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Big Sexy Chat Podcast
Healthcare Havoc: Breaking Bias for Size-Inclusive Care
Regan Chastain, a powerhouse advocate for fat liberation, joins us to tackle the insidious nature of medical weight bias and the challenges it presents in everyday scenarios, from healthcare settings to holiday gatherings with family. Discover strategies to combat unwelcome comments about your body, especially during Thanksgiving, and learn witty comebacks and boundary-setting techniques that empower you to manage those awkward family moments with confidence.
Our conversation shines a light on the alarming impact of weight bias in healthcare, where corporate interests have influenced perceptions and practices that disadvantage higher-weight individuals. We delve into the tactics needed to advocate for weight-neutral care, sharing insights on how to ensure respectful treatment during medical visits. Regan highlights the importance of organizations like Medical Students for Size Inclusivity, which are leading the charge toward equitable healthcare for all body sizes.
Addressing the roots of weight stigma in medical education, we explore the systemic exclusion of higher-weight individuals and how this bias affects research, medical training, and patient outcomes. Through personal anecdotes and emerging research, we reveal the long-term consequences of weight stigma, emphasizing the urgent need for patient empowerment and systemic change. Join us in this crucial dialogue as we navigate the complex dynamics of healthcare and champion the right to inclusive and respectful treatment.
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Welcome to Big Sexy Chat. Today we're diving into the critical topic of medical weight bias with the brilliant Regan Chastain. As a speaker, researcher and advocate, regan is on a mission to transform healthcare by challenging weight stigma and promoting respect for fat bodies. From her groundbreaking weight and healthcare newsletter to actionable ways we can combat bias, this is a conversation you don't want to miss.
Speaker 2:Hi, welcome to Big Sexy Chat. I'm Crystal, I'm Murph. We're just two rat fatties sitting around chewing the fat Twice a month. We'll be chatting about current events hot topics sex, sex toys, fat politics, fat community cannabis, cbd you name it. We're going to talk about it. We are very excited to have you a part of our community. Welcome and enjoy.
Speaker 4:Hey there, welcome back to Big Sexy Chat. My name's Crystal and I am so honored today because of all my amazing co-hosts. Is here with us tonight, Murph. And then we also have the privilege of having an amazing guest on tonight, Regan Chastain and I'll tell you more about her in a second, but I want to give Murph and Regan a chance to say hello, Hi. It's so nice to see and talk to everybody, hey everybody.
Speaker 3:I am so excited to be here. Thanks for having me, y'all.
Speaker 4:Thank you, regan, thanks Merv. Okay, so let's get into this. Regan, last time you were on our show, or the first time, first and only time, I think, we had you talk about dealing with your family members that supposedly love you at the holiday time, when they want to comment about our bodies and what are some things that you. Before we get into the strategies for dealing with anti-fatness in medical care, before we get into that, just could you give us a couple comebacks that we might be able to just sling at our family members, just like just to shut them down.
Speaker 3:Sure. So I, first of all, I want to say the most important thing to remember always is that this is becoming your problem to deal with, but this is not your fault. This shouldn't be happening. And so, even if it's a situation where you can't or don't want to respond, putting some space between you and the comment by realizing like, oh yeah, this is anti-fatness and I'm going to have to deal with it, but it's not my fault, can help you from internalizing the negative messages and help you kind of move away from that situation feeling okay Some of my favorites.
Speaker 3:So when someone says I'm just concerned for your health, I like to say, oh, please, unburden yourself. I don't need that from you at all. I have like a whole group of healthcare providers who support my health, so we can just have like you can just be my aunt or whatever. There's also a three-step boundary setting process that I use, where the first step is to say what you need, and you might do this before the holidays if there's a repeat offender, right? So hey, you might not realize it, but every time we see each other at the holidays, you say something about my food or weight and I just need to talk to you about that, because it's not okay for you to do that. I need you to stop and you can explain why or not. You can say like I'm working on my body image, or my therapist says it's harmful to me, or you can just say I don't want you to do this anymore. And then the second step is setting a consequence, and it doesn't have to be something big, but it does have to be something you can follow through with for sure. Right, so you might say, if it happens again this year, I'll just take my plate into my room or I'll leave and we'll try again next holiday, or I'll just have to stop interacting with you this year. Right? Just something that you are sure that you can follow through with.
Speaker 3:And then the third step is, if it happens, follow through and make sure the person understands they are experiencing the consequences of their actions. Right, you know what we talked about this. I said it wasn't okay. I told you that if you did this I would leave, and you did it, and so I'm leaving and I hope next time you can act better and respect my boundaries, and so that can be a really helpful tool to negotiate and you can, like I said, you can set that boundary ahead of time, or you can do it in the moment, at Thanksgiving dinner, and just be clear, because what happens when people step on boundaries is that they want to turn around and victim blame, right, oh, why are you ruining dinner? And so, being clear, I'm not ruining dinner, you ruined dinner. I made a simple, clear request and you wouldn't respect it, and so I'm going to do what I need to do for myself and I hope the rest of you have a great time, and so I think that can be super helpful in terms of just navigating those situations Hashtag boundaries.
Speaker 4:Boundaries are sexy. Those are the best ones. I love to say something along the lines of ew, it's getting a little creepy that you're monitoring my body so much. Is there something I should know about? That kind of makes them feel, oh shit, which is what I want. I want them to live.
Speaker 4:One of the things I like to say is you know, if it's a comment of like, oh, I can't eat that, or whatever I usually like, touch my belly and say you might end up looking as good as me. I wouldn't do that either. I absolutely love that. That's great. Thank you both, and we'll have to. Definitely. We'll tag our previous episode with you in the notes for this show so people can listen to both if they want to. We happen to be recording the week of Thanksgiving 2024. So that's why it came into my mind that we should give people a few zingers. Although we won't have it out before Thanksgiving, we'll have it out before the next holidays. But I want to give you a proper welcome before we get started too far into this.
Speaker 4:Reagan, for people that don't know Reagan, you should know Reagan and her website and her sub stack is weighthealthcarecom. Is that right? Reagan is a blogger, a speaker, a researcher, fat activist, fat liberationist. I'm going to call her a national treasure. I know I've called you that before, but that's how I feel, and I know that you're all helping us and coaching all of us to reclaim the word fat. It's a neutral descriptor. If you take the zing out of it. You don't have any more pain when people call you fat because you have no shit on fat.
Speaker 4:Captain Obvious, let's see you help us with dealing with the haters, coping with the haters. You're doing diversity. You're trying to teach people in medical schools and other places like that about how to deal with fat bodies, how to stop pathologizing our bodies. You do it all. You're an amazing speaker and you do so much for all of us. I don't even know if all of us could figure out how much you've done for us. I know it's far-reaching and I'm so grateful. So thank you for being here tonight. We're really happy to have you again.
Speaker 3:Oh, that's incredibly kind, thank you. I'm absolutely blushing over here, and you both do such incredible work, so I'm honored to be in this company and super excited to get to talk about this.
Speaker 4:Yeah, we're really grateful. One of the things that I think is fun is when someone's new to the fat liberation community and they're like, oh my gosh, have you heard of Reagan? I'm like, yeah, like, welcome to the club. It's pretty great. Yeah, I'm familiar, it's a good one, good one. So, reagan, tell us what you're up to these days, tell us how you're. I know you have all kinds of different things you do. You have your seminars, your webinars, but tonight we're really looking for strategies for dealing with anti-fatness in the medical world, and we all know it exists. We all know that. We all probably know people who've died because of the neglect and or been maimed by having their stomach amputated. So but how do we go and have them take us seriously, even though they consider us to be, I guess, some you know horrific thing because we're fat and because they believe that thin and health go together and fat equals unhealthy?
Speaker 3:Yeah. So I just to back up a tiny bit my so my area of expertise is the intersections of weight science, weight stigma and healthcare, and so one of the things I have, I've developed also sort of a subspecialty, as it were, in the ways that the weight loss industry has and continues to infiltrate and manipulate the healthcare industry, and it's almost impossible to overstate the influence that it has and continues to infiltrate and manipulate the healthcare industry. And it's almost impossible to overstate the influence that it has and continues to have on healthcare for higher weight people, on the idea of just, first of all, making up words like quote-unquote obese and quote-unquote overweight, words that were made up for the express purpose of pathologizing bodies based on shared sides rather than shared cardiometabolic profile or symptomatology, like we would see in an actual disease diagnosis. And now it's being pushed further, in particular by Novo Nordisk and Eli Lilly with their new GLP-1 drugs, to say, oh, quote unquote obesity is a chronic, lifelong, relapsing, remitting disease. And these definitions have been created and are being morphed specifically to serve the purposes of the weight loss industry. But they are so good at infiltrating and manipulating the healthcare system that they've really gotten this message all through healthcare and they conduct medical education, they conduct symposiums, they conduct grand rounds. It's really wild, not to mention all of the work that happens in the background and through their sort of astroturf organizations, which are groups that claim to be patient advocacy groups but are in fact almost fully funded by and acting as a lobbying arm for the weight loss industry. The biggest one here in the States is the quote Obesity Action Coalition, but there are many others and it's sort of an international web, most of which are now being predominantly funded by Novo Nordisk and or Eli Lilly. So that's sort of what we're dealing with when we walk in is a practitioner who is very likely of what we're dealing with when we walk in is a practitioner who is very likely.
Speaker 3:Now there are straight up fat phobic healthcare providers. Right, they have explicit bias toward fat people. They have. They take us less seriously, they give us less time, they ignore anything we say and focus in on weight loss because they think that that's we're only worthy of care once we get thin. That is absolutely a problem. That happens and weight stigma in many ways can be fatal, and weight stigma in healthcare certainly can and has been fatal.
Speaker 3:But there are also providers who are well-meaning and they might have implicit bias right subconscious bias toward higher-weight people because they live in the same like fatphobic world that we all do, but they really believe that what they're doing is the best for us. They're simply wrong about it. And then there's a power imbalance there between a patient and a doctor. I predominantly get paid to talk to healthcare providers about this, to teach healthcare providers and as a patient, it can still be difficult or even impossible for me to get weight neutral care from a doctor because of the power imbalance that exists there. So that's sort of all the bad news.
Speaker 3:The sort of good news is that we can use some strategies to help us get the care we need, and the first thing that I always say is I fully endorse doing what it takes to get the care you need right. So there's several strategies. We can start by asking for weight-neutral care, and we can do that before an appointment. If we're talking about a non-emergency appointment, right. If we're choosing a new provider, we can call ahead to the office, either anonymously we can have a friend or advocate call but we can say something like I'm looking for a provider who will provide weight neutral care, which means that they don't recommend weight loss as a health promoting behavior. Is there somebody here who can do that?
Speaker 4:Reagan, are you still doing some of that? Were you advocating helping people specifically one or 1% of time to go help them with their medical appointments?
Speaker 3:So I'm a board certified patient advocate.
Speaker 4:Okay, that's what it is.
Speaker 3:Yeah, I don't have the kind of time that I need, with everything else that I do, to do a lot of advocating. Typically, if I'm advocating for an individual, it's somebody in an emergency situation or somebody in a complex medical situation. But what I?
Speaker 3:did just finish is I created a course about weight-neutral advocating that's being put out through the Association for Professional Health Advocates, so people take the course. They have to pass a test and make a pledge about how they'll treat higher weight patients who ask for weight neutral care, and so I'm super proud of that and I'm super excited that it's something where it will be just the few of us who are doing it right now, but we'll be able to train more people who want to understand how to do this kind of advocacy.
Speaker 4:Right on Congratulations. How exciting for you and all of us.
Speaker 3:Thank you so much. I was super excited to get that opportunity and AFA was amazing around doing it. But yeah so, and speaking of advocates, you can take an advocate with you, and an advocate might be someone with training. It might also just be a friend or family member. What we see is that, even if the person doesn't have any medical knowledge, even if they don't talk through the whole appointment, just having someone else there tends to create better behavior from a health care provider.
Speaker 4:I have noticed that they are much more polite when there's somebody there witnessing them.
Speaker 3:Yes, yes, and this, sadly, is something that folks with multiple marginalized identities and with different marginalized identities can also utilize and, again, sadly, it can be helpful if it's someone with more privilege than you have and that can, and that it obviously it shouldn't be that way. Obviously it's wrong on every level, but in terms of strategies and the reality, that's something that can be helpful.
Speaker 4:I'm really glad that you're saying that, because I think you know there's very little opportunity to level the playing field. I work in healthcare and so I recognize how entrenched that entire culture is and so you know, I think, while it's not okay by any means, you have to take any advantage that you possibly can get and having an advocate that is somebody that has more privilege than you, it really will change the situation. I appreciate you saying that.
Speaker 3:Yeah, no, thanks, and thanks for the work that you do within healthcare to try to make the spaces better. So, yeah, so taking somebody with you can be really helpful. You can call ahead, like we talked about, and in my experience if you call ahead you might not get the answer you want, but they are typically honest about that. But even if they say, yes, you want to check in at check-in, right? So when you get there for the appointment and you check in, you have to say, as a reminder, I'm looking for weight neutral care. So please make sure the provider knows not to recommend weight loss or discuss my weight. And you know I'm going to decline weigh in. You can talk about that. Then you can talk about it when it's time for weigh in, and then you can.
Speaker 3:There's some sort of quick phrases to try to avoid the conversation, right, because what they tend to do is, no matter what's wrong with us, there's a tendency to blame it on our weight, right? If we're like, oh, I lost two socks in the dryer this morning, it's oh, that's obesity-related sock loss, such a shame. So we can say what do you do for thin people who have this issue? Because all of the issues, even those that they call quote-unquote weight-related or quote-unquote obesity-related. The issues even those that they call quote unquote weight related or quote unquote obesity related health issues, are health issues that people of all sizes get.
Speaker 3:That get called weight related when fat people have them, which is not remotely scientific Right. And so we can start kind of bypass the conversation by saying, hey, what would you do for a thin person? With the same presentation and I want to be clear none of what I'm saying is foolproof. I was physically in a room advocating for a patient with knee issues and she asked the orthopod that question and he said, oh, I don't have to talk to thin people about knee issues. And I was like, are you kidding me right now? Come on.
Speaker 3:Right, like I don't know. I was out in the waiting room. There are a lot of thin people with knee wraps and crutches, so I feel like you do Right. So nothing is foolproof and some doctors will pull some nonsense, but there are strategies you can try. You can also try the sort of combination of saying you know what I will Thanks for talking to me about that whatever, diet, pharmacotherapy, surgery I'm absolutely going to check that out.
Speaker 3:But for today I was hoping we could focus in our limited time on what I came in for, right, my sprained wrist, my severed arm, my whatever is going on. So you can kind of try to redirect. Yeah, no, I'm absolutely going to start that diet you talked about. Like, there's no way I'm doing that. But if I don't want to fight and if I need, like a prescription refill, right, if you need a referral and you don't want to pick a fight, especially if you're in a managed care situation where you don't have the opportunity just to leave and find another doctor, or if you're in a rural situation, you know, or a situation where your ability to get another doctor is really limited and you have to keep peace with this particular provider, you can do that Like yep, I'll absolutely talk about that. I'm going to make another appointment to talk about that, though, because today I really want to focus in on, like my you know compound fracture of my ankle.
Speaker 4:That's great, reagan. One thing that I have started doing is I say, oh sure, sure, I'll consider that diet. Just go ahead and send it to my email or to my dashboard. Just make sure that the diet you're going to ask me to do is that there's definitely like a better than 2% success rate. I need something like 98% successful as opposed to 2%. If you find that diet, I'll absolutely review it free, so just go ahead and send it to me that way, and then let's get on with my eyeball problem or whatever the hell it is.
Speaker 3:Exactly and you can. So that's another strategy is, if you want to talk about this, you can. I, you know, I'll often say I treat my doctor's appointments often as like fodder for pieces I'm going to write, so I'm willing to like, try stuff, and I'm coming to this obviously with a tremendous amount of privilege White cis, able-bodied, currently neurotypical, currently like and all the knowledge that I have and that I do this. There's a massive amount of privilege, and so I feel like one of the ways I can use that privilege is to really push these conversations and these appointments, and so I do that.
Speaker 4:Something I should add to my comment is that I've never gotten one of those emails. So they can't seem to find that particular diet yet. And then I'm talking with Kaiser. About three years I've been using that strategy because, even though I asked them it over and over again, I oh, I forgot. Yeah, go ahead and send me that diet. And I've never, ever, ever gotten one from them, because that doesn't exist. And also, Regan, isn't that kind of malpractice to prescribe a diet when we know it doesn't SN work? That's not fair.
Speaker 3:They shouldn't be able to do that, I would agree with you. But it's not considered malpractice. In fact it's considered the standard of care that higher weight people and this is again the weight loss industry working overtime. They know that almost everyone loses weight short term and they know that most people lose weight short term and almost everyone will regain that weight within two to five years, which is why you don't see weight loss research that goes past two years, right? So they've manipulated the research, even the studies on Wegovi, the GLP-1 from Novo Nordisk.
Speaker 3:So they put out their four-year outcomes and the headline was oh, people maintained a 10% weight loss for four years. But when you look into the figures, they started out with about 9,000 people in a treatment group and four years later they had about 900. That's they had an 89.5 percent dropout rate. And like if a sixth grader doing a fruit fly science fair project lost 89.5 percent of their fruit flies and then, like, tried to draw a conclusion from the fruit flies that were left, like that kid is not winning the science fair, that kid is going to get a top from their sixth grade teacher about scientific method. And so it's ridiculous the lengths that they'll go to to manipulate this research and a lot of the work I do on weight and health care is deep dives into these studies and analysis of these studies. But yeah, so doctors really believe that weight loss is something that everyone can do if they try hard enough.
Speaker 4:Yeah, and that's interesting because, on the flip side of that, the insurance companies and the managed care plans actually make it requirements that providers have metrics that they have to hit in terms of addressing an individual's weight. So if they aren't prescribing a diet, if they aren't getting the weight written down in the chart, all these very specific metrics, they'll lose quality incentives, money from the plans. So it's embedded into the health care work. It's wild.
Speaker 3:Yeah, and I do want to say like, for example, very specifically for Medicare's incentive payment, there is a reduction in payment if they don't get BMI calculated. However, if the patient declines weigh-in, they're removed from the numerator and the denominator of that equation. I did a deep dive into this a while ago because I was like this is incredibly complicated. So if the patient declines, there's an opportunity to say the patient declined the weigh-in and then they're not held against that provider, but their electronic health record system has to make that possible. So it's possible that they'll have to work and create that change. And I also want to say, because often what happens is if we don't get enough BMIs calculated, we'll experience a drop in compensation.
Speaker 3:It's communicated to the patient as your insurance requires this and those are not the same thing. Your provider getting less money is not anything that negates your right to informed consent and refusal of the weigh-in of a weight loss intervention, of any health care intervention, right. So you still have the full right to informed consent and refusal. And it's not true. And the person who's doing your weigh-in, who tells you your insurance requires it, may actually believe that. Right. So I will say, oh, that's such a common misconception, like I can absolutely explain that to you.
Speaker 3:It's my area of expertise. But for now just please put patient to client and we'll like move forward with this appointment. What, what room am I going to my? I am famous for just saying no, thank you and then walking past them because you're not actually allowed to wander a doctor's office by yourself. So they will come with you at that point and you can sort of move that conversation down the hall and away from the scale. But yeah, one thing I will say to providers is you know, it's my understanding that about 95% of people or more will lose weight short term but gain it back long term and that that weight cycling has negative impacts on health. And what's interesting is more and more doctors say oh no, that's true. But then they'll say you just have to keep trying till you're in the 5% and like look, not everybody studies statistics and that's absolutely fine, but I did so. I can tell you for sure that's not how statistics work, that's lottery logic.
Speaker 4:Good one. I like that. It's so shitty that we have to think about all this stuff. It's so shitty. We should just be able to go to the doctor and just get taken care of and get the care we need. And I mean, I know we all have to put a lot of mental energy into before we go to the doctor. It shouldn't be like that.
Speaker 3:This is crap, man, yeah it's difficult enough to get health care in the United States in many other places as well, obviously, but you know, here in the States it's hard enough without having to like gear up. I teach mostly I talk to healthcare providers, but I do teach workshops to help patients navigate weight stigma, and right at the beginning I'm like none of us should be here. This shouldn't be happening. You shouldn't have to take a class to go to the doctor, and it can be.
Speaker 3:It can get dramatically worse in an emergent situation where you don't feel well enough to advocate for yourself. Perhaps, or perhaps you're not conscious, you know so. Having friends and family who understand what you need, being prepared for those situations is also really important. But, yeah, we have the right to direct our healthcare. We're the CEO of our body, right, and the thing to remember is when you leave that doctor's office, they're on to the next patient, but you're still living in this body and with the consequences of their recommendations for better or for worse. And so, the more that we can see ourselves as the CEO of our body, with healthcare providers on our team, right, they can be on our board of directors or C-suite, but they're not the ones who are going to walk out of their office and live in this body full-time, and so we deserve the healthcare that is based on our priorities, that is specific to our situation.
Speaker 4:I just want what everybody else has. I'm not asking for more, I just don't want less.
Speaker 3:It's so perfectly said. I think back so I cut my teeth on queer and trans activism, starting in Texas in the mid-90s, and I remember making this argument. People were like, well, you all want these special rights and we're like they're not special, they're what everybody else already has. What are you talking about? Like that doesn't make any sense, but it's still that same thing. Like if we've been able to historically keep these rights from you that we enjoy now, if you want these same rights, that's a special thing that you want, as opposed to just wanting equity. So yeah, that's perfectly said, Thank you.
Speaker 4:Yeah, and I think you know one of the things. When you said that I was like they don't have to advocate for that. So they have no concept of the fact that it's not that you're wanting extra rights, it's that you're wanting rights like you haven't had to advocate for this. So I'm just saying I'm one of those people that has to advocate for this. It baffles me when people don't really understand that concept. I mean, I've shared with people you know experiences of going to the doctor and experiencing fat bias and you know they're usually thin, able-bodied folks and they're just like what you know. You get like the head tilt and the you've had to experience that and it's like honey. That is like the tip of the iceberg from what I've had to experience and it's just there's no concept of it because they've never had to deal with it.
Speaker 3:Yeah, exactly when I do talks to providers and I'll tell stories of weight stigma and everyone will gasp and I'll be like if you were super surprised by that. You're probably not fat, right, the fat people in the room are not surprised by this story at all. They probably have their own stories similar to it and even worse Like it's. It's one of the things about privilege that's a bit insidious, I think, is it puts us in a situation where we don't know what we don't know because we're not having the experiences. And what's important is that it's our responsibility to proactively learn about that.
Speaker 3:Right, in the areas where I have privilege, I'm responsible for seeking out knowledge. What experiences are people having? How do they want me to use my privilege to dismantle that privilege? And so what people can do if they want to work in solidarity with higher weight people is actively seek out that knowledge and seek it out in ways that don't create extra labor for the fat people in your lives. Right, there's a lot of people who write about this. There's a lot of people who are talking about this, and so really seek out that knowledge and if you have friends who want to work in solidarity, have you know it can be helpful to have resources to send them to read or listen to to have resources to send them to read or listen to.
Speaker 4:Yeah, can you imagine being, let's say, fat and black, or trans and fat, or trans black and fat? I mean, I already know I'm white. It's fucking shitty for me. I know it's way worse for people who have other, you know, marginalized identities and it makes me want to throw up when I think about it, because we already all know how black people aren't getting good care when they go to the doctors and it just compounds from that. But back to this whole ally idea.
Speaker 4:I did mention this in some of my posts on Facebook this week. Hey, thin people, could you please go to Thanksgiving or Christmas dinner and be looking out for how we're not being accommodated? Could you be looking out for us to see if you can see a chair that worked for me or just whatever the accommodation is that you need? Could you be paying attention to what's being said? If you hear some bullshit, could you jump in, because God knows that. You know we definitely believe thin people play more than a fat person. So you're going to be taken seriously and it would help us all a lot if you could just step in here and help us out. Help me out any way you can.
Speaker 3:Absolutely, and I think if you are someone who has size privilege and I also want to point out, size privilege is relative Weight stigma always does the most harm to those at the highest weights and those with multiple marginalized identities, and it's incredibly important that we be listening not just to fat people in general, but especially to people who are super fat and who have multiple marginalized identities in addition to fat. Right, but if you are in a situation where you don't know if somebody wants help like you haven't had a conversation with them beforehand one thing you can do when weight stigma or diet talk happens is change the subject, because for some people, the last thing they want is more attention to be drawn to this situation, and we never know If we don't know that person, we don't know if we're like on a bus or at a holiday party with some co-workers we've never met. So you can just change the subject. I have a friend whose sort of area of interest is primates, and so she will just say a random fact about apes out of nowhere, and I have seen it in action. It is a conversation changer, right. Somebody says some like bullshit, about like dieting or whatever, and she's like oh, did you know that silverback gorillas throw spider monkeys as weapons. That will stop a conversation right away and it doesn't have to be right, it doesn't have to be. They could be like your favorite animal knitting a tea cozy, your World of Warcraft rating group, like whatever your thing is. Just change the subject and do that consistently.
Speaker 3:And if you're hosting an event, remember that that's's your event, so you can say this is a no diet talk event. Eat the food, don't eat the food. We respect your choices, but nobody needs to talk about it, right? It's so weird to me, right? Sometimes I think, like one of the snarky responses I offer that maybe you just say it in your head is like, if you continue to talk about my diet, about your diet, I'm going to talk about my bowel movements, like with pictures and in great specificity, or like we could talk about something else. But it's so odd to me and I think again, people are driven by diet culture. They feel like they have to perform for food.
Speaker 3:So I'm going to take this cookie, but I'm going to tell everybody how much time on the treadmill I'm going to do. Or I'm going to take this cookie, but I'm going to tell everybody how much time on the treadmill. I'm going to do or I'm going to be I'm going to split this donut into eight pieces and I'm just going to take one. I'm going to make a big performance about that and like none of that is necessary Eat what you want, don't eat what you don't want. Like it's fine, but we don't have to talk about that. And the fact that diet culture says we do just creates so much like bad feelings and danger for people of size, for people dealing with eating disorders, for people who just don't want to hear that kind of talk. Like we can just stop having that kind of conversation.
Speaker 4:One of my favorite comebacks is I often get in the position where I'm serving the birthday cakes at events and I'm doing the slicing and handing to people oh, oh, oh, that's too big, I go, just eat what you want, doesn't matter, you can take the more and not eat it. So, just coming out, I'm not going to make individual slices for everybody. Okay, just take it and you just eat whatever you want. Nobody has to know, nobody. You eat whatever you can eat, the whole thing, nobody gives a shit. I'm way more petty. I'll cut it into like the tiniest little sliver and I'll be like this is still a lot.
Speaker 4:I know, you know, and I'll just like oh, put it on the plate Like you know like, yeah, I just I'm like, if you, if you're going to lean in, I'm going to lean in and I'm going to tell you I'm way worse than you are.
Speaker 3:I think it's such a tough thing because, like, we're all harmed by weight stigma and diet culture people of all sizes, but not again, not everybody is harmed. The same Right. And the way that some people are willing to buy into weight stigma and diet culture as a way to try to get a little more privilege right, the fat person who throws other fat people I'm not like those other fat people. I eat like this and I exercise like this and I do all these things and like that doesn't make anybody better than anybody else. But trying to use that to like gain privilege by being like I'm, it's that good fatty, bad fatty idea, right? Like, oh no, I'm a good fatty and it's like nope, that needs to die.
Speaker 3:And I talk about this a lot because I am somebody who happens to enjoy doing fitnessy things and so I'm privileged by that, whether I want to be or not. So it's incredibly important that I always be saying like participating in fitness doesn't make anybody better or worse than anyone else and health and fitness are not. They're these gooey, amorphous concepts. They're not an obligation, they're not a barometer of worthiness and they're not anybody else's business, unless we ask them to make it their business.
Speaker 4:Yeah, it's really. I appreciate that. That's nice. I was thinking about how there's this perception of bias when providers are going through medical school. Bias when providers are going through medical school and I mean there's been study after study. I use one of the quotes when I do cultural awareness for orientation at our health care organization and I'll talk about fat liberation and I'll bring up, you know, like I'm a very fat woman, you know, and I'll kind of like put my hands out like it's very obvious, and then I'll say you know, cultures, all these different things, and we're talking about equity, and I'll bring up the discussion of bias and how it impacts the decisions that people make. But there's it's like 68% of new grads or something like that have bias for fat people. It's just appalling. How do you address that? I know that's work that you've kind of stepped into.
Speaker 3:Yeah. So there's a tremendous amount of anti-fat bias within the medical school system, the way that higher weight people are talked about, the way that higher weight people are not talked about. So most medical schools do not accept higher weight cadavers and I apologize because this is a little bit morbid, but it's also really important because it means that students aren't seeing higher weight bodies as normal. So they work on thinner bodies and then when they are out in the world as doctors, as surgeons, for example, they're seeing fat bodies as inconvenient and abnormal and it just drives a tremendous amount of animosity toward higher weight people, right. And then there's just the way that being higher weight is still talked about, right. As you know, studies find that doctors feel that their higher weight patients are lazy, they're awkward, they're unlikely to quote-unquote comply with treatment, and that starts in medical school education. Also, not a lot of fat people getting accepted into medical schools. So most of the cohort is thin and so it's easy for them to just reinforce each other's bias. It's something that I've been working in for a while. I've had the very good luck and honor to speak at medical schools, including recently Yale School of Medicine, and there are people in medical schools doing really good work. There's a group called Medical Students for Size Inclusivity that's doing unbelievable work around this, but it really is something. This, but it really is something. And there's also a new organization, the Association for Weight and Size Inclusive Medicine. That is a physician's group that's also doing incredible work around this, but it really requires a change in culture, right, and what happened?
Speaker 3:One of the things that I think is really dangerous that the weight loss industry has successfully, at least to some extent done is co-opt the concept of weight stigma, so that what's considered now an anti-weight stigma message in training, in weight stigma research, is we don't want to treat fat people badly, but we definitely want to eradicate them from the earth and prevent any more from existing. But, you know, like in a non-stigmatizing way and like that's not a thing. In the case of higher weight people, pathologization is stigma. Now, there's nothing wrong with having a disease. No one with any disease should be stigmatized. The problem is being higher weight doesn't count as a disease. It doesn't work scientifically, and when they try to make higher weight a disease, that's where the pathologization turns into stigma, and so that's go ahead.
Speaker 4:I was going to say. Can we step back one step and just talk about why no fat cadavers? And from what I understand, they don't take fat cadavers because they don't have the right equipment. They when they embalm the body. It adds 100 pounds of weight to the body. It's harder for them to move it around. Their tables aren't wide enough. Is this all true that you know of?
Speaker 3:That's also what I've heard that fat cadavers require more resources to deal with, and my answer to that is so what? How?
Speaker 4:about let's fix that. Sorry, let's fix that now, yeah.
Speaker 3:Yeah, you must figure this out. It's not okay to just keep using these excuses, and we see the same thing in research. One of the things that I think some people don't really think about is that most of the healthcare system and I'm talking about tools, durable medical equipment, best practices, pharmacotherapies, surgical techniques all of that was created using research that did not include fat people, that specifically excluded fat people. Right, in fact, the COVID vaccine trials were groundbreaking in many ways in that they included fat people at the levels that we exist in the population. That's wild, that that's not something that we're doing, right, but it means that there are huge gaps in the research. And then, when that system doesn't work as well for us, when we have worse outcomes than thin people, they blame fat bodies and they say, oh, the problem is this quote unquote obesity, and the solution is weight loss, and so it creates this vicious circle. And within healthcare, this is the vicious cycle at the bottom of it all. Healthcare creates weight stigma and weight cycling and care inequalities, and then it blames higher weight bodies for the negative impacts that result, and then it uses those negative impacts to justify more weight stigma and weight cycling and healthcare inequalities. And so it's this vicious cycle that harms fat people at every single point and it is just continuously being replicated. And this idea that since we want to eradicate fat people, we don't need to include them in research around healthcare is just harm on top of harm.
Speaker 3:I spoke at a conference for anesthesiologists earlier this year and they were great, really fun, really receptive. But in researching that, I went through like 30 years of guidelines and each guideline would say something like we know that pharmacokinetics and pharmacodynamics are different for higher weight people, for those with more adipose tissue in their bodies, but we don't know how, because they were excluded from the studies that looked at that. So anyway, here are some guidelines for higher weight people. Like what they didn't say was dear God. We don't know what we're doing and we need research, like right now. We just lost over it. We're the majority. We are the majority of humans on the planet.
Speaker 4:Yeah, why are we treated like the infinitesimal minority of people? Okay, we've had like 30 or 40 years to know this too, so like it's time to catch up. Yeah.
Speaker 3:This isn't my line and I can't remember who said it first, so my deep apologies. But the idea is they don't treat us like higher weight people who exist. They treat us as temporarily inconvenienced thin people. So, like it's, the idea is we don't need a bigger MRI, we don't need a table that's higher weight rated, we don't need research about pharmacokinetics and pharmacodynamics and anesthesia for higher weight people, because we'll just make you thin and then you'll have access to ethical, evidence-based health care and like. The fact is, even if fat people could become thin, that would still not be okay. Somebody fat needs surgery today, not 50 pounds from now. Right now it's an emergency and we don't have the information or the tools we need for that patient.
Speaker 3:But the truth is there's literally not a single piece of research where even a simple majority of people were able to maintain significant long-term weight loss for more than even five years. Not a single piece of research. And when we talk about weight loss surgeries, it gets a bit more complicated, but that's because of the terrible quality of the research itself. Right, we know a lot of people regain weight, but the way that they tend to do long-term studies is if you're below your baseline weight and you're not dead, you're considered a success. And so people who are saying it was the worst decision of my life, I would do anything to take it back, you know, and I gained back 95 of the weight I lost are considered successes in these studies. It's really the way that the research is manipulated is, again, it's almost impossible to overstate. But, yeah, it creates a situation where we don't want you to exist, so we're not going to create health care for you. The only thing we're interested in is making you smaller.
Speaker 3:And what has happened is the weight loss industry created this mountain of research that correlates being higher weight to health issues and scrupulously avoids controlling for confounding variables like weight stigma and weight cycling, which are both independently correlated with the same health issues that get blamed on size. So when we hear weight-related health issues, what we actually might be talking about are weight stigma-related health issues and weight cycling-related health issues. We don't know what fat people's lives and quality of life would look like if we stopped exposing them to weight stigma and weight cycling. But you've got this big mountain of research that correlates weight and health and you've got a fatphobic society that just accepts like, yeah, if it happens to fat people, it's probably because they're fat, and this includes healthcare providers and executives.
Speaker 3:And so then the FDA when they approve these interventions, they approve them on what's called a risk benefit analysis. So when the FDA says something is safe, it doesn't mean it's 100% safe and there are no negative side effects. It means that, in the FDA's estimation, the side effects are not as bad as what the treatment is good, so the treatment is worth the risk, basically. But if you're using this big pile of crappy research that says that being higher weight is so terrible, then the argument that the weight loss industry makes is it's so terrible to be fat that it's worth risking fat people's lives and quality of life in attempts to make them thin. And the FDA agrees and these interventions get approved. But fat people think these interventions are, by and large, safer than they really are because the FDA approved them without understanding the massive research inequality that this decision is based on.
Speaker 4:Let's go back to the strategies we got down through weight neutral, asking for weight neutral treatment or service. Are there other things in addition to these that we've mentioned so far that can help people who need strategies for seeing a whole medical people?
Speaker 3:Yeah. So I think, with all of the strategies, I want to recommend practicing them. So one of the types of privilege that I have and I call it personality privilege there's probably a real name for it but in conflict, in confrontation, I get very calm, I get very clear-headed. All the information in my head is available to me. That is not everyone's experience. A lot of people get emotional, they get cloudy in their thinking, they might cry. That is such a valid response. But because of the way our culture is set up in terms of communication, I will tend to get more respect than someone who gets really emotional, and that should not happen, right? But if you are someone who does tend to get cloudy and you're thinking, who tends to get emotional, even if you're not, it can be really helpful to practice what you're going to say and really practice it. Think about, like, pretend like I'm in the office and this is how it sounds and this is how it smells, and the doctors just said this thing to me and I'm going to say what would you do for thin people with that issue? Or you know, I've tried a lot of weight loss in the past and that's just not what I'm doing anymore. So I'm going to exercise my right of informed refusal for weight loss interventions and what else do you have available? What are the other options? And so you practice that over and over, role play it with a friend, if you can right, so that you feel really prepared and really ready to advocate for what you want. And my thing is that I just always want to make sure the patient walks away from the interaction feeling okay about themselves. First and foremost, I want them to get the health care they want and need absolutely, but I also I want them to walk away feeling okay, and so practicing and thinking these things through can really help.
Speaker 3:Another area that is really dangerous is BMI-based denials of care, which happens when patients are denied the care that they want or need because of their weight or their BMI, and this is an area of a lot of intersectionality for trans folks who are also fat, because gender-affirming care is a really common surgery to be denied, and so on weight and health care, if you search the word hostage, you'll find a piece that I have called Healthcare Health Hostage BMI-based denials of care and it has steps that you can go through to fight those denials of care. It also has collections of resources. So I have, like collections for gender affirming care, joint surgeries, spine surgeries so you can use those in your defense and argument if you're fighting for care. It's a lot, so I think it would have to be the subject of an entire podcast and those, by the way, weight and Health Care is entirely free, so these are all free resources that I'm recommending.
Speaker 3:But, yeah, so understanding to what do I want out of this appointment and staying focused on that, and so creating a plan for the appointment can be a really helpful strategy, right? Like I need to get out of here with a referral to a dermatologist. I need to get out of here with a prescription refill, but, like everything else, I can let go, you know. So here's maybe three other things I'd like to get, but like this is the thing or these are the things I need to get. So starting from that so that you can really stay focused, can be helpful. Having that plan ahead of time for what you need can be really helpful. And then again, practicing.
Speaker 4:Are there any statistics, reagan? I don't know how people would measure this, but do we know what the data is or are, and based on this kind of shitty treatment, is there anybody that's been able to compile any of that kind of data? I don't know how you would study it, how you would control for it.
Speaker 3:Are you asking like data around how healthcare, weight-sickness, health care?
Speaker 4:Affect or impact us.
Speaker 3:There are some studies. There are studies around like provider bias. There are studies around weight cycling, which is like the most common outcome of these weight loss attempts. So we can kind of see how do these recommendations play out for higher weight people? Right, because we know weight cycling is independently correlated with a lot of the same health issues that get blamed on weight. So there's research around that.
Speaker 3:Dr Leslie Owen and I are in the middle of a study around weight stigma, anti-atrogenic harm in the highest weight patients, because often even in the weight stigma research they exclude. So there are these made up, messed up classes of quote obesity, right, and so it's one through three and they'll often either only include class one classes or mush class one and two together, but almost always exclude quote unquote class three. And so we were like this is something that needs to be talked about because these are the people most likely to experience weight stigma and to experience weight stigma in the most impactful ways. So we're in the middle of a qualitative study about that and we did the interviews and now we're in the analysis portion. But we need a lot more research that looks at how is weight stigma impacting higher weight people and what we did with our study was look at what's called iatrogenic harm, and that's harm that's caused by health care, right? So if you go into the hospital for broken ink and you get a MRSA infection, that's iatrogenic harm. If you are harmed by weight stigma, there are decent studies that talk about the amount of weight stigma that patients experience, and including in specific things like you can find good stuff around like pregnancy and weight stigma, though typically in that and almost everything, there's no trans or non-binary representation, which is a constant issue within research, and under representation of people of color, another constant issue. But you can't. What you can't find is research that then says the weight stigma did at real harm right. So we find stories, stories but we don't study.
Speaker 3:Okay, so what did that lead to? Did you disengage from care? Did you delay your next mammogram? Like, do you not go to screenings? Like what happened because of this weight stigma? And so in Dr Owen in my study, that's something that we really wanted to look at. Not just did you experience weight stigma, but what did that lead to? Because that needs to be considered iatrogenic karma. What happens now? You experience weight stigma, but what did that lead to? Because that needs to be considered iatrogenic karma. What happens now is the idea that, well, if higher weight people are avoiding care because of weight stigma, there's a lot of people who feel like that's kind of on them right, suck it up and go, which is absolutely wrong. So I think we need a lot. There is some research, and research says that the vast majority of higher weight people do experience weight stigma in various forms within health care. But what we don't know and don't track well enough is the actual then resulting harms.
Speaker 4:I don't know if this is indicative of anything, because it's just completely anecdotal. I have had two surgeries since 2020 where I was put completely under for an hour to three and a half hours and really experienced very little pushback or anti-fatness. But those are both experiences at Kaiser here in Northern California. But yeah, I mean, I had a three and a half hour emergency hysterectomy and I questioned the anesthesiologist like aren't you going to say anything to me? And she's like no, it's what I do. I keep people alive during surgery. I was like okay, let's do this. You know I was waiting for it. But she said, no, I do. I work on fat people all the time.
Speaker 4:Okay, I had a situation where I had to have surgery and I was up to the day before and got denied because, yeah, for carpal tunnel surgery, because my BMI was too high. And when I went to have the surgery two weeks later, they found someone who was willing to do it and I questioned the hell out of that anesthesiologist and basically she said what happens is your file gets sent to this company, the company looks at it and a person says, oh, you've fallen out of that range. She's like likely, a doctor didn't even see it. And so then it gets put into this other category of groups of who's willing to work on somebody with that BMI size. And I'm just like Jesus.
Speaker 4:I'm just like Jesus, I'm about to go under right. I mean like at least she's being transparent and honest with me in this process and she's like I do this all the time. This is not a big deal, you're going to be just fine. But to have to have that sort of anxiety in that process and to think like, oh, it's some person who's not even a medical doctor that makes that decision based on a number, that's faulty in a system that was created, you know, for classification, it's just like my brain was just like. It's just like I'm done. So, yeah, I, it's interesting how you know like one medical provider, it's fine, the other medical provider it's not. You just never know which one you're going to get.
Speaker 3:Yeah, and there's a thing called an ASA score that measures your anesthesia risk and it's I don't want to say four or six points, I'm sorry I can't give it right now, but at any rate they can choose to add a point for quote, unquote obesity, and it's a big deal to go up a point, and so you can disqualify for surgery based on simply the ratio of weight and height. And this is again the problem with pathologizing bodies based on shared size rather than shared cytometry, and I think an interesting study would be are they turning away bodybuilders and football players or are they ignoring these restrictions for them? Because I see some nonsense. One of the things I see unfortunately too frequently is someone will be denied a surgery that they want or need, but they'll be referred to weight loss surgery, and that's bonkers.
Speaker 3:I had a patient who was looking for gender-affirming care, was denied their procedure for anesthesia risk specifically, which is why you always want to find out why are they denying? You want to get as much information as you can, and so then they were referred to weight loss surgery, and we tried everything, and so my sort of last ditch was to write a letter and say look, it's the same facility. Can whoever's going to do the anesthesia for this weight loss surgery just like come down the hall and do the anesthesia for this gender affirming care and it worked, and the patient? I don't ever expect it to work again. I didn't expect it to work then but like it's. You know I was like. This makes absolutely no sense. They're using anesthesia in this other surgery. Let's not act like they're not.
Speaker 4:Well, thanks for sharing that, because I talk with a lot of trans people and because you know I do the hair removal and they often get turned down. Usually it takes three to four times for them to push, have their advocate, whoever's helping them, push, and then push, push, push, and then they're like, okay, yeah, we will do the surgery now. But even if the BMI hasn't changed, they just say, okay, you have to push, push, push, you have to keep pushing on the bit. That's a great way to say it because, yeah, they'll gladly amputate your stomach, no problem.
Speaker 3:Yeah, yeah. It seems like too often the only place where higher weight people are accommodated within healthcare is in these weight loss surgery centers. Suddenly, we can get armless, sturdy chairs, we've got tools to do surgeries, we've got an anesthesiologist who knows what they're doing. All of a sudden, everything's a possibility, right. But if you just want care that isn't taking your perfectly healthy digestive system and putting into a permanent disease state, if you just want your knee replaced, if you just want your gallbladder out, now we have this huge problem and it's impossible. Nobody could do this right. So it is a huge way that we see weight stigma show up is that when it comes to shrinking us, they're willing to put us at almost any risk and they're willing to pay any price and they're able to suddenly accommodate us in ways that are supposedly impossible in other situations.
Speaker 3:I had a patient who was taken in. She was having what she describes as a gallbladder attack and went in and they were like yep, like we can remove your gallbladder tonight. And she was like I'm really nervous about having surgery like in an emergency basis. What will happen if I don't have surgery? And they were like well, you can try to write it out. A lot of people will get through it, and then we can plan the surgery later. And she said that's what I want to do Because she wanted to take the time to get the surgeon. And so she did that.
Speaker 3:And then when she went back they denied her surgery for her BMI. They were going to do it with whatever surgeon and anesthesiologist happened to be there the night. She went to the emergency room, but when she wanted to plan it out and schedule the surgery, suddenly she was denied. So if you're not someone who's dealing with this, it can be really hard to understand all the ways that the healthcare system is just not equitable for higher weight people and again, that's always going to have a higher impact on those of the highest weights and those with multiple marginalized identities. And I absolutely recommend Sabrina Strings' Fearing the Black Body, deshaun Harrison's Belly of the Beast, joy Cox's Fat Girls and Black Bodies. There's so many books that talk about these experiences and again, especially if you're someone like me who has white privilege, understanding this is absolutely critical.
Speaker 4:I don't understand the gallbladder thing because, as far as I can tell, I know thousands of fat people and none of us have a gallbladder anymore. So there must be a long list of somebody that will do these surgeries, because it's really common for fat people not to have their gallbladder. Have you noticed that?
Speaker 3:Yeah, I think it is probably a more common surgery for higher weight people, though I don't have like the research on that. That's just sort of my observation.
Speaker 4:I think for me this was like 25 years ago, but I was doing Weight Watchers, of like, of course, for like the hundredth time. And then I went to walk to a taqueria with some friends, had a taco a vegetarian, because I was being good air quotes and then they used refried beans that had lard in it and you know, I hadn't been eating much fat because of Weight Watchers. And then white gallbladder. I was like oh hell, no. And then emergency gallbladder surgery. Nobody asked a thing and I was fat, but it was emergency and I didn't. I just said, okay, let's do this. But then every time I talked to a fat person like, oh no, I don't have a gallbladder either. I'm like, why? Maybe because we've all dieted? And then it got kickstarted by some fat. And then they're like, okay, you got to get that shit out of there.
Speaker 3:Exactly, that's exactly what I was going to say. What will happen is they'll say, oh, a higher percentage of higher weight. People have their gallbladders out. It must be due to being higher weight, instead of looking at what is the impact of a lifetime of dieting and weight cycling.
Speaker 3:Right, the body has so many things that it does to fight famine, and that's what intentional weight loss is. It's feeding your body less food than it needs to survive, in the hopes that it will consume itself and become smaller. That's intentional weight loss. And whether you're doing it with a drug that makes you not think about eating, whether it's just restriction, whether it's a certain, that's what it is. And your body cannot tell the difference between that and there's no food. And so it enacts all of these interventions that it has to try to protect you from famine, because your body's just trying to keep you alive. It does not know that you're not feeding it because you think it might better approximate a stereotype of beauty if it was thinner. It's sending hunger signals. You're not sending food. It's like, oh, there must be a famine. Then you go and run on a treadmill. It's like, oh, there's a famine and we have to run from bears, like I'm going to do all the things and also bringing it back to our holiday discussion.
Speaker 3:This makes dieters the world's worst company, because one of the things that the body does is it increases the hormone that makes you hungry, and so all you can think about is food, and that is why dieters are forever talking about what they're eating, what they're not eating, why they're eating it, what they're going to eat later.
Speaker 3:It's because it's all they can think about, because their body is saying, because what the body is thinking is like look with the famine and the bears, like, if you see some food, let's not forget to eat it. So it's. You know. All of this is comes full circle. But again, it's another way that that cycle harms fat people, because the encouragement to try intentional weight loss, even with over a century of data showing that almost everybody will lose weight and gain it back, and up to two thirds of people will gain back more than they lost, which, like I'm not saying there's anything wrong with being fat or becoming fatter, but I'm saying there's something terribly wrong with something that's considered a healthcare intervention that's currently prescribed to about 70% of the population. That is the opposite of the intended effect the majority of the time.
Speaker 4:I mean, I don't mean to be laughing, but you have to laugh or you would just cry. But it's all so true, like Lord. Why, why, why can't we just agree that we're allowed to exist exactly as we are and we should expect the same amount of respect and dignity that everybody else then that just gets, without even having to qualify for it? Anyway, I'm not really laughing, laughing, but I'm kind of laughing, just laughing, just like holy shit, this is ridiculous not funny, haha, but just funny laugh or cry laugh or cry, yeah, totally.
Speaker 4:So, okay, we need to wrap this up and I guess, like ruf, and I would love to just listen to you all night and all day, um, but are there any other um strategies that we didn't mention, or just do we cover them all you think? Is there anything else that we should tell our, our people, our community, to try to do when they go get their whatever? And you know, get your well woman exam or your whatever.
Speaker 3:You need to go for the doctor to to the doctor for um, I think just in general, remembering that you can ask for what you want, right? So I I'm in the middle of a well exam, like it's not appropriate to talk about my weight right now. Right, and just say that. Right and again, practice, practice, practice and have those sort of ready in your back pocket.
Speaker 4:One thing I did have to advocate for when I was having my emergency surgery is that one of the nurses really wanted to use the small cuff on me and I just had to ask her five or six times and then, after she finally got me a large cuff, and then they did my blood pressure again and guess what? It was perfect. I just kind of yelled out to the entire floor if you ever treat a fat person, don't make them beg for a larger cuff, just default to the larger cuff. And they're like what's going on? I'm like snap. Ladies and gentlemen, just if I say I need a larger cuff, can you trust me, I need a larger cuff. They might not have done my surgery if they didn't use a larger cuff because my blood pressure showed that it was way too high to have surgery.
Speaker 3:Exactly, a too small cuff will give an artificially elevated reading In general. One other thing is to know like what can happen is weight stigma gets blamed on higher weight people and it can sound like you're too big for the MRI or you're too big for the gowns, and that is never the case. There's nothing wrong with you. Health care is too small for you and that's absolutely wrong. Health care should fit all the people who exist. People should not have to change themselves to fit into health care.
Speaker 4:Perfectly said. Thank you, reagan Murph. Is there anything else that we didn't cover that you thought we should? I think you know giving the address for all the materials would be helpful again, just to make sure that everyone got it, and for Reagan to share, like where we can find her sub stack all that fun stuff. Yeah, that'd be great, reagan.
Speaker 3:Sure. So there's several free resources out there the Hays Health Sheets, h-a-e-s, healthsheetscom. Those are weight neutral diagnosis, specific care guides for patients, practitioners and advocates, so you can literally download, like high blood pressure, and see what are the options for weight neutral treatment. There's also a research bank and resource banks. You can find like don't weigh me cards or I have cards to print out for what to say at the doctor or how to get a proper length vaccine needle, and then we have an explanation of why we don't recommend weight loss, which can be a good like one pager to send to people. Then my sub stack is weight and healthcarecom and I sort of endlessly talk about this stuff there. And then the last thing is my original blog. Some of you may know me from the old dances with fat blog. Well, I don't post there. It still exists. And there's also. That is where I house my video workshops, including video workshops on navigating weight stigma in healthcare, and they all have a pay what you can option so that money is never a barrier to people getting information.
Speaker 4:Your Substack is one of the best out there and also with the Substack there's a way to basically kind of make like a Patreon type of donation for the Substack so that you know Reagan gets, you know, compensated for all the work that you do. I'm sure I know for a fact that you do a lot of work for Sheree. I'm happy to hear when you're getting paid to do work, because I know you work your butt off. And all those emails that you answer I don't know how you keep up with them. I'm always blown away. So thank you, thank you, thank you and thanks again for being with us tonight and we'll put all of your posts. You're on Instagram as just Regan Chastain, right?
Speaker 3:Exactly.
Speaker 4:R-A-G-E-N, Yep Chastain, C-H-A-S-T-A-I-N. Highly recommend following her on IG. And don't you have a webinar coming up in January about fat something fat myths right On January 22nd.
Speaker 3:Yeah, we're going to bust fat health myths. I do a monthly online workshop, and so that's our topic for January. By request.
Speaker 4:Oh, yeah, and that's at.
Speaker 3:If you go to danceswithfatorg, you can find all the information for that as well.
Speaker 4:Cool, I'll definitely sign up for that one. Thank you so much, regan, and we hope you have a great holiday. Thanks again, we always appreciate you being with us and joining. Give us your time and I'm going to tell everybody see you later. Alligator After a while crocodile.
Speaker 3:Bye to the lot of us hippopotamus.
