Episode 56 Transcript
[00:00:00] Welcome to Be About Being Better podcast, where we empower you to make evidence-based, sustainable and transformative changes for your health, leading to a more vibrant and fulfilling life. I'm your host, Abbie Stasior, a non-diet registered dietician, certified intuitive eating counselor, and master's graduate from Columbia University.
I believe that we can't make lasting or meaningful change single-handedly. So I'm so happy that you're here so that together you can see that a diet free, sustainable, healthy lifestyle is possible, and you can leverage that to live a better life. And remember my disclaimer, this podcast is meant to give you general information and is not meant to substitute or replace medical advice, a diagnosis or serve as treatment.
Abbie: hello. Hello, y'all. Welcome back to the Be About Being Better podcast. Y'all, in this episode, we're going to be covering some big topics that have a lot of nuance to their conversation. First, I want to acknowledge and talk about the Aspartame scandal that broke out recently.
There's a new article that was published by the Washington Post. And, uh, one of the writers of the article is actually Anadad O'Connor. And he came to speak to one of our classes at Columbia when I was getting my master's there. Such a great writer and he really looks at the scientific studies and relays the information that's in the studies in a concise way.
And he doesn't skew the data for any big fancy headlines or clickbait. I. I think he, he has a lot of integrity, and it's nice because I've actually gotten to meet him, and I just, I really enjoy his articles and his writing. So, when I saw that he came out with this article, I was like, oh, definitely gotta, definitely gotta read his article.
And then also, so many of y'all sent me his... article and it just this huge scandal that that blew up about the artificial sweetener, um, aspartame and dietitians that are being paid by the American Beverage Association to say that this artificial sweetener is safe, even though the World Health Organization has classified it as a possible carcinogen, meaning that it possibly causes cancer.
So I'll make sure to link. The article and the tick talks about it in the show notes that you can look into it yourself and be all the real problem Here is that the dietitians that that were involved in this and we're part of a paid Promotion either weren't disclosing that this was a paid partnership with the American Beverage Association, which is clearly a huge conflict of interest or They were hiding the fact that it was a paid promotion, like burying it in their hashtags and just, just being very sneaky about it and not very forthcoming.
So, they thought that people wouldn't notice, but people are smart, people noticed and people were putting in the comments like, Hey, Who, if this is an ad, who, what was this an ad for? Who's paying you for this? So even though the dietitians had full autonomy over what they said in their videos, and, uh, they claim that they stand by what they were saying in their videos, their opinions are now tainted.
And a lot of people aren't seeing these dietitians that are huge influencers and huge dietitians in the field. People aren't seeing them as trustworthy now because. It's like, do the dietitians actually believe what they say? Do they actually believe that aspartame is safe? Or are they just saying that to make a quick buck?
So, and that's the problem with paid advertising, y'all, and aligning with certain companies. In a lot of cases, depending on the company, it can make you less credible, and this is why I know I've said it in previous episodes, but I think, and I've said it in Tech Talks too, I think it just is worth repeating, especially at a time like this.
If you are looking over a scientific study, you need to be a critical consumer of that, but you always need to go to the funding source. Every scientific study... They should most do have a section of where that study got their funding from and if it's a study about you know aspartame and That it's so healthy and doesn't cause you any harm, but it's funded by Coca Cola, uh, a little bit of a conflict of interest there because obviously it's in their best interest to tell you that it's safe so that you go buy their product.
So overall it just makes it less credible. It's just frustrating for me to see as a dietitian. Like y'all know I partner with like next to no brands. I'm very, very picky, very particular. Um, I, I don't partner with a lot of brands for this reason and I'm like not a huge fan of supplements. I think there's so much we can do through food, but I also recognize that some convenience foods, some supplements are needed and warranted and not everyone can afford or has access to.
organic and whole fresh foods all of the time. So again, there's just a lot of nuance to this, but it's especially frustrating for me as a dietitian because I know, and y'all know because you've been following my journey, how much schooling Is involved in becoming a registered dietitian and how credentialed we are in the field like people trust us and When something like this happens it discredits the rest of us It makes the field of dietetics look bad and it obviously exposes the sketchy food and drink industry but you know it It makes dietitians look bad, and we've spent so much time, so much money, to get credential to really stand out as evidence based practitioners in the space, that when we align with the sketchy food and drink industry for these paid partnerships, it kind of ruins it for the rest of us.
It makes all dietitians look bad. And... I think what's even worse is that it makes people more confused about nutrition. Nutrition is already confusing enough, and as dietitians, we're striving to break through the nutrition noise and the nutrition confusion. To create less confusion for y'all and more clarity, but then scandals come out like this, and it's just harder for people to trust the nutrition information online.
So it's just, it's ultimately very disheartening. So I'm very upset about the scandal. I'm happy that it got exposed because I think we need to have conversations like this, and I think everyone, dieticians, Um, and they need to be careful of the platforms that they have and they need to steward them well, and they need to question who they're partnering with and what their intentions are and how that looks, because all the dietitians could have been saying their own opinion, truthful things, you know, truthful things, I don't know, like they could have been saying truthful things and stuff that they agree with in their videos, but because of who was paying them to say that, you know, It now leads people questioning their integrity and questioning what they were saying.
So that's when it becomes a problem. It's not a problem what they were saying. It's a problem of who's paying them to say it because now we're not able to trust. Are you saying that because you genuinely believe it? Or are you saying that because You were getting paid to say that so it's hard and you know because of this I've been asked by several of you now Well, can I have aspartame?
Is this artificial sweetener safe? And again, there's a lot of nuance here because y'all know that I'm a non diet dietitian So I wouldn't recommend that you cut out any foods and that everything can fit in moderation And whenever we get restrictive and labeling foods as good or bad and attaching any sort of morality to a food, it's, it's a slippery slope and it can lead to binges, overeating, guilt and shame, and even more restrictions that can trigger an eating disorder.
And an eating disorder is worse for your health than if you had a Diet Coke with some aspartame in it. I feel that the mental and emotional stress that people have around food and all of this food related anxiety from the fear mongering that people have around marketing of these foods can wreak more havoc on your system than just having the Diet Coke will.
And also my question If we're feeling convicted about certain foods, why don't people in society feel more convicted about alcohol? Alcohol is a known toxin and it's actually ranked as a higher level of a carcinogen or a higher cancer causing chemical than aspartame is. So A group one carcinogen is like the one that is the most cancerous and has the most evidence to support that it causes cancer.
Some things that are in that category are alcohol and smoking. Then we have group two, a. These are probably carcinogenic to humans, meaning that there's limited to no evidence in humans that it causes cancer, but there's sufficient evidence in animal studies. And this is, you know, consider like steroids, exposures from working in hair dressing, red meat, night shift work where it's kind of messing up your circadian rhythms, emissions from high temperature frying, things of that nature.
Then we have group 2B, which is possibly carcinogenic to humans. So this means that there's limited to no evidence in humans that it does cause cancer, and there's limited to insufficient evidence that it causes cancer in humans. animals. And this is gasoline or gasoline engine exhaust, welding fumes, pickled vegetables, aloe vera, whole leaf extract, and now aspartame.
So those are just a few examples. And then there's also like group three and group four. Um, so it's in group two, but group two B and Um, you know, things like smoking tobacco and alcohol exposure to solar radiation are classified much higher because they're in group one than aspartame. So just something to consider and again, adds more nuance to the conversation.
So as a non diet dietitian, I say that all foods fit and that we can have everything in moderation. Every food has a risk. If you drink too much water. You have a risk of water toxicity. There's a higher risk with alcohol and smoking, like I said before, and also Roundup is on that list. It's not a group one, but it's a group 2a carcinogen and Roundup is the pesticide that we use on like all of our crops.
So it's probably on our food. So try not to let the media scare you. Y'all, everything has a risk. And we're just out here trying to do the best that we can in the food system that we have. And I also can assure you that this is not paid advertising. I am not being paid by the American Peppers Association.
I feel like I need to be, uh, um, transparent about that. That this is not paid advertising and I am not aligned with any of these companies. And I am not saying that aspartame is safe. It is and has been found to be a possible carcinogen according to the World Health Organization. But again, have everything in moderation and also maybe consider alcohol intake.
You know, that's something to consider as well. So there's just a lot of nuance to the conversation. I've also been asked, well, since all this came out about an artificial sweetener, is it better to just have a regular Coke? Instead of diet coke and have like the real sweetener and the real sugar versus the artificial sweetener And I would say probably not to be honest There's more research on the negative impacts of sugar sweetened beverages and like the quote unquote real thing and the real coke or the real Pepsi and how that drives your blood sugar up So in that sense if we're trying to control our blood sugar The diet is better because it doesn't have any real sugar in it.
It's not going to have the same impact on your blood sugar. It's not going to drive that up. It's not going to lead to these big insulin spikes. And if you want to decrease any toxins, I would consider having more of these types of beverages in moderation without completely restricting them. And also examining your alcohol intake, especially if cancer tends to run in your family too, because smoking, tobacco use, Alcohol, red meat, processed meats, these things there's more evidence to support that they are carcinogens and can lead to cancer.
So let me know what questions y'all have about that, and I'll definitely link everything up in the show notes. And I appreciate y'all's questions and you bringing me these TikToks and this article so that we could talk about it and kind of open up this nuanced conversation. And keep the questions coming.
I love chatting with you about this and these are really, really important topics to talk about. And especially when the field of dietetics is involved, it's like, I definitely want to have something to say in the conversation because I'm not being paid by these people. And I do have an opinion and I want to make sure that you all are getting the nuanced approach that you can do what's best for you and your body.
to get to your goals. And that's all individual. I feel like I've been asked to like, Oh, like, I feel like this comes up a lot on Tik TOK, but people will say, Oh, it seems like you're very like anti birth control. It's like, yo, I was on birth control for 10 years. I'm not anti birth control. What I am is anti people prescribing birth control to people like without giving them the full scope of the risks and not talking with them about the natural ways to also align your life to your menstrual cycle, to naturally heal your hormones and making it seem like being on birth control is the only thing that people can do, which we know that's just not true.
So I just strive to give y'all all the information so that you can make the best, most informed decision for you and your body. I don't necessarily like care what it is or have a preference. I want you to do what's best for your body because ultimately you have body autonomy. So going off of that, we're going to get into our next big nuance topic for today, talking about weight loss, drugs, and intuitive eating these GLP 1 agonists like Wigovi, Manjaro, and Ozempic.
We're going to talk about what are they? What are the risks? What is the nuance of this conversation? And can you intuitively eat? when you're taking them. So GLP 1 agonists are glucagon like peptide agonists and they interact with our glucose or sugar metabolism. When someone has hyperglycemia, meaning high blood sugar, and it works by decreasing glucagon release to lower your blood sugar.
So basically these medications are making people less insulin resistant. Insulin is the hormone that gets released when you have high blood sugar and insulin. is a hormone that goes into your bloodstream, sequesters all of the sugar, all of the glucose molecules, and takes that out of your blood vessels and goes to different places in the body, like your skeletal muscle and your liver to be stored or used and does a bunch of things.
But it takes it out of your blood vessels. And this is important because if sugar just sits in your blood vessels, it can be very damaging. And this is why you hear a lot of people that have diabetes or poorly controlled diabetes for so many years, they end up having poor vision or diabetic cataracts or neuropathy.
They can't feel their feet or maybe even needing foot or toe amputations. This is because they have damaged blood vessels from having so much sugar Sitting in their blood vessels for so long and when people have high blood sugar for so long It's we become insulin resistant. So insulin isn't as responsive to high blood sugar because it's kind of like well It's just like high all the time So what's the point of getting in there and do anything about it?
Like insulin kind of gets lazy stops working properly So it it just becomes resistant to It's normal cue to start working. So insulin doesn't work as well to lower blood sugar. So sugar just ends up sitting in your blood and doing a lot of damage. So these medications help with that.
These GLP 1 agonists help lower your blood sugar. So they were first used with people that have diabetes. They also have been shown to slow the movement of food out of your stomach and through the GI tract. So it makes you feel fuller longer. So people end up eating less. So overall these medications do have an impact on our brain.
They affect our mood. They affect our addictive behavior in those centers of the brain. They impact our hunger cues by giving us this sense of fullness. It's pretty widespread, the effects, and it doesn't just impact our GI system. it impacts our brain health and our hormones as well. So it has pretty systemic effects in the body.
And it's also important to note that although these medications have a lot of hype now, these meds have been around for a while and they've just gotten more and more popular recently, I think because of a lot of celebrities that are taking them and also because there's a shortage of them because so many people are using them now for weight loss.
They really were for people that have diabetes, and it's actually harder for people with diabetes to get these medications because so many people are getting them for weight loss. According to Forbes, between January and May of this year, 2023, there have been 6 million prescriptions of these.
Medications that is so significant and not everyone has diabetes. A lot of people are using them for weight loss. So these medications were first released in 2005. Uh, they were first used for diabetes in 2010, and then the dose was increased and they were rebranded for weight loss in 2014. So even though we're just hearing about them now, in the last couple years, they've been around for weight loss since 2014.
But it's important to note that when doctors are prescribing this, obviously, if they're a good doctor, um, they're not treating the weight. They are treating people for metabolic syndrome, and that's why they would use this. Meaning you have that underlying insulin resistance. either have or are at risk for diabetes, hypertension, which is high blood pressure, hyperlipidemia, which is high cholesterol.
Um, myocardial infarction, which is a heart attack, stroke, and heart disease. So, metabolic syndrome is when you kind of have multiple of these things, or you're at risk for these conditions, or you have multiple of them. So you just have a lot of things going on with your metabolism and your body. Ah, so that's what people are really treating with this versus just treating it for weight loss.
And it's also important to note that these medications are very costly. They're risky. So by the time people are having conversations with their doctors about these medications, they have tried other treatments, most likely if they have a good doctor, and these treatments either haven't worked or haven't agreed with their system.
So kind of the normal order of events is somebody would try healthy lifestyle behaviors first. Then they would try metformin, which is another medication, and then they would try a GLP 1 agonist. And the dosing of these medications has to be monitored very closely every four to six weeks, and there needs to be a lot of discerning with that, because we don't want people losing weight too fast, we need to manage symptoms, there are risks with these medications, and some nausea is to be expected, but are you having nausea because you're eating less?
It's not eating enough because it's keeping you full, or is the dose too high? So there's just a lot, there's a lot going on there as well. So yeah, nausea is a huge side effect and, um, it's important to note too that just because this is a treatment doesn't mean that it doesn't cause harm. Every medication has the risk of being harmful.
a toxin. I've also heard and have seen articles that people are developing gastroparesis from being on these medications, and that's delayed gastric emptying, which we know that that tends to happen because it's slowing down your gastric emptying to give you that sense of fullness so that you end up eating less.
But gastroparesis is a real lifelong condition where You have just like such delayed gastric emptying. It's more than what the drug is doing. It's a condition where you have delayed gastric emptying like as a consequence of maybe this medication or whatever it is and ultimately people are just having food stuck in their stomach and then they keep eating.
Because they're eating every day as, you know, as much as they can and the food's just piling, piling, piling on top of their stomach. And then the food doesn't have anywhere to go except back up. So people are throwing up and they're noticing that they're literally throwing up food that they had days ago, weeks ago.
And they're like, has this not left my stomach yet? No, it literally hasn't. It's just been sitting there. So, there's, there's a lot of issues with this medication for sure. And I don't deny that people are having those. symptoms and having that experience and are now being diagnosed with gastroparesis as a consequence to being on these GLP 1 agonists.
But I did attend a panel of different doctors and dieticians and practitioners that work with a lot of patients that use these drugs recently and one of the doctors commented on this and said that it's really only a small percentage of people and it might not be the right dosing of the medication.
But you know, it's these medications are still a risk. So it's It's something to consider. There's also a risk because people are eating so much less and maybe aren't seeing a dietitian after they're prescribed these medications. Like when I was in my dietetic internship, I rotated in our medical weight loss clinic and people would be prescribed these medications and then they would have to make an appointment with the dietitian and attend a nutrition class online on Zoom.
And not that many people showed up. People didn't have their cameras on. They probably weren't paying attention. Some people had their cameras on, but they were literally in their car. Some people looked like they were still at work. Like, I don't know how effective these nutrition classes were. And then to go see the dietician, there was like a six month waiting period.
So people would be on these medications for six months, not getting any dietician support. Very, very frustrating. Um, so yeah, there's just a lot of risk that people are getting on these medications, not eating enough, drastically changing how they're eating, not getting counseled in any way, and ultimately are malnourished.
And then say you get in an accident or you need emergency surgery, you're risking not having that surgery like be successful or have your, your healing might be hindered because you're going into that surgery malnourished. So you might not have the ability to heal. And there's also an aspiration risk.
Like if you're going into surgery and. Um, I think most people know this, that they need to fast before they go in for surgery and they call it being like NPO, like you can't have anything by mouth for, you know, you need to stop eating like at least 12 hours before your surgery. If you go into emergency surgery and you don't have time to fast before, And if you have slowed gastric emptying and you have extra food in your stomach because it hasn't left your stomach in an extended period of time, you have a risk of being put under anesthesia and having that food come up and you literally choking on it and passing away.
Like, there's a huge aspiration risk when it comes to surgery. And there's also that healing risk, because you may be malnourished, you may not recover as well from surgery. So that's just another risk to these medications as well. Another larger conversation, this like hurts my heart to talk about y'all, the FDA has approved these medications to be used on kids, even though we don't have the longitudinal evidence that these medications are effective and safe for people over the longterm.
So we are making these decisions to give these medications to children with very little evidence and We know that nausea is a huge symptom and a very common symptom when you first start these medications Like imagine if you are a 12 year old and you just had nausea all day long Like what kind of quality of life is that?
How is that student performing in school? Think of your first semester of pregnancy It's debilitating for people. How would that child be functioning optimally? So, I, I just, I really don't think it's safe for kids, and I think it's teaching them at a very young age that they need, I, I believe it's teaching them at such a young age that their bodies need to be fixed, and being fat is something that you do not want to be, and We need to constantly be striving for thinness, but we also have to consider the other side of the coin here.
What is the impact of being in a larger body? I think we have to consider the fat experience, especially in America. I mean, kids that are in larger bodies are typically picked last for sports games or teams for their gym class. Their clothes might not fit. They're tired. They might be made fun of or bullied more.
So it's, again, there's just a lot of nuance to this conversation. Thank Ultimately, people want to be treated like a human being and not viewed or cared for differently because of their size. And there are a lot of doctors out there that have an anti fat bias or are fatphobic and are prescribing this drug because they're afraid of fat people and they see fat bodies as something to be fixed, but this can do a lifetime of harm for children.
And people are just out here thinking that it's okay to discriminate against people based on their weight and judge people. So there's side effects to the medication, but we also know that there are side effects of living in a fat body in a fat phobic society. No, that just makes me very frustrated and I think ultimately If young kids are taking this medication, like I said, it's setting them up for a lifetime of being concerned about their weight consumed by it.
And that's going to make them more likely to engage in disordered eating habits and more likely to develop an eating disorder. And I know that I said before that doctors are really prescribing this medication for people that have diabetes or this metabolic syndrome. And there have been studies that a Small amount of weight loss, like maybe 10% of your body weight can help alleviate symptoms of metabolic syndrome.
But that doesn't always change someone's world experience and the discrimination that they have navigating as someone in a larger body in our society. So it may alleviate their symptoms, but it may not change their world experience as someone that's in a larger body. So we need to work on this piece.
You know, someone's health and their symptoms as well as dismantling people's fat phobia, which again there's just so much nuance to this conversation and I really see both sides and even though I'm a non diet dietitian and I don't want people to be striving for weight loss or feel this pressure to be in a smaller body and I want people to embrace Not just the body that they have and just work on healthy habits outside of striving for weight loss.
Because I believe that's possible and I've seen it happen in my clients. These drugs are out there. Um, So how do we work with them? So then that leads to the conversation and the question, Can we intuitively eat when we are on these medications? And I think, like, it's yes and no. It kinda depends. It's a drug that increases your fullness cues.
So you end up eating less and you're not as in tune with your hunger and fullness cues. I know and I have talked with people that are on these medications and they'll say that they just don't eat for a long amount of time because they're not getting any sort of hunger cues, but they're not eating enough for what they actually need to be at a healthy baseline for adequately nourishing themselves and they are severely under eating and becoming malnourished, but they're not getting any hunger cues.
So in that sense, it's very hard to intuitively eat. And if people are experiencing nausea, is it because they have incorrect dosing from their doctor? They're on too high of a dose or are they under eating severely? I actually got to counsel a client during my dietetic internship who originally started with intuitive eating.
And she found a lot of body positivity and dove into all the principles and was feeling so good in her body. But then her doctor, because of metabolic syndrome, or I think she had PCOS, so she had the insulin. resistant type of PCOS. She was prescribed ozempic and she started losing weight on the drug and her blood sugar was better controlled and her PCOS symptoms started to be relieved.
And then I saw her for her first appointment back to the dietitian and I was shouting with this dietitian. She was like, Hey, like this is an intuitive eating client. Like, even though she's on ozempic, I would love for you to lead the session because she's going to want to talk about intuitive eating.
And I know you're an intuitive eating counselor. I said, okay, great. I've never worked with someone that wanted to do intuitive eating while on these, this medication, but I'm excited to. Have a conversation with her and she was really struggling with the weight loss piece of it because she said when she was working on intuitive eating, she felt very much at peace.
In her body and loved intuitive eating, but it was her doctor that suggested because of her BMI, which we know BMI is B. S. Which I need to do a whole episode on that, y'all, because it truly is, and if you care about your BMI, if your doctor's like shoving that down your throat, like, We need to talk about that because it's not okay and you do not need to worry about your BMI.
But anyway, she's like, oh, my doctor was so concerned, they put me on this medication, and then I started to see weight loss, and now I'm Like, a lot of stuff is coming up for me and it's hard for me to not be happy about the weight loss. And it's also hard when people are complimenting me in society and saying that, like, I look so good now and what am I doing that's, you know, getting me to lose weight.
And I was so happy before when I was in my body and I had better eating habits, but now I feel a lot of disordered things coming up again being on this medication and how do I intuitively eat when I'm on this? So I only had a one hour session with this client and I would, I have never seen her again cause I don't work at that practice that I was just rotating in for those couple of days.
So I never got a chance to follow up with her, but her and I had a really good conversation and we talked about our healthy habits and making sure that even though she wasn't getting her hunger cues, she still needed to eat regularly and give herself a little something for good blood sugar control and to just have that consistency.
Very similar to what I say to, Patients or clients that have ADHD and are on, um, you know, Adderall or Vyvanse or any of these appetite suppressing medications to help with their ADHD, they don't get a lot of hunger cues, but they still need to eat. So we got to set alarms, just eat a little bit, different things like that.
We also talked about other intuitive eating principles that she could focus on, like discovering the satisfaction factor. When she eats, could she slow down, savor her meals, and make sure that she's making meals that are... actually satisfying to her and things that she's excited to eat and show up for. We also talked about how she can cope with her emotions through kindness and not turn to food for comfort.
So we talked about that intuitive eating principle as well. We also talked about movement and feel the difference that intuitive eating principle. How do we show up for intuitive movement and joyful movement that we genuinely enjoy? So it's not militant exercise. We're not working out to lose weight, not working out to burn calories or to make room for what we ate or to burn off what we ate yesterday, but just moving our bodies because it makes us feel empowered and good and energized.
So that's how we started to talk about intuitive eating. So she's limited with her hunger cues because of the medication, but it doesn't mean that she is now disqualified from being able to engage in intuitive eating.
I would overall recommend that if you are on one of these medications and you want to be engaging intuitive eating that you work with a dietician and a certified intuitive eating counselor because it is possible to be honest and engage intuitive eating, but I think you're going to need some support and you're going to need to talk out and process what comes up for you when you are losing weight, if you're losing weight, what your symptoms are on this medication so that you can have good eating habits while, while on this.
And ultimately, I believe that You have body autonomy. You can do whatever you want with your body. And this is a shared decision between a patient and their healthcare provider to see if being on this medication, engaging intuitive eating, doing a mix of both, works for your individual goals and if the potential risks are worth it for you and your body.
When I was on that webinar with a bunch of different practitioners that work with patients that are on these GLP 1 agonists, someone said this really well. And they said, I find it such a push and pull between not wanting to support the systems and culture in place that enables the discrimination and judgment of people in fat bodies, which leads me to not want to support these medications for weight loss only because isn't that just contributing to our toxic culture that worships thinness?
Like, oh, it's okay if , you're on this for diabetes or like metabolic syndrome, but if you're just doing it for weight loss, then. Like, isn't that just perpetuating, you know, toxic diet culture, um, versus meeting the patient where they are while supporting them in however they need to move through the world in a fat body, which I do not have the lived experience of.
, even if that means they start. You know, getting on these meds and can be treated like a human being. Can we do both? And how? So I hope that that made sense. She was just giving a verbal response and I was trying to write down what she said because I was like, Oh, like the way she worded that was so good.
Like it's this push and pull between not wanting to support diet culture, but also wanting to support people's body autonomy, meeting the patient where they are, validating their experience in a fat phobic society and a larger body. How, how do we do all of that? There's just a lot of nuance and we have to kind of hold space for all of these things and see people as individuals and treat this as a case by case basis.
And again, going back to what I said about birth control a while ago, being honest with people about all of the risks. all of the nuance so that someone can make the best decision for their body to get to their individual goals. So again, there's a lot of nuance to this conversation. I'm happy we opened it up.
Thank you all for sending me DM, sending me questions. Please continue to do that. I would love to continue this conversation. And if there is. If there is a guest and somebody else out there that you follow that would be great to have this conversation with, let me know and I'd love to connect with them and bring them on the show and continue this.
Thank you all for listening and I will see y'all in the next episode.
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