Breaking News

Weight stigma in eating-disorder treatments, research against involuntary addiction treatment, & working conditions and psychological distress

April 25, 2023
Reporter, Morning Rounds Writer
Good morning. Don't miss the latest story in our coverage of the Obesity Revolution: a look at weight stigma in eating disorder treatment.

Health

'A huge fatphobia problem' follows patients into eating disorder treatment

Shira Rosenbluth poses for a portrait at her home
Allison Dinner for STAT

At 14 years old, Shira Rosenbluth (above) entered the first of many treatment programs for eating disorders, after four years of purging to lose weight. In retrospect, she says, every treatment center was steeped in weight stigma. "It wasn't until I left treatment where I started to look at all the things that happened and I was like, 'Oh, you never actually had the chance to even have a shot at recovery,'" Rosenbluth, now a social worker, told STAT's Theresa Gaffney. "There's a huge fatphobia problem in the eating disorder world."

Nearly a dozen eating disorder clinicians and researchers told Theresa the field is grappling with the tension between treatments for obesity and eating disorders, an issue that may become more urgent for two reasons. There's the current frenzy over weight loss drugs and there are new American Academy of Pediatrics guidelines on obesity treatment recommending the drugs for kids as young as 12 and bariatric surgery for kids as young as 13. Read more.


global Health

Closing the vaccine gap requires a 'big catch-up'

The WHO, UNICEF, and other players in the vaccination sphere launched an effort yesterday aimed at undoing the damage the Covid-19 pandemic wreaked on vaccination levels worldwide, STAT's Helen Branswell tells us. "The Big Catch-up," as the program is being called, is targeting the millions of children who didn't get recommended vaccines during the pandemic. In 2021 alone, 18 million children didn't receive a single dose, raising the risk of outbreaks of measles, yellow fever and other diseases.

Playing catch-up on missed vaccinations is a more of a challenge than one might imagine. Vaccines are typically given during scheduled medical visits early in childhood. If they miss those, it can be hard to figure out who needs to be caught up. Kate O'Brien, who heads WHO's department of immunization, said some countries discourage health workers from opening a vial of vaccine if they aren't going to use multiple doses. WHO's advice, she said, is to use every opportunity to vaccinate kids, even if that means some vaccine doses are wasted.


mental health

The uncertainty principle: Work conditions are linked to serious psychological distress

Percentage of adults reporting serious psychological distress by pay variation and perceived job insecurity. (CDC)

Work and serious psychological distress sometimes go hand in hand, especially for people pulling night, evening, or rotating shifts and for those worried about losing their jobs. Results from a CDC survey conducted in 2021 reveal how uncertainty in work conditions — whether shift work, changing amounts earned, job insecurity, or inflexible work schedules — is associated with serious psychological distress among working-age adults. That means work conditions, not just occupation and employment status, become social determinants of health, the researchers conclude.

Overall, 2.7% of adults met the criteria for mental health problems severe enough to impair their social and occupational functioning and to require treatment. Besides uncertainty, other important factors were the availability of sick leave and schedule flexibility. More psychological distress was reported by those who worked night or rotating shifts, whose earnings varied, whose schedules were inflexible, and who worked when they were physically ill.



Closer Look

Opinion: The trouble with forced treatment of substance use disorders 

While the overdose crisis seems never-ending, calls to commit people to involuntary treatment are growing louder. Some people see it as protection, a way to clear city neighborhoods of people visibly using drugs. Others think it's a necessary act of compassion to help people unable to help themselves. Then there's the desperate wish — from medical professionals and loved ones alike — to do something, anything to make addiction stop.

Here's the thing: Research shows involuntary treatment doesn't work. "The definition of addiction is compulsively using a substance despite bad things happening to you. And substance use is a powerful coping mechanism for when things are going terribly," addiction medicine physician Sarah Wakeman writes in a STAT First Opinion. "So why would making someone's life worse, making them feel even more beaten down, help someone get well?" Read more about what decades of research tell us does work.


pandemic

During Covid, people of color more likely to die at an earlier age than white people

We've learned over the past three years how Covid-19 has affected people from different racial and ethnic groups, often mirroring socioeconomic status. While the coronavirus continues to be especially severe for older people, a new report looks at younger people whose lives have ended prematurely. Most lives were cut short by Covid, followed by drug overdoses, suicide, heart disease, and liver disease. 

The new KFF analysis finds people of color were more likely to die at younger ages than white people, using the pre-pandemic life expectancy of 75 years as a benchmark. All groups saw their premature mortality rate rise, but some lost more years than others: American Indian and Alaska Native (22), Hispanic (19.9), Native Hawaiian and other Pacific Islander (18.8), Black (18.3), Asian (14), and white (12.5). Overall, the U.S. rate was highest among peer nations, including double the rate years lost in the U.K.


health

Ask about sex and gender, researchers recommend 

Most health studies and surveys ask people for their sex (a biological definition) or their gender (a social construct) but not both, new research points out. Sometimes they use the two categories interchangeably, which can exclude transgender and nonbinary people and lead not just to imperfect research results but potentially inferior care. It could affect decisions on providing mammograms or prostate cancer screening, for example.

In a new PNAS study, the researchers report 200 people among more than 470,000 individuals in the U.K. Biobank for whom sex and gender were discordant. Most of these individuals had medical records of intersex traits, gender dysphoria, and prescriptions for gender-affirming hormone therapies for transgender individuals. The authors offer a simple solution: Ask for both sex and gender. "Health and clinical researchers have a unique opportunity to advance the rigor of scientific research as well as the health and well-being of transgender, intersex, and nonbinary people," they write.


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What we're reading

  • Florida surgeon general altered key findings in study on Covid-19 vaccine safety, Politico
  • Chemical plants destroyed these Black towns. The EPA hopes new regulations will help, Capital B

  • Bluebird submits sickle cell gene therapy to FDA for approval, STAT
  • The new face of Alzheimer's: Early stage patients who refuse to surrender, Washington Post

  • Did a military lab spill anthrax into public waterways? New book reveals details of a U.S. leak, KFF Health News


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