaceutically aided losses to confer similar results. Yet when I looked at some of the more publicized charities and organizations, though weight was listed as a risk factor, most provided zero guidance on how to manage it /5

There is benefit too to non-surgical weight loss where even modest and sustained weight loss is protective against breast cancer where sustaining a 2-4.5 kg loss was associated with an HR of 0.82; 4.5-9 kg of with an HR of 0.75; and > 9 kg an HR of 0.68. /4

Studies show hormone receptor +ve breast cancer risk increases 12% per 5-points of BMI in postmenopausal women, and he data on weight loss' prevention benefits is dramatic whereby bariatric surgical patients' hazard ratio for breast cancer's development was an astonishing 0.52 /3

I looked primarily at breast cancer organizations and charities as I think breast cancer is likely the most discussed cancer and where there are strong public and medical pushes to educate around its risks and preventions /2

My latest for @Medscape asking why, despite robust evidence demonstrating sustained weight loss significantly decreases both cancer incidence and recurrence that both patient and doctor facing literature on same nearly never mention it? /1

Developing an evaluation framework for public health environmental surveillance: Protocol for an international, multidisciplinary Delphi consensus study Introduction Public health environmental surveillance has evolved, especially during the coronavirus pandemic, with wastewater-based surveillance being a prominent example. As surveillance methods exp...

I had a small role to play in this @dougmanuel.bsky.social led publication which hopefully will help to pave the way for the development of a multinational, multidisciplinary evaluation framework for public health environmental surveillance (including wastewater) journals.plos.org/plosone/arti...

Don't hold breath

Maybe Using BMI to Diagnose Obesity is just Fine Actually BMI has come under fire recently as an unreliable marker for diagnosing obesity, but a recent paper contends that BMI is still a valid measurement.

but rather whether BMI is the right one. And at least according to the criteria set out by The Lancet as being better, it seems pretty fine all by itself www.medscape.com/viewarticle/...

whereby 98.4% of persons with obesity assessed by BMI only had confirmed excess adiposity, with consistent results by age, sex, and race and ethnicity. Again, the argument isn't whether we need a biomarker to diagnose obesity - they are how we diagnose all chronic diseases /3

or ignoring both and using something like DEXA scanning? Well turns out that when researchers looked at NHANES data where both BMI and secondary adiposity markers were collected, that BMI only was nearly wholly concordant with the Lancet's call for more complicated calcuation /2

My latest in @medscape.com - remember that recent ginormous The Lancet paper that among other things was highly critical of the use of BMI to diagnose obesity that instead recommended either the use of BMI along with a secondary marker of excess adiposity /1

3. But the others aren’t interested

Her name is Leah, and I am her father (as promised - father/daughter tattoos for getting into her University of choice)