A third of NHS areas are denying hip and knee replacements based on BMI alone—not for medical reasons, but purely to save money. In this episode, I expose how the medical establishment openly admits these discriminatory policies lack evidence while pushing profitable weight loss interventions instead. Meanwhile, actual surgeons and researchers confirm what we've known all along: this is financial discrimination masquerading as healthcare.
Have you been denied a knee replacement because of your BMI? Get your free, customizable template here.
The Newspaper article by Rebecca Thomas is "Obese patients denied knee and hip replacements to slash NHS costs"
The Journal Article is: Pavlovic, Natalie et al. “The effect of body mass index and preoperative weight loss in people with obesity on postoperative outcomes to 6 months following total hip or knee arthroplasty: a retrospective study.” Arthroplasty (London, England) vol. 5,1 48. 1 Oct. 2023
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Coming out as fat is harder than coming out as transgender, at least in our experience. When performer and cabaret artist Ross Anderson-Doherty refused to pursue weight loss as medical treatment, their healthcare became a weapon of punishment rather than care. In this raw conversation, we explore how medical fatphobia intersects with transphobia, classism, and ableism to create devastating trauma that nearly destroyed one person's will to live. Ross's journey from medical neglect to triumphant revenge reveals the urgent need to recognize healthcare discrimination as the trauma it truly is.
You can catch Ross performing at the Cabaret Supper Club in Belfast. Be sure to follow them on Tik Tok and Instagram - you’d be a fool not to!
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Medical weight stigma creates dangerous catch-22 situations for patients seeking care. In this episode, I share Cameron's story of developing gallstones after weight loss surgery, only to be denied treatment because their BMI was "still too high."
In this episode, I expose how rapid weight loss can trigger gallstone formation and how medical professionals often ignore evidence-based care when treating higher weight patients. I challenge the "lose weight to get treatment" narrative while offering practical advocacy strategies for navigating a biased healthcare system.
Today’s journal article was Gregori, Matteo et al. “Day case laparoscopic cholecystectomy: Safety and feasibility in obese patients.” International journal of surgery (London, England) vol. 49 (2018)
For free resources on the management of galbladder disease head to noweigh.org
And don't forget to check out my masterclass on gallstones
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The obsession with calculating the "cost of ob*sity" to society reflects our troubling tendency to commodify human life and health. In this rather ragey and explosive episode, I expose how a widely-cited figure of £98 billion was manufactured by pharmaceutical interests to sell weight loss drugs.
I challenge the notion that we "owe" society a debt of health and explore how weight stigma, not weight itself, drives depression and poor health outcomes. Through a rather provocative thought experiment, I reveal the absurdity of reducing human experience to economic calculations and argue that tackling stigma, not eradicating fatness, is the real path forward.
Today's journal article was: Stevens, Serena D et al. “Adult and childhood weight influence body image and depression through weight stigmatization.” Journal of health psychology vol. 22,8 (2017): 1084-1093. doi:10.1177/1359105315624749
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Medical trauma is more than an abstract concept—it's a physical reality that impacts millions of people daily. In this episode, I share my transformative experience at a gender identity clinic, contrasting it with previous healthcare encounters that left me hypervigilant, tense, and bracing for judgment.
I explore how our bodies physically store medical trauma—in our gut, our muscles, our posture, and even our skin—creating patterns that repeat with each new medical encounter. For fat people and those with other marginalized identities, this trauma compounds exponentially.
This episode invites listeners to recognize medical trauma's physical manifestations while questioning a healthcare system that continues to perpetuate harm despite decades of evidence.
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In this episode of The Fat Doctor Podcast, I'm joined by Elle Bower Johnston, a breathworker, rest teacher, and somatic trauma resolution practitioner who describes herself as a "body witch." Our conversation explores the intersection of trauma, embodiment, and healing beyond traditional therapy.
Elle explains trauma as "when our body-mind experiences something that it can't digest in the moment - either too much too fast, or not enough over too long." While our protective mechanisms (fight, flight, freeze, and fawn) are natural responses to threats, trauma occurs when these responses get stuck and can't complete.
We discuss how systems of oppression create ongoing trauma, particularly for marginalized bodies accessing healthcare. Elle shares how our bodies develop protective mechanisms that may have been necessary for survival, but can become limiting patterns later in life.
The conversation moves beyond cognitive understanding to explore embodied healing. As Elle notes, "You can't think your way through" trauma - we need approaches that engage the multifaceted aspects of our bodies: physical, emotional, energetic, and relational.
In a world disconnected through capitalism and colonialism, Elle suggests that rest isn't just about lying down or taking a bath - it's about reconnecting with something larger than ourselves. This might be as simple as noticing the seasons changing or feeling gravity's pull on your body. These small moments of connection become pathways to true rest and healing.
This episode invites listeners to honor the wisdom in their protective responses while exploring gentle ways to expand beyond them, finding rest and embodiment in a world that often disconnects us from our bodies and each other.
You can learn more about Elle through her website.
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In this episode, I explore the journey of Robin, a 45-year-old art teacher navigating a high cholesterol diagnosis and the frustrating world of weight-centric healthcare. Through their story, I break down the actual science of heart disease risk factors (spoiler: weight is the least of your concerns), explain the difference between primary and secondary prevention, and reveal how the medical establishment's obsession with numbers obscures more important social determinants of health. I also dissect the evidence (or lack thereof) for dietary and lifestyle interventions, highlighting how medication decisions should be based on informed consent, not fear.
This episode asks: What if doctors treated us as whole people instead of just collections of numbers?
This week's journal article is: Ras, Rouyanne T et al. “LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies.” The British journal of nutrition vol. 112,2 (2014): 214-9. doi:10.1017/S0007114514000750
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Our worth as human beings is not determined by our health status. In this powerful episode, I challenge the pervasive narrative that ties personal value to health metrics and physical ability. I explore how healthism is deeply rooted in capitalism, racism, ableism, and colonialism, creating harmful hierarchies even within marginalized communities.
Drawing from my own personal experience with chronic illness and analyzing problematic media representations of 'fat but fit' bodies, I make the case that every person is equally valuable, regardless of their health or ability to contribute through productivity.
This episode asks: What if we collectively rejected the notion that health determines our worth?
The Guardian Article is “‘Plot twist - I’m still a fat person!’: meet the people proving you can be fit at any size” by Sarah Phillips, Sun 29th March https://www.theguardian.com/lifeandstyle/2025/mar/29/im-still-a-fat-person-meet-the-people-proving-you-can-be-fit-at-any-size
The journal article is: Metabolically Healthy Obese and Incident Cardiovascular Disease Events Among 3.5 Million Men and Women
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Medical moralism has transformed heart health from a medical issue into a moral judgment. When we label cholesterol as "good" or "bad" and patients as "compliant" or "non-compliant," we're not practicing medicine - we're passing judgment.
In this episode, I expose how the "lose weight or die" narrative serves financial interests while ignoring the real social determinants of health. I ask whether our obsession with metabolic markers has become a moral measuring stick rather than genuine care, and challenge listeners to question whether health status should ever define human worth.
This episode's journal article is "Evidence for the Association Between Adverse Childhood Family Environment, Child Abuse, and Caregiver Warmth and Cardiovascular Health Across the Lifespan: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.”
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We’re doing things slightly different this week (it is episode 13, after all). As a 44-year-old doctor who recently discovered I'm autistic, I'm sharing my personal journey of self-discovery for Autism Awareness Day. In yet another deeply personal episode, I walk through the signs I missed in myself while recognizing them in my kids, how I've been masking my whole life, and why I'm now embracing a more authentic way of living and working.
I also explain why I'm done trying to build a business the neurotypical way and how I'm restructuring my work to avoid burnout while still continuing to create content I love. If you've ever wondered about late-diagnosed autism or are feeling burnt out trying to follow other people's rules, this one's for you!
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In this episode, Dr. Asher Larmie speaks with fellow weight inclusive GP Dr. Molly Moffat about creating safe feeding environments for neurodivergent children that goes beyond conventional nutrition rules. They explore how diet culture and neurotypical expectations harm autistic individuals, while sharing personal stories of parenting neurodivergent children and navigating healthcare as autistic doctors themselves. Dr. Moffat offers transformative insights on helping children develop healthy relationships with food by prioritizing emotional safety over nutritional perfectionism.
Molly works as an NHS GP and Doctor in Community Paediatrics, as well as a workshop facilitator for the social enterprise Body Happy Org. She is both neurodivergent herself and a parent to neurodivergent children. Molly offers support to families whose children experience feeding differences, and to adults who want to improve their relationship with food. She practices through a neurodiversity-affirming, weight inclusive lens celebrating both diversity of bodies and diversity of minds.
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In this episode, I dive into Charlie's story, who develops Idiopathic Intracranial Hypertension (IIH) in their early thrities. Charlie's journey reveals the terrible reality of weight stigma in healthcare - from delayed diagnosis to being blamed for their condition, and ultimately being prescribed weight loss instead of effective treatment. I also get pretty fired up discussing how the medical establishment continues to prescribe weight loss for IIH based on a single terrible study with just 25 participants who were essentially starved on 425 calories a day!
If you'd like to learn more about IIH and weight-inclusive approaches to healthcare, head to noweigh.org for my free resources. My IIH Masterclass which is available now to all Masterclass members (£40/month). I also referenced my upcoming book and No Weigh program where I cover the evidence that everything you've been told about weight loss is a lie. And don't forget to grab a free ticket to my Fat Joy Celebration happening on Friday, March 21st at 5pm UK time (1pm Eastern, 10am Pacific) - we'll have a virtual potluck, dancing, and celebration of fat community!
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In this episode, I tackle the simple but revolutionary idea that if we can't control our health (and we can't), then we shouldn't be blamed for it! When healthcare professionals blame patients, patients stop trusting us and start avoiding care. That's dangerous! This week I offer some straight-talking advice for both doctors (ask better questions!) and patients (call out the blame when you feel it!). Let's take the shame out of healthcare and remember that illness isn't a personal failure and when all else fails, chose compassion over judgment, folks. Every time.
RESOURCES MENTIONED: 👉 Unshrinkable Course (£25): Learn the science behind why weight loss is unsustainable 👉 Masterclass Membership: Evidence-based health education without weight stigma 👉 No Weigh Membership: Monthly chapters challenging weight-centric healthcare 👉 Weight Inclusive Wednesdays: Join our confidential Zoom sessions (2nd Wednesday monthly, 5pm UK) 👉 Free Healthcare Script: Download my guide for navigating difficult conversations with doctors 👉 No Weigh Newsletter: Get weekly evidence-based content delivered to your inbox
The aritcle quotes in this episode is " Veenendaal, M V E et al. “Transgenerational effects of prenatal exposure to the 1944-45 Dutch famine.” BJOG : an international journal of obstetrics and gynaecology vol. 120,5 (2013): 548-53."
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CW for the o-word
In this rather passionate episode of The Fat Doctor Podcast, I take on World Obsity Day and use this farce to challenge the very foundation of weight-centric healthcare. We take a look at how organizations like the World Obsity Federation medicalize and pathologize fatness while claiming to fight weight stigma, exposing the contradictions and financial interests behind these narratives.
Key moments:
My revolutionary approach to medicine: simply not mentioning patients' weight and instead focusing on providing evidence-based care. Find out more at noweigh.org.
Want to learn more about Fatty Liver Disease or Osteoarthritis, then check out my free resources.
For a deep dive, you’ll find both masterclasses in the masterclass membership.
Make sure you’re subscribed to my mailing list for daily moments of awesomeness delivered straight to your innbox.
The journal article I referenced is: Laperche, Jacob et al. “Obesity and total joint arthroplasty: Does weight loss in the preoperative period improve perioperative outcomes?.” Arthroplasty (London, England) vol. 4,1 47. 4 Nov. 2022
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In this explosive episode, Dr. Asher Larmie speaks with Dra. Mónica Peralta, a physician from Nicaragua specializing in diabetes, intuitive eating, and Body Trust. Together they explore weight stigma in healthcare across cultures, focusing on the unique challenges faced in Latin America. Dra. Monica shares her journey from promoting weight loss to becoming a weight-inclusive practitioner, offering a candid critique of how diabetes care is too often reduced to weight management. Their conversation tackles the harmful impacts of GLP-1 medications being repurposed for weight loss, the deeply problematic concept of World Ob*sity Day, and the hope found in the organization AWSIM (Association for Weight and Size Inclusive Medicine).
Key Moments:
0:00 Introduction
11:02Diabetes and Weight Stigma - A Double Burden 18:40
19:12 Weight Cycling and Its Impact on Diabetes Management
27:12 GLP-1 Medications: From Diabetes Treatment to Weight Loss Industry
38:42 World Ob*sity Day - "A Day to Eradicate a Type of Human Being"
50:12 AWSIM: The Association for Weight and Size Inclusive Medicine
57:42 Connecting with Dra. Mónica Peralta and Final Thoughts
Dra Mónica Peralta is a nutritionist and diabetologist who practices in Nicaragua and sees clients worldwide. She is certified in intuitive eating, eating disorders, psychonutrition, and body image. You can learn all about her and the services she offers on her website, and follow her inspiring content on Instagram.
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Through Harper's journey from dismissive doctors to eventual fibromyalgia diagnosis, I explore how weight stigma, medical gaslighting, and inadequate pain management create layers of trauma for patients in marginalized bodies. I break down the science of fibromyalgia in accessible terms and explain how the nervous system's "volume control" for pain gets stuck on high.
Key moments:
This week's paper is Tomiyama, A. Janet, Britt Ahlstrom, and Traci Mann. "Long-term Effects of Dieting: Is Weight Loss Related to Health?" Social and Personality Psychology Compass, vol. 7, no. 12, 2013, pp. 861-877. Wiley Online Library, https://doi.org/10.1111/spc3.12076.
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You can't control your health any more than you can control the weather. In this episode, I explore how holding individuals responsibe for their health is a relatively recent phenomenon tied to capitalism and neoliberalism, contrasting it with historical perspectives where health was viewed as a collective responsibility. I talk about the benefits of moving from body control to body trust, while addressing systemic factors affecting health and the importance of building supportive communities.
Key moments:
Learn more about my Free Course "Redefining Health"
Join The Weighting Room before the 19th February and get a free 30 minute chronic pain consultation
This week's paper is Tomiyama, A. Janet, Britt Ahlstrom, and Traci Mann. "Long-term Effects of Dieting: Is Weight Loss Related to Health?" Social and Personality Psychology Compass, vol. 7, no. 12, 2013, pp. 861-877. Wiley Online Library, https://doi.org/10.1111/spc3.12076.
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In this powerful episode, I examine the critical intersection of fatness, chronic pain, and medical bias. Drawing from both my professional expertise as a doctor and my personal experience with frozen shoulder, I expose how the medical system frequently fails fat patients seeking pain management – not through lack of treatment options, but through prejudice and assumptions.
Key moments:
Learn more about my Fibromyalgia Masterclass
Join The Weighting Room and get a free 30 minute chronic pain consultation
This week's paper is Andreoli, María F et al. “Leptin resensitisation: a reversion of leptin-resistant states.” The Journal of endocrinology vol. 241,3 (2019): R81-R96. doi:10.1530/JOE-18-0606
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In this powerful conversation, wellness practitioner and anti-diet educator Leslie Jordan Garcia (MPH, MBA) joins me to explore the deep connections between diet culture, racism, and body liberation. From personal experiences with eating disorders to profound insights about food systems and movement, Leslie shares how her journey informed her mission to help others heal and reclaim their power. We discuss the rebranding of diet culture, the impact of racial stereotypes on healthcare, and why true wellness must include dismantling systems of oppression.
Leslie is a wellness practitioner and anti-diet educator. She works with clients both locally in Austin, Texas, and worldwide through virtual sessions, offering movement coaching and partnership in liberation work. You can also find her on Instagram "shaking that moneymaker" and bringing joy to all who are fortunate enough to be in her orbit.
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Meet Jay, whose twenty-year health journey reflects the experience of countless Fat patients in rural communities. From an old motorcycle injury to high blood pressure, their story illustrates how weight-centric medical care can lead to years of frustrated consultations, missed diagnoses, and deteriorating health.
00:18:44 - What does weight inclusive care look like?
In this episode, I break down how weight-inclusive care changes everything - from the first examination to long-term treatment plans. I share how proper medical investigation, understanding of weight cycling, and compassionate care can transform both patient outcomes and the doctor-patient relationship.
00:27:19 - Everything You've Been Told About Weight Loss Is A Lie
Diet and exercise do NOT reduce the risk of developing OA of the knee according to the PROOF study. Today's study is entitled "The role of diet and exercise and of glucosamine sulfate in the prevention of knee osteoarthritis: Further results from the PRevention of knee Osteoarthritis in Overweight Females (PROOF) study"
00:31:13 - Ask Me Anything
I was asked to weigh in on the weight inclusive treatment of high cholesterol (nice pun, by the way!)
Want to learn more about the weight inclusive management of high blood pressure and arthritis of the knee? Then check out my on-demand masterclasses.
And if you're looking for a weight inclusive doctor and struggling to find one, don't forget that you can consult with me anytime.
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Health isn’t a one-size-fits-all concept. It’s as diverse and dynamic as the people who experience it. In this episode, I challenge the narrow, static definitions of health and asks whether health is a basic human right or a privilege. A binary concept or a specturm. A journey or a destination.
If you want to explore health in more detail, don’t miss my FREE workshop, Redefining Health, available to download anytime.
Feeling exhausted by the endless "New Year, New You" hype and its narrow definition of health? Join my FREE 7-day email challenge - the perfect antidote to diet culture January.
This week's Everything You’ve Been Told About Weight Loss Is a Lie features the article "Lower carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling of prospective studies" (Mazidi, 2019)
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In this episode, I uncover the truths about prediabetes - what it is, what it isn’t, and why you’ve been misled. Meet Joy, a mother navigating the weight stigma tied to her diagnosis, and stick around for the debut of my new segment: "Everything You’ve Been Told About Weight Loss Is a Lie."
Learn more about my masterclass *“Prediabetes Isn’t A Real Medical Condition” or sign up right now.* Alternatively, check out my blog post “Prediabetes: A Lesson In PR”. https://www.fatdoctor.co.uk/2023/03/19/prediabetes-a-lesson-in-pr/
Today’s article was “Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program”
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In the final episode of season 4, Asher recounts his personal growth over the past year and has a message for 2025. WE WILL NOT BE SILENCED. Season 5 launches on Wednesday the 15th January.
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Raven's story is one that I imagine many of us are intimately familiar with. Raven is a 34 year old graphic designer, A plus student and all round badass who has been trying to shrink their body their entire life. This episode is just in time for the holiday season and the run up to the January New Year, New You nonsense that we know is coming. It's the penultimate episode of season 4.
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Jude is Fat, exahusted, and ashamed. They've been so tired lately they finally bit the bullet and visited their doctor. Of course the doctor told them to eat less and get some exercise. But they also mentioned a sleep study. But Jude can't possibly have sleep apnea because that's just another thing everyone will blame on their weight. What's Jude to do?
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