You also can't fix internalised stigma and body shame by dieting.
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Replying to @HelenlouWest @JimJohnsonSci and
My point is not about fixing it, it’s about it already being there, this is what the screening questionnaires are designed to trigger, if there are concerns, individuals are excluded! I did this in my research, pt safety is imperative!
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Replying to @BrownAdey @JimJohnsonSci and
But you have had professionals share evidence that the harms of these interventions may not be picked up until much later. We know this intervention is highly unlikely to "fix" their weight. Its not going to help them fix their DE. Have you read the pilot study?
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Replying to @HelenlouWest @JimJohnsonSci and
But there is no proof that this intervention is the cause? What if it’s from a previous unsupervised attempt started the 27month countdown! I do appreciate what’s being said, but supervised wt loss is better than unsupervised & if ED picked up, pt will be triaged for treatment!
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Replying to @BrownAdey @JimJohnsonSci and
It may cause ED/DE. If ppl have DE it won't fix DE. It will cause short term weight loss (if they are able to put up with the hunger and deal with psychological pressure of not eating). They will probably (IMO almost certainly) regain the weight they lose.
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Replying to @HelenlouWest @BrownAdey and
But given that DE and ED are secondary endpoints for the trial, surely it's important simply for the question of psychological harm? If the trial is stopped early due to
DE in intervention group, we'll have a definitive answer as to the risks of VLED in kids2 replies 0 retweets 3 likes -
Replying to @GidMK @BrownAdey and
I disagree with this stance. They are children. Not stats or lab rats. We don't have the right to put them at risk in the pursuit of knowledge.
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Replying to @HelenlouWest @BrownAdey and
But you've identified yourself that there's a lack of knowledge here. Without running a trial, we're guessing either way
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Replying to @GidMK @BrownAdey and
I don't think we are guessing. The objections come from what we know in adults + additional risks posed by growing kids - i'd say it's an evidence informed objection.
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Replying to @HelenlouWest @BrownAdey and
I'd argue that this study is dissimilar in that there is tight oversight of the included children which will hopefully minimize/obviate those risks
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Also in terms of what we know in adults - I don't believe there were any risks identified in the DiRECT trial for DE/ED so would this be an issue? Not long term perhaps but certainly comparable in terms of intervention
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Replying to @GidMK @BrownAdey and
Feel like I’m repeating myself, but as shared earlier, ED/DE are u likely to be picked up in a study window and their effects are long standing and difficult to measure.
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Replying to @HelenlouWest @GidMK and
Let’s not forget, direct is an MNT with a goal of treating T2DM by targeting beta cell function. This study is targeting a background risk factor of ‘high weight’, In kids who don’t have a diagnosed disease for ‘prevention’.
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