Episode 118: The Issues with Weight-Centric Medical Care


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Episode Description

In this episode of The Up-Beet Dietitians podcast, Emily and Hannah dive into the controversial topic of weight-centric care and discuss if it has a place in healthcare. The girls dive into their 7 biggest issues with weight-centric care and break down how this affects people’s quality of care. They then provide alternative options to weight-centric care and what they hope to see incorporated into healthcare in the future. Tune in for a juicy episode!

Episode 42 - BMI

Episode 95 - Obesity as a Disease

More resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386473/

Tune in on Spotify, Apple Podcasts, or YouTube to listen.


  • 0:08

    hello everyone welcome back to another episode of the upy dieticians

    0:13

    podcast Hello everybody welcome back to the Pod I feel like today's episode is

    0:18

    kind of like an OG episode I feel like we've been like really mixing it up this season and trying new things but this one is just like the old days talking

    0:26

    about diet culture and how much it sucks so as you guys know from the title today

    0:32

    we're discussing all of the issues with weight Centric Medical Care we've of course touched on this multiple times

    0:38

    based on like our own experiences and what we hear from like clients and patients and also we talked about things

    0:45

    like obesity and OIC and things like that but today we're going to get specifically into like weight Centric

    0:53

    Medical Care and why it just really sucks so buckle up it's going to be

    0:59

    maybe a little little bit ranty for a few minutes here yes probably quite a

    1:04

    bit of time yeah so we'll just dive right into it because we're going to have a lot to say so just in general the

    1:12

    traditional healthc care model which I'm going to say this is specific to Western medicine I don't know much about other

    1:20

    medical systems but this is going to be specific to Western because that's what we know best we work in it we were we

    1:26

    were brought up in it we are very exposed to this so traditional Health

    1:32

    Care kind of tends to be more weight Centric meaning that there is this heavy emphasis on BMI and weight being

    1:40

    utilized as a measure of health so essentially like if you're in a larger

    1:46

    body you're viewed as being less healthy and since weight and BMI emphasized so

    1:52

    much that just keeps being pushed and pushed yeah exactly as we've alluded to

    1:59

    before and you guys likely know if you're not new to our podcast like this obviously can do more harm than good

    2:05

    when all we think about is someone's body weight like it's all we're looking at when we they come to the doctor's

    2:10

    appointment they are there for a sore throat but because their BMI is overweight or obese which by the way

    2:16

    we'll be using kind of in like air quotes today we talked about this in the Obesity episode way back which we'll link below um but don't really jive with

    2:25

    those terms but to kind of tie it into this episode will be using them but with with good old Air

    2:32

    quotes um but if someone comes to their doctor with that non weight related issue but their weight is an issue to

    2:38

    that doctor the doctor or whatever provider might bring up weight as an

    2:44

    issue even though it's not taking away from the care of the actual issue at hand which sucks yeah which sucks I've

    2:51

    heard just so many stories from people in my DMs people in real life like patients and

    2:58

    clients like we are not just saying this because we

    3:03

    are like weight neutral dietitians we have all this bias against like using

    3:09

    weight in health care like no like we see this like all the time causing

    3:15

    problems with people we also have studies to back it up too which we'll link some of those below

    3:21

    too yeah and it unfortunately goes beyond the Health Care system which

    3:27

    makes sense from where it comes from because we were like taught this weight

    3:33

    Centric model to follow every single case study we did in college we had to

    3:38

    calculate the BMI like it was never relevant but no always why why I you're

    3:49

    so right I like thinking I'm like why did we do that but we always had to

    3:55

    identify the case studies BMI even in like our exercise classes

    4:01

    too like when we're talking about like training clients hypothetically like in our like x fiz classes and stuff too

    4:07

    always calculating BMI yeah it is crazy how much power BMI has

    4:16

    over the education system the healthare system the

    4:22

    world we are giving this tool too much power I mean we'll get to this but like

    4:28

    insurance companies are looking at bmis like it is used so frequently and it's

    4:35

    literally just a ratio of height to weight which I feel like we shouldn't go too much into BMI we have a whole episode on it but I was gonna say that

    4:41

    go listen to our BMI episode it is very good also very ranty but we really dive into BMI and

    4:49

    why it's such a silly little tool yeah in this world we live in

    4:56

    so well before we get into sort of our folded list of all of our issues with this model I also wanted to just address

    5:03

    sort of my history and our history together even speaking to like how we

    5:09

    were raised under this weight Centric model like if you listen to all podcasts

    5:15

    you'll hear us talk about things differently I used to work as a weight loss dietician like straight up

    5:21

    prescribing weight loss for every single issue for my patients boo to that

    5:28

    like I guess I'm just bringing this up because it's showing

    5:34

    how like again like how Norm not normal is normative the right word like it's

    5:40

    what's happening like we don't question these things yeah like we don't question

    5:45

    these things until we have a reason to question them so like for Me Maybe maybe you two Emily like being in the field is

    5:53

    what led to me like having this change of heart so if you maybe are like brand

    5:59

    new to this concept and you like read this title and you're like what do you mean the issues with potential care like nothing wrong with that like I myself

    6:07

    and this BMI so I should be losing weight it's not hey for me like we were there too and not to say that your

    6:15

    beliefs are wrong but there's just a lot to think about and to talk about when it comes to all this and I guess that's the

    6:20

    point of today's episode is just to raise awareness I think it's overused

    6:26

    but that's what I'm trying to say I think I think that's a good way to put it

    6:32

    we're here to provide another another perspective as providers who work in a

    6:38

    weight Centric world and don't have weight Centric philosophies but we're at

    6:45

    one time part of the problem so we can kind of speak from both sides so look at that growth look at that growth we love

    6:52

    that grow so let's get into it so I feel

    6:57

    like I'm already not going to be Happ happy I'm I'm sweating like I have

    7:02

    sweaty hands but it's okay what's you yeah so start off the first issue with

    7:09

    the weight centering model is BMI we're not going to go a ton into BMI listen to the episode listen to our obesity as a

    7:17

    disease episode we'll link both of those in the show notes and essentially just

    7:23

    like you can't the long story short you can't identify someone health status by

    7:31

    their VMI it's an incredibly flawed tool it's one data point and this whole

    7:38

    plethora of health and it

    7:43

    is heavily utilized because it's cheap and quick and very

    7:51

    discriminatory I don't know if I'm I don't know if it's being used honestly because it's discriminatory but it's an

    7:56

    easy tool to use and it ends up being very harm harmful yeah and I don't want to speak

    8:02

    badly about all doctors and P pasas because of course there's really good ones out there and ditions are on the

    8:08

    bad end of things too sometimes but that happens all the time like as someone who works has a history of working in a

    8:17

    large system with just you know good old charting like what happens is you put

    8:24

    your patients's height and weight in it calculates BMI if it is overweight or obese it is red or underweight too which

    8:31

    is good I'd say that it pops up red so that's like the first thing that your eyes are drawn to on their chart in the

    8:37

    system that I've experienced with anyway and some providers see that not it's not

    8:43

    flashing but I was going to say flashing red but doesn't flash that'd be crazy that red number though and they're like

    8:49

    we have to talk about this because it is an issue for this person yeah and you're already like just making you're even if

    8:56

    you're like subconsciously doing it you're making an an assumption about someone before you're even going in just

    9:03

    based off of that bolded red box or whatever it's true like pre-charging

    9:10

    patients like we can see all of your past weights and all of that and I'm

    9:16

    sure there are plenty of providers who see a patient for the first time and

    9:21

    before they come in they see their weight is whatever number the BMI is whatever number and like you just said they kind of make a a snap judgment

    9:28

    about that person Health based on their weight history

    9:34

    yeah H one not great data point like Emily

    9:39

    said yes this one so yeah that is one of the issues isue number two kind of goes

    9:46

    right along with it but contrary to what diet culture will tell us weight does not equal Health we often see people

    9:57

    like complimenting weight loss because we feel like their health is improving they're so much better off now that they're losing weight and on the flip

    10:04

    side if someone gains weight you're like oh my gosh what's going on are you okay you must be getting sick their health is

    10:10

    getting worse because they are gaining weight that is just like not necessarily how it works in fact being underweight

    10:17

    again like all based on BMI here but being underweight has a higher mortality

    10:23

    RIS than being overweight or even obese um I think I can't quite remember in terms of ranking is it overweight has

    10:30

    the lowest mortality risk then normal weight then obese and then underweight

    10:36

    so being underweight is right yeah which is like

    10:42

    romanticized right exactly but being at a lower weight and again you know we

    10:50

    can't necessarily say that being naturally thin is a bad thing because being naturally larger isn't a bad thing

    10:57

    but like Emily said it's romanticized and it's glorified in this way that we were always pursuing being as Sin as

    11:03

    possible below what our body wants to weigh and when that happens we do have that risk of that low weight being

    11:10

    linked to things like you know weakened bones and fertility issues poor healing

    11:17

    poor recovery from illness so and of course like you just said higher mortality risk as well

    11:24

    so it's like when in the weight Centric model like being overweight or obese is

    11:30

    what is so demonized but usually those people are actually healthier than those who are according to thei

    11:38

    underweight yeah and it's just because we live in a

    11:44

    like thin focused diet culture ridden

    11:50

    world that in a very fat phobic world that there's all this emphasis on

    11:57

    weight and like you said the weight loss is always

    12:02

    complimented I hear people talk about like I'll just be out in a restaurant or

    12:08

    out and about and I like recently heard some this like group of people talking

    12:13

    and they're like have you seen so and so recently they look so good and they they're like yeah they lost 30 pounds

    12:20

    and I'm like this is what we're taking our time to talk

    12:27

    about like I am one I am all for gossiping but not like there are more

    12:33

    fun things to gossip about than someone's changes in their body that's incredibly boring yeah and like

    12:42

    yeah like meanwhile Emily and I were just talking about before we got on air

    12:47

    about like selling eggs and how much money and our child birth yes and our

    12:56

    babies marry themselves in inst I think that's way more fun than

    13:01

    discussing our weights yes much more fun we're entrepreneurs if I say

    13:09

    myself uh but there are other things you can utilize to measure your health so you're probably like well I

    13:16

    hope I'm not going to assume what you're thinking about health but weight is placed so much on that pedestal there

    13:24

    it's kind of like other things are forgotten like Health markers like lab value blood

    13:30

    pressure things of that sort are a little bit more objective

    13:35

    and can improve even if someone's weight doesn't

    13:41

    change happens all the time all the time and then like Hannah said actually

    13:48

    I don't know if you said this I might be confusing this with like the other 50 episodes we talk said what we said is

    13:54

    that like there isn't any evidence that says weight to loss weight weight a loss

    14:01

    weight loss alone cannot improve a person's health or lower their risk of

    14:06

    disease like weight loss and weight changes in weight is not a behavioral

    14:11

    change it's an outcome people make like changes to their dietary

    14:17

    habits their physical activity levels things like that might lead to weight loss but it's not like oh I'm going to

    14:26

    start like compare like I'm going to start eating being a vegetable a day compared to like I'm going to start

    14:31

    losing weight and suddenly it happens that's not how it

    14:37

    works right right I don't think I said that this episode but I've definitely said that until I was bleue in the face

    14:43

    a million other times and I probably will just continue to say it until

    14:48

    everyone understands it but yeah we have this concept because again of diet culture and all those things

    14:55

    that okay but what about like type two diabetes and heart disease it's all because people are getting fatter right

    15:01

    but we don't have any evidence that shows that direct correlation there or that direct causation excuse me there is

    15:08

    correlation but there's not causation um and those are very different things so

    15:15

    we just can't say that if someone has type two diabetes that losing weight is going to get rid of their type two

    15:21

    diabetes it's just not how it works people of all siiz bodies get heart disease type two diabetes have bad knees

    15:27

    have bad backs it's just more complex than that one

    15:32

    data point the number on the scale so fun so fun I'm so glad we went

    15:38

    into this as a profession um our next issue we'll just

    15:44

    keep this fun train going is maintaining long-term weight loss is difficult and not even always

    15:52

    possible like it's not I know I'm going to trigger Hannah it's not as simple as

    15:58

    a calorie deficits like genetics plays a role into our weight social determinant of Health

    16:06

    play it role are like body's natural biochemical processes fight against

    16:11

    weight loss the body does not like to change and weight loss is a pretty big change and it will fight to remain

    16:18

    stable maintain that homeostasis and dieting is the number

    16:24

    one predictor for am I seeing this wrong dieting is the number one predictor for weight gain

    16:31

    after weight loss or is it dieting is the number one predictor for disordered eating could be

    16:36

    both both could be both but many Studies have shown that after

    16:43

    two years people gain the weight back and it's incredibly hard to keep off especially with those

    16:51

    extreme methods that people are utilizing and that diet culture is pushing it's not like the people's it's

    16:58

    like this system is setting you up for failure it's not sustainable so they make you come they're making sure you

    17:04

    come back and give them more money yeah I I have said this hypothesis before and

    17:10

    it is just a hypothesis I think as far as I know anyway maybe there's some that's proved

    17:15

    it but people are always talking about you know oh we have this obesity epidemic everyone's getting bigger we

    17:22

    need to stop it but more and more people are dieting and like restricting

    17:30

    maybe that's what's leading to this quote unquote obesity epidemic like because we know that dieting and

    17:35

    restricting can actually just lead to this weight cycling and weight regain have we ever considered that maybe that

    17:41

    is what is leading to people continuing to put on weight beyond their body set

    17:47

    point happy weight because they're constantly restricting and their body is always trying to fight back against that

    17:52

    leading to that weight cycing that leads it to go back [Music] up

    17:59

    just a thought we are it is a very interesting hypothesis I've

    18:04

    never thought about it that way but that's true like as time goes on like a 100 years

    18:11

    ago what year are we 2023 100 years ago there were probably

    18:17

    still diets like some some type but not nearly as accessible and as market like

    18:25

    heavily marketed as they are now well and now like it's so disguised like wellness

    18:33

    culture and just clean eating and I mean orthorexia basically in a nutshell

    18:38

    like pretty much everyone is dieting and they're usually getting praised for it but it's actually just a sorted eating

    18:44

    in Disguise yeah and I want to mention too with my hypothesis that I fully believe

    18:51

    that there is always been people in larger bodies in the world obviously yeah so that's that's the other argument

    18:57

    against the Obesity epidemic like there's always been people that are just in the overweight and obese category

    19:03

    that's just how bodies work but if there is that rise where there's more and more

    19:08

    people in larger bodies I do wonder if it has something to do with just the constant dieting and

    19:14

    restriction and the yo-yo dieting and the weight cycling and all that goes along with it something interesting to

    19:20

    think about maybe my new life's work will be doing whatever has to happen to

    19:25

    prove that I don't really that would look like it'd be a lot of long-term research I

    19:32

    might die say a lot of research which I don't actually like to do so that'd be interesting totally fine

    19:40

    we'll have to find someone else to do it for you yeah I'll just be the I'll be the um the spokesperson the face of the

    19:47

    there we go the movement well you mentioned weight cycling I know I'm jumping down but you

    19:54

    mentioned white cycling so I want to talk about We Cycling me too

    19:59

    and if you're not familiar with this term it's essentially when people like dramatically lose a lot of weight from

    20:05

    dieting and then reain the weight in in most cases even more than they lost in

    20:11

    the first place and it's this like yo-yo dieting where you're kind of going back and forth back and forth and yo-yo

    20:17

    dieting has been shown SL weight cycling has been shown to have negative side

    20:22

    effects that like is linked to a shorter lifespan it's linked to increase risk of

    20:29

    type two diabetes high blood pressure high cholesterol and heart disease and it's

    20:35

    possible there's an association between the weight and the health RIS can be attributed to the weight cycling more

    20:42

    than the body size because you're just throwing your body in this Loop like back and forth back and forth back and forth freaking it out putting in fight

    20:49

    ORF flight it's trying to do everything it can to just remain as it is but

    20:54

    because all these extreme changes are getting thrown at it it it's not happy

    21:00

    and not stable exactly like a person who maintains a little bit of a higher

    21:07

    weight but they're about that weight for most of their adult life of course we're going to fluctuate a little bit but they

    21:12

    are likely going to have again depending on many factors but possibly Better Health outcomes than someone who was at

    21:20

    that same weight but then lost 20 pounds gained 30 back lost 40 gained 10 back

    21:25

    because of that weight cycling that person is likely going going to be at higher risk like Emily said typ to diabetes high blood pressure all those

    21:32

    things because of that weight cycling even though now they're at that lower weight than that person who just maintained that higher weight but that

    21:39

    weight cycling puts so much stress on their body that at least those possible negative

    21:44

    outcomes yeah that doesn't get talked about very much the weight cying piece it's like again it's so it's so

    21:51

    glorified to lose weight like you get praised from Friends peers doctors your

    21:56

    all your providers probably and so so many cases that we don't think about

    22:02

    how our body is actually reacting to that weight loss because even even if you are sustaining weight loss and you

    22:09

    maintain it for the rest of your life like even that act of losing weight probably puts some stress on your body

    22:15

    and again we can't say that every person who loses weight is like worsening their health like again there's two sides to

    22:22

    this coin but it just gets so again like glorified

    22:28

    even though we don't really see the big lifespan picture where they could gain it back maybe this is the end of them

    22:36

    you know losing and gaining the same 50 pounds for the last 40 years which has led to all the stress on their body it's

    22:44

    just H it's just not as simple as oh you lost weight you're

    22:49

    healthier and it's not that simple or black and white like we want

    22:54

    nutrition and health to be right well I feel like the biggest issue with the

    23:01

    medical care piece specifically is the weight stigma side what we've mostly

    23:06

    been saying so far honestly has been just like why weight and health aren't really correlated which is why I think

    23:12

    that Medical Care shouldn't be so weight Centric but let's talk about weight stigma which is I think the most

    23:19

    inherent like thing that's happening like in this weight Centric

    23:24

    Medical healthc Care world so oh boy oh boy people will say this

    23:33

    doesn't exist which is crazy to me like it's usually people who haven't experienced it will say it doesn't exist

    23:40

    yeah yes or people who just don't see it as bad thing because they hate bad people yes

    23:47

    yeah so there're two types of people in the world no there's

    23:53

    not yeah yeah well what weight Sigma is it is the internalized negative

    24:00

    attitudes and discriminatory acts targeted towards individual individuals because of their shape size or weight so

    24:07

    basically what we've been describing where people in larger bodies are treated worse simply because they have a

    24:13

    larger body and there's tons of examples of this and if you are a person who has

    24:19

    a larger body you can probably give me about 18 more examples of this just from

    24:24

    the last two months of your life I'm guessing because people suck um but even in medical care specifically there are a

    24:30

    lot of things um like receiving negative comments about your weight including

    24:37

    again like from your doctor your dietician your endocrinologist whoever

    24:44

    um it can also happen in the workplace you know poor treatment by co-workers or bosses because of your size or shape not

    24:49

    getting a job because of your size or shape not getting a promotion because of your size or your shape um we talked

    24:56

    about insurance a little bit but but higher insurance premiums because they're going to ask for your weight and

    25:02

    possibly charge you more if you are at a higher weight because they think that being at a higher weight automatically

    25:09

    increases your disease risk um this one I see probably the

    25:15

    most not personally but like I see happening to people that I

    25:20

    know as patients but being required to lose weight for a medical procedure such as a joint replacement an organ

    25:26

    transplant or infertility treatment I see that a lot with kidney

    25:32

    transplant I was going to ask you yeah you see that what I do and I hold this

    25:38

    against the hospitals I do it um so just so you know admins at these hospitals I know what you're

    25:44

    doing um I'll send the patients to hospitals that are a little bit more

    25:50

    open-minded yeah you have to play the system that's the world of healthcare

    25:56

    like I can't get a new kidney because my BMI says that I'm unhealthy like I've

    26:02

    literally had multiple patients who like their

    26:08

    labs are every single month like right where they need to be they are doing

    26:14

    their dialysis treatment they are like following the dietary recommendations

    26:20

    they take like they're prioritizing their health so they

    26:25

    can try to set their body up for like the most seamless transplant transition

    26:32

    and they'll be categorized as like overweight or obese and they will not like take them

    26:40

    or put them on the list and I'm like insane what so they're not allowed to

    26:46

    get on the list even though like I said labs are better they're prioritizing all

    26:51

    the good things but maybe someone who as a normal weight is on the list even though they

    26:58

    aren't having as good as this person yeah it's crazy and so frustrating I'm

    27:06

    literally like if you were normal you were at a normal like categorized at a normal weight you would have had a

    27:11

    transplant by now and that's so frustrating I've seen lots of patients

    27:17

    who have told me that they were advised to lose weight before they could start infertility treatments like they

    27:23

    couldn't do IVF until they lost weight I feel like the biggest one I see is joint Replacements they won't do their knee

    27:29

    replacement until they reach a BMI of 40 uh so frustrating especially because

    27:37

    again people of all size sizes can get knee injuries and have knee issues but

    27:42

    also their knee hurts so bad they're pretty much immobile they can't exercise

    27:48

    so weight loss becomes even more difficult for them and so they're just like stuck between a rock and a hard place because they need to lose weight

    27:56

    but they can't do a whole lot about it because their knee is so effed

    28:02

    up H it's frustrating I can only imagine how frustrating it is for those who actually

    28:08

    are experiencing it yeah it's crazy and I want to point up before

    28:15

    we move on to our last couple points that this is even worse for those who not only are in larger bodies but also

    28:21

    have other stigmatized things like a disability

    28:26

    people love certain races genders ages sexual identity all these things can compound together for

    28:34

    just like all this again like compounded stigma that leads to all these negative

    28:40

    Health outcomes so it's bad enough if you are in a larger body but if you've got a larger body and all these other

    28:45

    things too that everyone also doesn't like it's rough out there for those

    28:51

    people it is so that's why we just want to talk about it and raise awareness to

    28:57

    to it and hope that other providers will hear this

    29:02

    and open their minds up to it so they can help out those who are fighting against the

    29:09

    system because the system was not created in a sense to favor them

    29:17

    correct well we've got a couple more these should be quick because we can

    29:23

    definitely piggyback off other episodes but the other issue obviously at least obvious to us with this weight Centric

    29:29

    Medical Care is the possible development of disordered eating and eating disorders I'm not going to go too much

    29:35

    more into that because we've mentioned it a little bit already and also we talk about it constantly but of course when we're telling someone to lose weight all

    29:41

    the time without even like screening them for any kind of disorder to eating or eating disorders that's one thing

    29:47

    that never happens unless you like show signs for it and even then people aren't

    29:53

    really trained to look for those red flags of disordered eating and so again they might glorify them like oh you're

    29:59

    intermittent fasting you must be so healthy that's so good for you like keep it

    30:04

    up so that's one thought on that one before I move on to our last bullet

    30:09

    point I don't have anything to add we we talk about it all the time all the time I'm honestly I don't want to say I'm

    30:16

    tired of talking about it because it's very important to me and I'll keep talking about it but it's just

    30:22

    frustrating that this just keeps it keeps happening it never is going to go away it feels like yeah

    30:27

    um but our last Point we've also talked about a million times before but if providers do prescribe weight loss

    30:34

    medications Andor bariatric surgery because they're telling their patients they need to lose weight for

    30:40

    whatever reason of course there are lots of side effects both of these things I know right now OIC is having tons

    30:47

    of stuff coming out side effect wise and we know barric surgery has you know lots

    30:55

    of stories there too so there is the risk of that if those options are pursued or strongly encouraged by your

    31:02

    doctor even if you don't want to do them but because you're fat they said that you

    31:07

    should yep that's kind of the exact like

    31:14

    thought process yeah for those providers of that your body is wrong let's amputate your

    31:20

    stomach to take care of that problem but now they're doing it in a way where they're trying to make it seem all like

    31:27

    body positive and stuff it's like all the different like weight loss websites that are like what do they say I don't

    31:35

    know they basically just like hijack the non-diet language to make it seem like it's it's loving your body

    31:42

    when you amputate your stomach that's because you love yourself that's why you should do this I was actually listening to a

    31:49

    podcast today and one of the ads that were set up which I'm hoping never is an

    31:55

    ad for us because I think we turned them off um was like are you sick of extreme

    32:00

    dieting blah blah blah blah blah blah blah join goo and I'm that was going and

    32:07

    I was literally like getting so mad one because I was driving so I couldn't skip

    32:12

    ahead and I had to sit through this ad and I was like

    32:19

    it's it's very easy to me to see they have good marketing teams they have very

    32:24

    good marketing teams that they put a lot of money into and they know what the people are

    32:29

    talking about so they just jump on to like that Trend even though like non- Diet

    32:38

    like is not a trend it's a different way of practicing medicine I don't know if I'd

    32:44

    say we're practicing Healthcare yeah providers are

    32:49

    practicing their skill yeah we know what you're saying

    32:56

    yeah yeah but yeah I think that is what makes us even trickier is people are pretty aware now most people are anyway

    33:05

    that those crazy restrictive diets where I guess not everyone is this aware but

    33:12

    where it's like if you eat an egg for breakfast and wine for lunch and that's it for the next 40 days you'll be skinny

    33:19

    and healthy like most of us now are well aware that like those things are crap

    33:25

    but the things like Emily just said or like n all these things that like use

    33:31

    the non-diet language and sell their disordered eating if you don't know what to look

    33:37

    for they're G to get you and they're going to sell really well to you and that's why this is even more difficult because we don't even know what to look

    33:43

    for and all these companies are making it harder to identify what's

    33:50

    right and what's wrong or what's not right and wrong what's helpful and not helpful

    33:55

    yeah let's propose our solution yeah our

    34:01

    solution is weight neutral care for everyone like like SpongeBobs like

    34:09

    rainbow yay essentially it's like a concept of weight inclusive care crazy

    34:16

    where health is not defined by your weight and people in all body sizes

    34:21

    receive the same level of care and medical attention and it sounds very

    34:27

    simple but I feel like you're promoting obesity right now I actually yep yep

    34:33

    that's what I'm doing I yep that it's like as simp it's

    34:40

    literally as simple and as not simple because the world does not will not make

    34:45

    it simple as just treating a person without allowing the bias of their

    34:51

    weight to get in the weight of your care and this doesn't mean that like

    34:58

    weight has no impact on your health in any way mental or physical it is a

    35:03

    component of your health like we talked about it's one data point but it's looking at the bigger picture and not

    35:09

    just this one thing where like someone comes in for a sore throat and weight loss is recommended someone comes in for

    35:15

    a sore knee weight loss is recommended we're not looking it's like taking that

    35:22

    into account but looking at other things going on like I don't know maybe they maybe they have the flu run a swab test

    35:31

    maybe they have some type of like inflammatory disease going on check their Labs don't just it's

    35:39

    beyond just their weight and it doesn't mean we can't discuss it but it's like the way you

    35:47

    discuss it with the patient there is a way to discuss weight without being

    35:52

    triggering and it's something that I say more newer providers are

    35:58

    adapting that language but it's we there's a lot of people

    36:03

    who do not speak about weight in a non-triggering way yeah and I think it

    36:10

    should be the patient's choice too like if they want to bring up concerns they have about their own body weight by all

    36:17

    means like bring it up and talk about it and like as a dietitian working with clients who know that I am a weight

    36:24

    neutral dietitian I always tell them like we can still talk about your weight and they'll bring it up the concerns

    36:30

    they have about their weight and we'll talk about it but not in a way where I'm like oh yeah you're totally right like

    36:35

    your body is too big let's talk about how to cut calories like it's not off

    36:41

    the table we're just talking about it completely differently than how it's usually happening right now and it's the

    36:47

    patient's choice to bring it up I'm never going to bring up a patient's weight and say oh I see in your chart

    36:52

    last time you got weight it was this let's take care of that as a problem because obviously your health

    36:58

    is getting worse because of that one number yep that's not happening and we

    37:05

    have to also acknowledge which I don't think I don't know any health care policy like screening

    37:14

    system that acknowledges or looks for the risks that come with weight loss

    37:19

    like that's not even talked about all definitely yeah but or I think of like

    37:26

    medication commercials like I've never heard one say you might lose weight on this be warned but they will say weight

    37:33

    gain is a possible side effect yeah I have heard them talk about weight loss

    37:39

    but it's always spun in a positive way like you might also they say like you might also

    37:46

    lose weight kind of like OIC being for diabetes but now being for weight loss

    37:51

    yeah yeah it's the way they like the positive versus like the negative verbage around it

    37:57

    exactly and to just list off the many other positives that come with weight inclusive care and why we want it it's

    38:05

    linked improvements in not limited to the following but we'll list off a few

    38:10

    General Health behaviors of like increasing movement and more nutritious food choices improvements in blood

    38:17

    pressure cholesterol levels self self-esteem and mood Body Image Weight stability eating behaviors like

    38:24

    reduction in disordered eating which is great we don't want to drive them to an eating disorder and engagement levels so

    38:31

    like lowering Dropout rates stuff even beyond that like it is crazy how much a

    38:40

    switch in our mentality around weight and how we Counsel on weight and talk

    38:46

    about weight can change someone's Health it's also evidence-based and

    38:52

    ethical we'll throw that in there I think that's the main point like that's the main I think that should be reason

    38:58

    enough for us to just like ditch this weight Centric model is like we have evidence to back up that weight

    39:04

    inclusive care it's Health promoting it's also ethical and people are going

    39:09

    to feel better about themselves and not have as many Eating Disorders like would

    39:14

    that be the worst thing people fing about themselves like is that is that so bad like sure you might make less money

    39:21

    insurance companies but really like if people like themselves a little more is that really so bad

    39:28

    we live in a capitalistic World capitalism and I don't know if you've seen this guy okay I promise I'm not

    39:34

    going to draw this out because we're literally on the last B done and we're not gonna extend this for another 20

    39:40

    minutes I'm gonna make this very fast have you seen that one guy on Tik Tok his skits who he's like oh I didn't want

    39:48

    to work today and he's like I'll sad he's like but the shareholders I have to do it for the shareholders and I'll send

    39:56

    you one his videos he so funny he's done done another one he's like the pizza party I have to show up and put in 110%

    40:05

    to get my pizza party and it feels very much like that we're like all these changes would be very great but

    40:11

    unfortunately at the end of the day it's very money driven um so maybe from on

    40:16

    the inside we can just change it and that your mission will be to educate on

    40:21

    this my mission will be to take down insurance companies oh I like it together we will rule the world I like

    40:29

    it in a weight inclusive insurance free world healthc care for everyone imagine

    40:36

    what a radical concept that a lot of other countries have successfully implemented and look how much happier

    40:43

    they are and better off they're doing it's like we're not the only ones

    40:49

    who have this idea it's crazy it's

    40:54

    crazy okay well that's my rant we're we're not g to stay long be a whole

    40:59

    other episode yeah so that's weight Centric Care we're gonna keep it light

    41:05

    in the bonus question today so if you're wanting a more light-hearted hily

    41:10

    conversation head over there but yes this is weight Centric Care and why it sucks so

    41:15

    hopefully if you're new here you learned something new and if you've been around for a while hopefully you enjoyed a

    41:21

    little ranty rant which we haven't done in a while it's been fun

    41:27

    we hope you guys learn something definitely go listen to the bonus question it's going to be fun I have a

    41:32

    fun answer in mind oh um I don't know I was thinking about it as I just read it

    41:38

    um so I'm excited to go over that with you and share this food combo with you

    41:43

    kind of a spoiler but I'm excited for you to hear about it but we'll catch you guys next week thanks for listening

    41:50

    and take care take care how old are you I've never said that before I don't want to

    41:58

    be I'll sign off like my email my email sign offs all the best to you all the

    42:03

    best yep I I like all the best born I like saying all all the best I like saw

    42:08

    someone use it I'm like that feels a little bit more personal I like that I like that but if it's someone I don't like I definitely change my email

    42:15

    signature oh this would be a good bonus question like what your signature says about you okay we'll hold this off for another

    42:22

    one okay bye guys we'll let you go that bye guys


The Beet Deets Bonus Segment

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In this bonus episode, Emily and Hannah debate which is better: What is the best Food Duo? Tune in to hear more about Hannah's throwback to Purdue dining courts, Emily's experience with Chicago food fests, Hannah's recent ice cream stock, Emily's texture discovery, and their significant other's interesting food choices.


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