My latest, published ahead of print in the Canadian Journal of Cardiology looks at the historic failure of public health to move the needle on chronic non-communicable diseases like obesity, and its historic opportunity now to find some success /🧵 - ThreadSky

yonifreedhoff.com • 72 days ago

My latest, published ahead of print in the Canadian Journal of Cardiology looks at the historic failure of public health to move the needle on chronic non-communicable diseases like obesity, and its historic opportunity now to find some success /🧵

Comments

yonifreedhoff.com•72 days ago

And it's not just public health's failure. As I've noted in the past, there has never been any diet or intervention, demonstrating reproducible, clinically meaningful, sustained and durable weight loss in even a study group, let alone one scalable to a population /2

yonifreedhoff.com•72 days ago

That said, suddenly we find ourselves with an intervention that does in fact lead to very meaningful sustained average weight losses - obesity medications - and they just keep getting better and better (google retatrutide) /3

yonifreedhoff.com•72 days ago

Bringing me to my two key points: 1. Traditional public health interventions targeting food and fitness behaviours, even when supported by regulations targeting those same behaviours, are unlikely to lead to any demonstrable impact upon obesity rates. /4

yonifreedhoff.com•72 days ago

2. If interventions designed to support the use of current obesity medications were deployed, we might reasonably expect to see both obesity rates decline and increased impact of existing food and fitness behaviour interventions /5

yonifreedhoff.com•72 days ago

Full text available online here (at least for now)
https://onlinecjc.ca/article/S0828-282X(25)00191-6/fulltext

drjeffreyb.bsky.social•72 days ago

Yet these drugs remain prohibitively expensive in the US. A report by the Milken Institute estimated that the annual cost and economic impact of obesity exceeds $1.4 trillion. Time for common sense healthcare reform ("shouting into the void").

viato.bsky.social•71 days ago

Take a look at our Canadian Heart Health Surveys. We started the process, but unfortunately we lost colleagues along the way. The intention was to establish a baseline, test interventions and then repeat the surveys. We wanted an evidence-based approach.

cqmoi.bsky.social•72 days ago

This is very intriguing. One question in my mind is about the long-term effects of these drugs. What do we know about the risks, in absolute terms and relative to the risks of obesity?

yonifreedhoff.com•72 days ago

We know the benefits and multiple comorbidities whose risks are reduced by these drugs vastly, by many orders of magnitude, exceed their miniscule risks.

cqmoi.bsky.social•72 days ago

Thank you

Comments

Posting Rules

Reply