What to Say to a Doctor

The F*ck It Podcast

What to Say To a Doctor, when intro-ing anti-diet stuff This episode's sponsors are Juliette Sakasegawa - Your Empowered Life, and StitchFix (and my desire for as many $25 coupons I can get). More info on both all the way at the bottom 👇🏼 This week I had an appointment with a cardiologist because my dad has a heart condition that can be genetic, so I was being screened for it. Turns out I DON’T have it, but while I lay there getting the echocardiogram he asked me what I did, and I said that I was a writer. "About what?" Sigh, here we gooooo. "I write about diet culture." I don't always know how to approach the subject with people in the medical field who I USUALLY assume will be extremely indoctrinated with food-fearing, weight centric beliefs. I usually tread lightly because I never know how people are going to respond. I said, "I think we have a blind spot when it comes to disordered eating. There's nuance of course, but it is more rampant than we tend to think." He seemed open, and said was interested in hearing more about it, because he is often put in the position of telling people to make changes to their diet, but he knows it’s not his area of expertise. He also said he is rather “atheistic” about diets, and that he is aware that different things work for different people. Which all seemed like a good sign! So he said he may want to follow up with me on the subject so he could learn more. So! I went home and figured out what I would want to say to best intro the subject to someone who is likely entrenched in diet culture already, and a weight-centric paradigm. What I wrote: First and foremost, we have a problematic way of approaching weight in the pursuit of health - or in the pursuit of improved health. There is an assumption that weight is just a simple calorie math equation, and that is inaccurate for lots of people who have naturally higher weight set ranges, genetically or because of underlying health issues- and that belief leads to a dysfunctional way of approaching weight and weigh loss, and often leads to a dysfunctional relationship with food, that will ironically lead to poorer health outcomes long term. This hyper-focus on weight is a cultural issue first and foremost, but what we tend not to understand, is that health habits can and do change people’s overall health for the better, often without any change in weight. When there is a change in weight, longterm, thanks to better health habits, it’s usually because the dysfunctional relationship with dieting (and often bingeing in response to dieting) has been healed. There is a lot of talk about people having a “food addiction” or “sugar addiction” which doesn’t actually have data to back it up - in fact the studies that show food addiction actually starve and restrict the subjects (rats) beforehand, and then the rats act food addicted, and it lights up pleasure centers of the brain (that also light up with things like hugs and playing with puppies). So the “addiction” part is actually the consequence of the restriction. Simply… restriction leads to something that looks a lot like food addiction, and then often starts a viscous cycle. Another issue is the lack of fluency around the social determinants of health, as well as how much weight cycling, not weight alone, accounts for a lot of health issues- and weight cycling is a direct results of attempted weight loss. The following quotes are pulled from this article: Weight Science: Evaluating the Evidence for a Paradigm Shift, and if you want to find the references for the quotes below, they can all be found at that link above by going to the referenced study number below. "Ob*se people who have had heart attacks, coronary bypass [50], angioplasty [51] or hemodialysis [52] live longer than thinner people with these histories [49]. In addition, obese senior citizens live longer than thinner senior citizens [53]. " "Weight cycling can account for all of the excess mortality assoc...