Hello, readers!
It’s a new year, and I’m returning to Substack. I am looking forward to writing more, reading more, and getting to know more of the interesting people on this site. Some of my favorite emails every week — honestly, some of my favorite reading, period — is right here on Substack. I’m excited to dive back in.
Many of you are here because of an essay I wrote for NPR earlier this fall, about coming into my own as a “size inclusive doctor.”
I’ve been overwhelmed with the positive feedback, and shockingly, very few trolls.
Image credit: Nicole Xu for NPR
People are desperate, it turns out, for doctors who don’t yell at them for being fat. I’ve had new patients come see me specifically because they want a fat-friendly approach. They don’t want to be told that every ache and pain is their fault for having a high BMI. They want to be seen as a human, not a number on the scale.
Journalists are also interested. I was quoted in Time, Vogue, and I was a guest on “Talk of Iowa.” I also filmed a TV segment for CBS Sunday Morning, which should be out soon — more on that, later. It’s been hard for me to be the interview subject, not the interviewer. I like to be the one asking questions!
The news hasn’t caught up with many of my forward-thinking patients and the size-inclusive community I love so much.
There’s been a frenzy of news about GLP1 agonists, the medications like Ozempic that can help patients lose weight. That’s among many other things, like lowering blood sugar or preventing heart problems in people who have diabetes. These medications can be life-saving. Some of the more antagonistic interviews I’ve done involved reporters trying to nudge me into saying I don’t prescribe Ozempic, which is just so dumb! It has many different uses in medicine. I do think it’s good to take pause before we assume every human with a BMI over 26 should be on a GLP1 agonist. But I absolutely prescribe these meds, and have been doing so for many years before they were understood to be effective for weight loss.
Part of the problem with the media coverage of GLP1 agonists still is rooted in a fundamentally fatphobic framework.
I’ve been asked about Oprah’s “weight loss journey,” to which I generally replied, “She’s not my patient, none of my business.” (Also, I can assure you, Oprah gives zero effs about what Mara Gordon thinks of her.) I’ve been asked if I, myself, want to take Ozempic. (To that I responded, “That is a rude question.”)
Reporters seem more concerned about the financial cost of Ozempic than what it might cost teens and young adults to be pressured into using these drugs, or what it costs our culture when we start to believe that everyone should have the exact same body shape. They asked me if Ozempic will put an end to the body acceptance movement, when the real question is how the body acceptance movement – an intersectional movement that is, at its core, about bodily autonomy – will make narrow definitions of what it means to have a “good” or “worthy” body obsolete.
I’ve been humbled at how fraught and intimate these questions are. I’ve been humbled by how deep the stigma of obesity runs. I’m grateful for the wise community of fat thinkers and activists whose work helped get me started.
So, it’s a new year. No new year’s resolutions around here, no promises to “get back to the gym” or “give up sugar,” whatever that means. Just the same old me, doing the best I can. I’m excited to be back here in this space, thinking about challenging topics with all of you smart people. Thank you for reading.