In this issue:

• DEADLINE TODAY: NAAFA Research Scholarship

• Size-Inclusive Primary Care Competencies

• Featured Research Article: Associations of Obesity with Chronic Disease and Mortality

• Upcoming AWSIM Events

• Find us on Instagram!

LAST CHANCE: NAAFA Dr. Paul Ernsberger Research Scholarship!

The National Association for the Advancement of Fat Acceptance (NAAFA) is accepting applications for the Dr. Paul Ernsberger Research Scholarship until June 1, 2026. Scholarships are available for research graduate students within specified areas of concentration in scientific research, including nutrition and higher weight people, metabolic syndrome, weight cycling, medical harm from being obsessed with weight loss, and medical harm from the bias of physicians.

Up to three scholarships in the amount of $2,500 will be awarded.

Prioritization will be given to applicants of marginalized identity (POC, LGBTQIA+, disabled, fat/superfat) and those who demonstrate financial need. Scholarship will be paid directly to the graduate student.

REQUIREMENTS:

• Online application

• Transcripts (unofficial are acceptable)

• Proof of enrollment

• Recommendation/Reference form(s) - At least one recommendation/reference other than your advisor

• Copy of your FAFSA Student Aid Report

TIMELINE:

• Filing deadline 6/1/26

• Decision letter and agreement sent by email by 7/7/26

• Returned signed agreements by 7/14/26

• Scholarship issued 7/21/26

New — Size-Inclusive Primary Care Competencies

We are excited to share a new resource created by MSSI advisor Krista Handfield, LICSW! The Size-Inclusive Primary Care Competencies are a set of guidelines designed to help primary care providers develop an ethical and evidence-based size-inclusive approach to patient care.

The seven competencies include:

1. Identify structural weight stigma and unlearn weight bias

2. Identify and address weight stigma

3. Address health concerns independent of weight

4. Focus on size-inclusive health enhancement and sustainable health behaviors

5. Provide informed consent regarding weight-focused interventions

6. Practice through an equity and trauma-informed lens

7. Promote a size-inclusive environment

Featured Research Article: “Associations of obesity, systemic inflammation, and hyperinsulinemia with the incidence of non-communicable chronic disease and mortality: A prospective cohort study”

In a recent article published in Diabetes, Obesity, and Metabolism, Natasha Wiebe et al. question long-held assumptions about the association between weight and chronic disease. While previous studies have shown associations between obesity and metabolic syndrome (Guh et al. 2009), these studies are limited by their failure to measure incident disease (the number of new cases of a disease that develop over a specific time period) and lack of population-representative sampling designs. Furthermore, high BMI has been associated with a lower risk of mortality in the US population compared to “normal” BMI when controlling for inflammation and hyperinsulinemia (Wiebe, Muntner, and Tonelli 2022). If obesity is associated with chronic disease, and chronic disease is associated with mortality, then why do higher-weight patients experience decreased mortality compared to their lower-weight counterparts? In their recent study, Wiebe and colleagues investigated this question by following a population-representative cohort of Canadian adults for an average of 6.7 years and tracking markers including BMI, C-reactive protein levels (a marker of inflammation), fasting insulin levels, incidence of non-communicable chronic diseases (NCDs), and all-cause mortality.

Key takeaways from the study:

• Inflammation and hyperinsulinemia were strongly associated with an increased risk of mortality.

• Initial results showed increased risk of death in those with elevated BMI. However, when controlling for inflammation and hyperinsulinemia, higher-weight individuals had lower all-cause mortality than those with normal BMI. This suggests that the increased risk of death in higher-weight individuals is likely due to inflammation and hyperinsulinemia rather than BMI itself. Notably, weight stigma is also associated with elevated inflammatory markers (Keirns et al. 2025).

• High BMI, inflammation, and hyperinsulinemia were all associated with increased risk of at least one non-communicable chronic disease. The authors found a significant positive association between elevated BMI and hypertension, a non-significant association with cardiovascular disease and type 2 diabetes, and an inverse association with cancer (individuals with higher BMI were less likely to develop cancer). Again, inflammation resulting from weight stigma and weight cycling may account for some of the association between high BMI and chronic disease.

• Critics argue that elevated BMI causes systemic inflammation and hyperinsulinemia. However, Wiebe and colleagues suggest that “changes in fasting insulin precede changes in weight and not the other way around.” This claim is supported by evidence from randomized trials showing that patients treated with exogenous insulin or sulfonylureas (which increase release of endogenous insulin) gain weight (Holman et al. 2007; UKPDS Group 1998). Conversely, patients who undergo bariatric surgery experience decreases in fasting insulin and inflammatory markers prior to weight loss (Abbasi 2017).

• Adipose tissue has critical metabolic and immune functions, suggesting that “obesity” may “act as a protective mediator … and temper acute exacerbations of NCDs.”

• “As there are more people with metabolic syndrome without obesity than with obesity, future research should prioritize the study of how to best diagnose, monitor, and treat inflammation and hyperinsulinemia rather than obesity.”

Click here for the full article! Ragen Chastain has also written a helpful analysis of the article which can be found here.

Upcoming AWSIM Events!

June 8, 2026: “When Weight Misleads: Rethinking Dermatologic Diagnosis and Care” with Dr. Zed Zha

Free for AWSIM members and students

$35 for non-members

Find us on Instagram!

This newsletter was authored by MSSI member Megan Coolahan (Tufts University School of Medicine).