What you Should Know About Weight Loss Surgery

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.

Listen on:

Libsyn
Apple Podcasts
Stitcher
YouTube

Episode 65 – What you Should Know About Weight Loss Surgery with Lisa DuBreuil

Lisa’s website

Lisa on Twitter

Will I Ever Stop Gaining Weight?

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.

Listen on:

Libsyn
Apple Podcasts
Stitcher
YouTube

Episode 64 – Will I Ever Stop Gaining Weight?

Listen on:

Show notes:

Undersummers Slip Shorts https://www.undersummers.com/

Other anti-chafing solutions: https://www.buzzfeed.com/nataliebrown/best-anti-chafing-products-save-your-thighs

Coach Cinder Ernst offers Plus Size Knee Pain Solutions

Challenging Negative Body Beliefs with Kristina Bruce

Ep 63 - Kristina BruceAaron 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.

Episode 63 – Challenging Unhelpful Beliefs with Kristina Bruce

Visit Kristina Bruce at her website

Kristina’s Instagram

Kristina’s YouTube Channel

Moving toward Body Liberation with Jes Baker

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Photo courtesy of RepresentationMatters.me

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.

Episode 58 - Jes BakerEpisode 58 – This is Body Liberation with Jes Baker

Show notes:

Learn more about Jes Baker

Read Jes’ writing at The Militant Baker

Check out Jes’ books Landwhale and Things No One Will Tell Fat Girls

Nike’s Plus Size Mannequin Backlash

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.

Episode 60 – Nike Plus-Size Mannequin Does NOT Promote Obesity

Show notes:

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.

Telegraph’s Fatphobic Take On Nike’s Plus-Size Mannequins Receives Backlash

Nike’s plus-sized mannequins don’t ‘promote’ obesity – they reflect reality. Why on earth is that an issue?

The Real Issue With Nike’s Plus Size Mannequins

Dances with Fat: Nike’s Plus Size Mannequins Uncover the Truth About Weight Stigma

Study showing lower mortality in “overweight” category (referenced)

You are already sick enough with Dr. Jennifer Gaudiani

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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.

Listen now:

Ep 56 Jennifer Gaudiani
Episode 56 – Sick Enough with Dr. Jennifer Gaudiani

Show notes:

Gaudiani Clinic

Sick Enough, a Guide to the Medical Complications of Eating Disorders

Getting Back into Your Body

Stock Photo: Hands Holding Hydrangea Flower
Photo courtesy of Representation Matters

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!

Cover2Episode 55 – Getting Back to Our Bodies with Tracy Brown, RDN

 

 

HAES Care for Diabetes

Rebecca Scritchfield and I are working hard on a new, expanded offering of our weight-inclusive diabetes groups. Make sure to sign up on this page to be one of the first to find out when it launches.

Is there a size limit for HAES?

Cover2People often send us questions for our Dietitians Unplugged podcast. We love getting questions and once in a while we’ll pick one to answer in our show. This one in particular was one we felt was probably on the minds of many people for whom HAES was a completely new concept.

Our listener wrote:

I just listened to Dietitians Unplugged episode about Tess Holiday. Can you explain to me your feelings around obesity in a little more context. I am confused with what you actually promote around being very overweight. I do understand intuitive eating.  And let me note, I’m not commenting on Tess Holiday specifically or her being on a cover of a magazine. I’m talking about obesity in general. In your opinion obesity is not bad? How can you support that opinion if obesity is linked to an endless number of medical conditions? I see how one can be overweight but still healthy. Just as someone can be skinny and unhealthy. But at a certain point in time, if you are so over weight that you are declared obese then you have fat crushing your major organisms, you are shortening your life, and setting yourself up for a difficult aging processes. How can someone with that amount of excess weight still “healthy.”  Thank you for reading, your inquisitive listener.

To be very honest, I wasn’t sure if at first we were being trolled. But I sometimes forget what a wonderful little HAES bubble I live in much of the time, both in my mind, and online (and even IRL with most of my local friends and acquaintances), and I realize that in fact, most people haven’t even heard of HAES and might have questions (and I’m pretty sure that early on, this was one of the skeptical questions I had very early on when being introduced to HAES). 

For those of you who aren’t podcast listeners, I’ll give you the very quick and short answer to the question of, “Is there a size limit to HAES?”: No. Slightly longer answer: I feel that anyone of any size can benefit from Health at Every Size principles, and furthermore, dieting to lose weight is probably doing actual harm. My clients in large bodies have tried dieting more times than you can count, and aside from usually gaining even more weight than they lost in the first place, they come to be with extremely disordered eating and total confusion and frustration around the best way to take care of themselves with food and movement. And finally: I never promote a particular body size. To me, all bodies are good bodies. I am more interested in promoting the best, most sustainable and life-affirming ways to take care of the body a person has right now. 

If you want the longer, much more nuanced answer to our listener’s question, give this episode a listen!

Episode 52 – Is there a size limit to HAES?

 

HAES Focused Diabetes Care

Rebecca Scritchfield, RDN, of the Body Kindness book, and I have cooked up something wonderful for those with diabetes who don’t want to diet. Our HAES Care for Diabetes Concerns has been getting rave reviews from participants, and we are working hard to expand access to this program this year. Get on our priority email list to find out when this group is happening next!

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What is Orthorexia?

almondsMany of you have heard this word before: orthorexia. But what is it?

While not an official eating disorder listed in the DSM V, orthorexia is a growing concern in the ED world. The NEDA website tells us,

The term ‘orthorexia’ was coined in 1998 and means an obsession with proper or ‘healthful’ eating. Although being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself, people with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.” However, since there is no official diagnostic criteria, it can be very hard to recognize. It’s kind of a “I know it when I see it” situation, which isn’t great for those who suffer from it, because it means many people are probably getting overlooked.

I have orthorexic clients, and they’ve sought help because their “healthy” food choices are starting to ruin their lives. They have anxiety at the thought of eating anything outside their rigid “clean eating” food rules. It’s beyond “healthy eating” and making choices that meet both satisfaction and nutrition needs. It’s an obsession, and sometimes becomes a full-time job.

Aaron and I decided to tackle the topic on our Dietitians Unplugged podcast when he found a blog post that felt dismissive of the issue. If you are wondering if your eating might qualify as orthorexia, give this podcast a listen, and if you think you need it because your life is not your own anymore, reach out to a professional for help.

Cover2Episode 51 – When Caring About Food Becomes Orthorexia

Show notes:

Read the blog that inspired this episode

Need Diabetes Care that isn’t Weight-Focused?

imageRebecca Scritchfield, RDN, and I run a HAES-based virtual support and education group that helps with self-care for diabetes and other metabolic concerns. Get on the email list so you can be the first to find out when our next group is open.

Feedback from participants has been great and we are helping people to get past the feelings of shame that sometimes come with a diabetes diagnosis, especially for those who are in larger bodies, and moving towards positive self-care. Learn more: HAES Care for Diabetes Concerns

Finding Fat-Friendly Health Care

DU + AmpleI am often painfully reminded of the fat phobia perpetuated by the medical community on a regular basis. Not just from my clients and others who have countless stories of being denied adequate health care because of their weight, but also from my own personal experience.

I was 15 years old when I went to the doctor for my annual check-up, stepped on the scale, and was told that I was getting “too heavy” and would have to eat differently. Since at age 15 I was still largely reliant on my mother for meals and my school cafeteria for lunch, I could not imagine what “eat differently” looked like, especially as it pertained to my weight. Luckily, my Mom must have delivered a private screed to this doctor (the one that later dismissed her expanding belly as “weight gain” instead of the ovarian cancer it actually was) because he never mentioned it after that and my strategy to never get on the scale again worked until my early 20s, when I turned to dieting to manage a major life crisis. Notably, after that comment from my doctor, my eating became increasingly disordered as I internalized the shame of that visit.

I was reminded of all this the other day when I went to a “sleep class” to diagnose possible sleep apnea (a long shot, but my doctor thought it was worth a try for some recent stuff going on). The person leading the class explained how to use the equipment we would take home to monitor our sleep that night. She also said, “If you are diagnosed with sleep apnea and you weigh too much, you will have to lose weight, because that is probably why you have it.” She went on to say that thin people had it for other reasons, and that once we lost weight, they could look to see if we also had it for those other reasons. As though our weight was an impermeable barrier that would obscure any other problems we could potentially have.

It took all the willpower in the world for me not to stand up on a table and have my Norma Rae fat-solidarity moment, and luckily we found that no matter what we weighed, if we had sleep apnea, we would get the APAP machine anyway. Because, you know, “you need to be able to sleep so you can lose weight.” Whereas I thought we needed good sleep for health and to feel well, silly me!!

Anyway, all this to say that we need medical care and medical providers that aren’t fat phobic, that don’t prescribe interventions that are temporary at best, and who provide us with the medical care that people in smaller, more conforming bodies get. But where can we find these providers?

That’s where Ample comes in. Aaron and I recently did a podcast with Alissa Sobo, one of the founders of Ample, a rating site for people in marginalized bodies (think fat, trans, people of color, disabled people). The creators of Ample know that when someone fears stigmatization from the doctor, they don’t go, and that can lead to worse health in the long run. But we need to know who can provide stigma-free health care – and that’s where Ample comes in.

I hope you’ll give this great Dietitians Unplugged episode a listen to find out more about Ample and how you can help build this amazing resource. THIS is how we exercise the power of voice that we do have — and we CAN create a better future.

Ample

Listen now:

Episode 50 – Finding Fat Friendly Providers on Ample with Alissa Sobo

Show notes:

Is it Ample? Aaron and Glenys talk to Alissa Sobo, the creator of Ample, the first app that rates businesses specifically on their accessibility and inclusiveness towards marginalized bodies (fat, trans, people of color and more). In this episode, Alissa talks about her origin story of being fat-shamed at the doctor when she was pregnant and why she decided she needed to create a review site for people in marginalized bodies whose needs are just not being met. She also explains how this amazing resources works and how we can all help build on it. This is something all our listeners can help contribute to and we can’t wait to introduce you to Ample! BONUS CONTENT: stay tuned to the very end to listen to our first fun bonus content!

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Need help with non-diet diabetes care?

HAES Care for Diabetes starting soon – get on the mailing list to be notified first when registration opens!

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