I want to be as transparent as possible about my feelings on this topic, so here goes.
I am not a fan of weight loss surgery.
I was not a fan of it when I first started to know people who were getting it, 20 years ago, even as I was steeped in diet culture. Twenty years later, I do not feel any better about it, based on the (scant) available evidence around the long-term outcomes, and on the personal evidence I have seen in my own life (weight regain, multiple surgeries, pain from surgery, and, sadly, even death). I don’t think the medical community does enough to prepare people for this surgery and the physical and psychological after-effects, and I don’t think it properly addresses possible underlying disordered eating which can continue even after surgery.
So that’s me. But I can’t make anyone’s decision for them. And I won’t judge anyone for choosing this surgery, especially in the fat-phobic culture we live in. What I can do is hold space for this kind of decision-making, and provide important information to help a person make a fully informed decision. (I, of course, prefer the path of radical body acceptance and Health at Every Size, but again, I can’t make that decision for others)
This Dietitians Unplugged podcast episode is part of providing that information. We talked to the wonderful, fierce HAES advocate Lisa DuBreuil, LICSW, who frequently works with clients who are considering or have undergone weight loss surgery. In this episode, we discuss the erroneous idea of “weight loss surgery as panacea”, how the medical community doesn’t do enough to prepare people before making this decision, and the possible medical and psychological consequences of having bariatric surgery.
I hear this from my clients a lot: “I’m afraid I’ll never stop gaining weight!” Thanks to societal weight stigma, I understand why anyone would have this fear. Large bodies have long been stigmatized and no one wants to put themselves in the way of stigma.
At the same time, how do we control our weight as we go through the normalization process with food? The answer: we really can’t. After all, wasn’t it trying to control our weight, over and over, that got us in this mess of weight cycling and food struggles in the first place?
And yet – the pain of weight gain is real. We want to be relaxed, happy eaters, but when it comes with weight gain, the whole process can feel confusing and discouraging.
So in this Dietitians Unplugged podcast, Aaron and I talk about that fear, and also about caring for your body as it is now.
Aaron and I welcomed Kristina Bruce to the Dietitians Unplugged podcast to help our listeners learn to challenge negative, unhelpful beliefs about themselves and their bodies.
Kristina is a certified Integrative Life Coach, Body Acceptance Coach and Certified Body Trust® Provider and a strong advocate for Health at Every Size®. She employs Byron Katie’s method, The Work, to help clients question beliefs that cause them stress and to help see those beliefs for what they are — thoughts, not reality. During this interview, we were so grateful to Kristina for sharing an important tool to help do this work and this episode will be pivotal for anyone hoping to get free from the negative beliefs they feel about their body.
BONUS! We had a sponsor for this episode with a special deal on free shipping for plus size clothing — go to the show page for the details and the special link you can use until the end of August! We included our experiences with this product during this episode if you want to know more.
In this episode, she explains the six Paramitas (generosity, discipline, patience, exertion, meditation and wisdom) and how we can apply them in approaching intuitive eating. Her compassion-based framework asks us to see ourselves as a beloved other in learning how to listen to our inner wisdom and bring about sustainable, positive self-care.
The Dietitians Unplugged podcast was excited and honored to host Jes Baker, aka The Militant Baker, author of the books Landwhale and Things No One Will Tell Fat Girls: A Handbook for Unapologetic Living to talk about what body liberation means and how it can change our lives for the better.
Jes is a positive, progressive, and magnificently irreverent force to be reckoned with in the realm of self-love advocacy and mental health. She is internationally known for preaching the importance of body liberation, hard conversations, strong coffee, and even stronger language. Jes burst onto the body image scene when she created her own ads mocking Abercrombie & Fitch for discriminating against all body types – a move that landed her on the Today Show and garnered a loyal following for her raw, honest, and attitude-filled blog missives.
In this fantastic episode, she tells us about her revelation that she hadn’t been a fat child, turning insults into cool nicknames, and how talking about mental health can be healing.
Nike recently unveiled a new plus-size line of athletic clothing and with it, a plus-size mannequin on which to display the clothing. Makes sense, right? A plus-size mannequin to display plus-size clothing.
One journalist, however, railed against this move as “promoting obesity.” In this Dietitians Unplugged episode, Aaron and I talk about the reaction to the mannequin, both good and bad, how promoting obesity is not actually “a thing”, and the role that internalized weight stigma may have played in this reaction.
I’m not linking to the original article because it’s pretty mean, and you can search the Tanya Gold/Nike article if you want to read it (it’s pretty easy to find). Instead, here are some great articles clapping back.
In this episode of the Dietitians Unplugged podcast, we were thrilled to talk to Dr. Jennifer Gaudiani of the Gaudiani Clinic in Denver, CO which provides in-person and telehealth care to people with current or a history of eating disorders.
Dr. G is the author of the book Sick Enough, a Guide to the Medical Complications of Eating Disorders. She talked to us about her journey to becoming a HAES-aligned doctor, and how she realized that HAES is the only ethical way to treat patients, especially those in larger bodies. She explains her “house on fire” analogy which helps those who struggle to understand that they are already sick enough with their eating disorder and don’t need to delay treatment any longer. We think everyone will benefit from listening to this podcast – patients and doctors alike.
I’m a long-time TV fan but as I get older, my time is precious. I want to watch things that I find really entertaining. And with the rise of more fat representation on TV, there are more things for me to think about watching. But just because something includes a fat person doesn’t necessarily mean it will be a great show.
So in this episode, Aaron and I discussed the viewing options presented over the past year (thanks to streaming!) and offered up some criticism to help you in deciding what to watch. And it is summer after all, which, if you’re old enough, you remember as the time of summer reruns and trying to figure out what’s on that’s good (apparently this is no longer a problem, but nostalgia dies hard in my home).
In this episode, we talked about the TV show Dietland, based on the book of the same name by Sarai Walker, that aired last year on AMC and now streams on Hulu, and Shrill, which debuted this spring and runs on Hulu as well. We also mention a few shows with dubious fat representation that we have not and will not be watching (return of The Biggest Loser, Insatiable) for a variety of reasons.
Our bodies tell so much of the story of ourselves. In an ideal world, we’d be good friends with our bodies, appreciate them for what they allow us to experience of the world, and be in tune with what they tell us about those experiences. But because we don’t live in a perfect world, we can lose touch with the wisdom of our bodies. Or, because of past trauma, our bodies have become a scary place for us to be.
Getting back into our bodies can be a challenge, so we asked Tracy Brown, RDN, LD/N, a somatic nutrition therapist, how she helps people do just that. She talked about the effects of trauma on the body, how “feeling fat” isn’t really about body size at all, how the fight/flight/freeze reflex can keep us trapped in the diet cycle and how reconnecting with the body can help end the cycle.
And if you want to see body disconnection in action, I provided a spectacular example during this episode (you’ll probably know it when you hear it!). Last year was great professionally, but tough and also way too busy. I spent too much time working and growing, and not enough relaxing and regenerating. And I am someone that needs a fair amount of relaxation in order to function optimally for the long run. When we recorded this episode, I was experiencing the late effects of total body breakdown: exhaustion, headaches, and a real difficulty with concentration. It’s been a hard lesson in knowing my limits and learning to respect my body, but life is always a work in progress!
I rarely bring up the concept of thin privilege with thin people unless the situation warrants it (like when they are tsk tsking about fat people). My goal is always to try to bring people into the HAES fold with kindness and compassion, and I find bringing up something like thin privilege gets them on the defensive fast and shuts everything down and my seed planting goes to waste. Some might disagree with this philosophy and that’s okay.
I do talk about this quite a bit, however, with my clients in larger bodies because it provides a framework and understanding for why they experience weight stigma, and for why they long to be in thinner bodies. Who doesn’t want privilege?? We all want that.
At the same time, I strongly feel that dietitians and dietitians-to-be — thin or not –absolutely must understand this concept if they want to practice compassionate care. At some point, dietitians will treat people in fat bodies, and it is imperative that they understand how people suffer so under such an unfair system of privilege. (It’s also important to understand that we need to change the unfair system and not the body size)
So when Aaron and I gave an introductory talk on Health at Every Size and Intuitive Eating to a large group of dietetic interns, we were a little surprised at the “feedback” (more like vitriolic criticism) we got from several attendees for mentioning thin privilege (an example of the aforementioned shutting down). They felt they had been attacked personally by even the mention of thin privilege, even though no person in the room had actually been identified by us as having it — we were simply bring it up as a concept to consider when treating people in larger bodies.
Since we consider all life experiences fodder for a podcast, this was our effort to process the whole experience and talk about why acknowledging thin privilege exists is so important (I had it once and can tell you it exists). If you are in a smaller body, I hope you’ll listen to this podcast with an open heart and mind, because no matter what, all bodies are good bodies, and we always appreciate our thin allies.