Weighted Wisdoms

05/31/2026

05/31/2026

The compliment that broke something
Why "you look amazing" after is more complicated than it sounds — and what it reveals about what we believed before.

Why "you look amazing" after weight loss is more complicated than it sounds — and what it reveals about what we believed before.

05/31/2026

Most of my clients come in on Mondays already behind.

Not behind on tasks — behind on themselves. The week hasn't started yet, and they're already managing yesterday's feelings, bracing for tomorrow's demands, and wondering why healthy intentions never seem to survive past Tuesday.

So I'm curious what you actually do on Sundays — if anything — to set yourself up for the week ahead.

Not the aspirational version. The real one.

Do you meal prep, or just think about it? Do you check in with your body, or mostly ignore it until something hurts? Do you have a routine that's working, or are you still looking for one?

I ask because the gap between intention and follow-through is something I work on with clients constantly — and it's rarely about willpower or discipline. It's usually about nervous system load, unprocessed emotion, and whether someone has built any structure that actually accounts for who they are, not who they think they should be.

Tell me in the comments: What's one thing you do — or wish you did — on Sundays to prepare for the week?

Those habits shape your success. Your answer might be what someone else needs to hear.

05/27/2026

Count the WINS! Advocacy matters. This measure, if passed by the legislature, will bring GLP-1 coverage to Louisiana Medicaid members in January 2027!!

Obesity Action Coalition - OAC Action Update: Progress Continues in Louisiana

We’re excited to share that obesity care legislation in Louisiana has passed out of the House Health and Welfare Committee, moving one step closer to improving access to care. This progress reflects the power of advocacy and the importance of continuing to elevate the voices of people impacted by obesity. We’ll continue monitoring today’s appropriations hearing and share more updates as they become available.

Today, Secretary Greenstein, Seth Gold, and Senator Boudreaux testified before the House Appropriations Committee on SB 433, which covers GLP-1 medications in the Medicaid program for residents affected only by obesity. Today’s hearing was the last committee stop for this bill, and it passed without objection. This process could not have gone this smoothly without Senator Boudreaux’s leadership.

05/27/2026

Obesity is a chronic, complex disease driven by dysregulated neurohormonal systems — elevated ghrelin signaling relentless hunger, impaired leptin signaling blunting satiety, systemic inflammation altering metabolism, and neural pathways that override conscious intention. Biology is not a character flaw. Yet we have built an entire cultural infrastructure that treats it as one.
The food industry engineers hyperpalatable products optimized for overconsumption. The fitness industry profits from the myth that results are simply a matter of effort. Too many clinicians still attribute every health complaint to weight rather than investigating it. And when people affected by obesity internalize these narratives — as they inevitably do — the damage is not motivational. It is psychological, persistent, and compounding.
Then the system that should intervene refuses to. Obesity treatment remains among the most frequently excluded benefits in employer health plans. Coverage for evidence-based pharmacotherapy and surgery is denied at rates that would be considered unconscionable for any other chronic disease of comparable prevalence and mortality risk. The gap is not accidental — it is a policy choice.
This has to change. Concretely:
Insurers must cover evidence-based obesity treatment — behavioral, pharmacological, and surgical — without arbitrary exclusions.
Employers must stop stripping obesity benefits from health plans as a cost-cutting measure while funding treatment for other chronic conditions.
Clinicians must receive mandatory training in weight-inclusive care and weight bias.
Policymakers must regulate food marketing and hold the food industry accountable for its role in the chronic disease burden.
All of us must stop using the language of willpower and failure for a disease driven by biology, not character.
People affected by obesity are not failing the system. The system is failing them — and continuing to hand them the bill.

Join the Obesity Action Coalition - OAC to learn more about our advocacy efforts to improve treatment coverage, gain knowledge and insights about obesity and weight bias, and find support from a community of people who understand you.

05/25/2026

Obesity treatment programs should be comprehensive or at least have the resources to refer patients to appropriate clinicians. This is a guide for patients to speak to providers about psychological needs often overlooked in obesity care. Worth a read for patients and providers alike.

A practical guide to having the conversation most clinical appointments don't leave room for — and advocating for the support you actually need.

05/24/2026

Feeling seen.....

05/22/2026

As more receive pharmaceutical indication, let us not forget that bariatric and metabolic surgery still holds a place for effective obesity treatment. What we need to pay attention to is supporting patient interventions on their terms, when they are ready to commit, and over the long term for comprehensive care. The wave of GLP-1 may be a flash in the pan or a puzzle piece to treat obesity, a chronic disease, not a cure. Read more on Substack about my latest take on how we could improve outcomes, support patients, and define the future of obesity treatment.

Why bariatric surgery remains irreplaceable — and why that means almost nothing if we don’t fix what comes after.