October 23, 2021 • 33 mins
Dr. Joshua Wolrich (@drjoshuawolrich) explains what weight stigma is and the dangers of it. He challenges the statement “you need to lose weight” and shares how weight stigma negatively impacts patient care. This is a conversation that lives in Ep. 4 of the "OG" 4-part OUTWEIGH series from 2020 on the '4 Things With Amy Brown' podcast. If you haven't listened to all 4 parts...we highly encourage you to check it out.
Follow the hosts on instagram!
SUBSCRIBE and follow so you never miss an episode and SHARE with your friends & family.
Questions? Guest Submissions? Email us: hello@outweighpodcast.com
This podcast was edited by Houston Tilley
Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I won't let my body out out well everything that
I'm made do. Won't spend my life trying to change.
I'm learning to love who I am. I get I'm strong,
I feel free, I know who every part of me.
It's beautiful and now will always out wait if you
(00:24):
feel it with yours in the here, she'll love to
the boom. I am there. Let's say good day and
time did you and die out? Happy Saturday? Outweigh fam.
It's Amy here and today we're gonna be recapping the
dangers of a statement like you need to lose weight.
I'm gonna share with you a conversation we had with
(00:45):
Dr Joshua Woolrich, who explains what weight stigma is and
the dangers of it. He actually challenges the statement you
need to lose weight and shares how weight stigma negatively
impacts patient care, being that he's a doctor. This is
a conversation that lives in episode four of the o
G four part Outweigh series from on the Four Things
(01:06):
with Amy Brown podcast. If you haven't listened to all
four parts, we highly encourage you to check it out.
But for now, here is our conversation with Dr josh
We are so excited to have doctor Joshua will Rich
here with us, all the way from the u K
where he works as a surgical doctor at the n
h S. Hey, josh you're all about fighting Waite stigma,
(01:30):
which is awesome. And if people want to find you
on Instagram at Dr Joshua l Rich w O L
R I c H, you will not be dissorry. I
just I just laughed because of the way you said
NHS that was all. Did I say it wrong? And
apopping anyone say slowly before such a common phrase. Here
you say, well, we are so excited to have you here.
(01:54):
Thanks for your time. I know we've got quite the
time difference going on here. I found you over Instagram.
I have no idea how I've started a few months ago.
And it's always a treat because you question everything we've
been told that the plan, so sometimes get in trouble
for it. But it's more fun that way, of course,
(02:15):
And that's what I love about you. You have more
than passion. You have the confidence to speak for what
you believe in without worrying about the haters. For lack
of a better word, I feel like you're one of
those people that never says, Oh, well, what will happen
if I say this? You just say it, but it's
with conviction and most importantly, with evidence behind it. I Well,
(02:39):
to be fair, I do hold back on quite a
lot of stuff. You probably just don't see it. But yeah, no,
I agree, there's I think I'm less afraid to speak
out about stuff than a lot of people are. I'm
not entirely, entirely sure why, and I will probably get
myself in trouble for it at some point, but I'd
rather get myself in trouble for doing something like that
(03:00):
than kind of just sit by and watch it will happen.
Really well, Josh, we wanted to specifically, have you wanted
to talk about weight and how it is not equal
health and we'll just fire off some questions to you
and then you can give us your answer. Yeah. So,
I mean you're always talking about weight stigma, and this
is a brand new series. It's not a topic that
(03:22):
we've spoken about before. So could you actually just define
for everybody what weight stigma is. It's it's discrimination of
someone based on their size, and that can go and
buy the way. It can be due to someone having
a higher body weight or due to someone having a
lower body weight, but more typically it tends to be
the format, So it tends to be assumptions and discrimination
(03:43):
because of somebody at a higher body weight, usually without
any good basis behind it, but just purely because of
their size. And what are the dangers of weight stigma
on our actual health? So I guess, you know, starting
with the bigger body, which you're saying gets discriminated. So
this this was something that at one point obviously was
new to me as well. It wasn't something I'd ever
(04:04):
thought about. But it's the more I looked into it,
the more kind of concerned I was about just how
much of an impact it does have, not just on
the mental side of things, things which would be the
more would would be the more obvious things to think about,
you know, the whole psychological impact of people discriminating against you,
(04:24):
But it's also the physical side, so we know that
the people's physical health actually ends up worse off after
they've been subject to discrimination for a period of time.
It is quite all encompassing, and it's quite concerning, especially
when you look at the fact that it's it's often
completely ignored, and so just how much of an impact
it's having on someone's health is really really hard to define,
(04:47):
but we know that it's nothing but negative. Right. So
one of the things, you know, I'm a registered dietitian,
and one of the things that I've had to unlearned
over the past few years is that most people, most Americans,
I could at least infinitely say, I think that higher
weight means you will get disease, and therefore it is
your life's purpose, your duty to lose weight so that
(05:12):
you don't have disease. So what would be a more
correct way to talk about weight in a way that
propels us to help people actually achieve better health. So
one of the things, and I just wanted to clarify,
that's the UK as well, by the way, it's not
not just the US. But one of the things that
i'd kind of heard a bit more recently that struck
(05:34):
a chord with me that I thought was really interesting
was somebody kind of comparing it to age. So if
you if you take somebody's age, as we get older,
we're more at risk of certain things, right, We're you know,
we're we're more at risk of getting cancer. As we
get older, we're more risk of getting arthritis, as we
get older, and that's just a risk that we acknowledge,
and we we put certain things in place to try
(05:56):
and minimize that risk or to try and kind of
pick up on on certain health conditions, So for example,
screening programs increasing frequencies we get older, and things like that.
And I found it really interesting thinking about weight in
a similar way. So not not pretending that there is
no potential health consequences from being at a higher body weight,
(06:18):
just like there are at being in a much lower
body weight as well, but it's more the manner in
which we talk about them, and the manner in which
we think about whether they're actually changeable or whether they're
just something that we need to be aware of and
need to improve our healthcare around. And a lot of
that is around whether or not deliberate weight loss is
actually sustainable and whether or not the process of deliberate
(06:42):
dieting is actually overall positive or negative for our health.
And I'd argue it's the latter. I'd argue that for
the majority of people going on diets and deliberately restricting
calories for the purpose of losing weight tends to end
up as a as a net negative effect on their health.
And so instead of just treating somebody of a high
(07:04):
body weight and saying, well, you're at risk of disease,
you need to lose weight, it's more a case of
looking and treating those people with compassion, but also with
knowledge of how just how unsuccessful deliberate weight loss is,
and therefore not stigmatizing, but in fact looking at ways
of supporting and helping, just like we would in healthcare
(07:27):
with anything else. I just think we've we've completely started
from the wrong angle when it comes to weight. So, Josh,
I saw something that you posted on Instagram. But I
don't normally advocate burning books, but I think we should
make an exception for one's written by medical doctors claiming
to have discovered the perfect diet. Whatever you do, don't
regift them. And then in your caption you put accurate
(07:50):
diet advice isn't sexy. It doesn't really sell books despite
being pretty straightforward. And you said, prioritize vegetables and fruit,
prioritize comp carbohydrates, prioritize polly unsaturated fat, prioritize lean sources
of meat, get plenty of fiber, and so you want
to expand on that just for a second, because I mean,
(08:11):
I'm sure people like it's this weird we're in this place,
so we want to tell people, Okay, don't join this
diet culture and don't be a part of this world.
But there may be someone genuinely listening. What if a
patient is coming to you and they do need to
lose weight, Like, is this how you would handle that?
The thing that flags in my mind and I really
want to hear your response, Joshua, is the what I'm learning, right,
(08:35):
is like, they need to lose weight, but what is
the behavior that they need to change? Because weight lass
is not a behavior, right, So we've been telling people
to do something that's not a behavior. But how can
we better communicate to get them to where they need
to go? Which is essentially I think Amy's questions. Yes,
there are kind of two questions there. I would go
(08:56):
start with that second one. So I firstly, I just
challenge the statement of somebody needs to lose weight. I
challenge that statement at the beginning because I think what
people actually me and when they say that is people
need to improve their health or people are wanting to
improve their health, And the issue is that we put
all of that down to weight when actually there's a
(09:18):
lot of evidence that healthy behaviors play a much bigger
role in our health than the actual number on the scales.
And so when we've got this attitude from the from
the get go of you know, well, this patient needs
to lose weight, how can I actually kind of approach
this in a in a more compassionate manner. I think,
actually we need to start reframing that conversation going Okay, well,
(09:39):
this patient is coming in and my job as a
doctor is to help them get healthier. So how can
I actually advise them to do certain things that I
know are guarantees for their health? And so, you know,
when when I'm when I work in the hospital at
the moment, I don't actually I can't think of the
last time I actually told a patient that they needed
to lose weight, because I don't actually think that that's
(10:00):
particularly relevant or helpful advice to be giving people. Instead,
it's those behaviors such as improving the frequency of exercise,
improving sleep, improving their intake of nutritious fruit and veg
and and food in general. Like you talked about one
of my posts earlier, Having that kind of advice to
people is not only obviously depending on on privilege and
(10:23):
ability to do so, and not only relatively achievable, but
they're not damaging and they're not harmful. If somebody attempts
to exercise more frequently, the odds of that actually being
harmful for them is very low. Whereas if you tell
somebody they need to lose weight, not only if they
actually end up doing so, not only is that not
guaranteed to improve their health, but the potential for that
(10:44):
actually leading to them, you know, ending up with a
disordered eating, ending up with the worst body image. All
of that kind of stuff is very is very true,
and is very real, and so just personally, I would
just challenge that that first statement of a patient comes
needing to lose weight. I would always us, well, why
what what what do you mean by needs to lose weight?
Does that make sense? And it's the perfect example of
(11:06):
how language matters. Yes, And one of the things that
I've I've been so astounded to learn, which of course
you know, is that weight stigma is an independent risk
factor for disease. And one of the things that I
think you say is that weight is we're not saying, okay,
weight has nothing to do with your health, just like
age has nothing to do with you know, getting risk
(11:29):
of disease. But what we've oversimplified, shrunk down, you know,
boiled it down to, is that weight equals disease, higher
weight equals disease. Whereas there's it's it's correlated, but it's
not caused by So what are the other factors that
we can break down? Like feeling shameful and having the
(11:52):
stigma of how you're being perceived, or having your doctor
tell you that you're losing weight is actually backfiring, which
is like, oh my, I'm gosh, I'm terrified because doctors
one of the things that they don't have again this
in the US, is time with their patients. So oh yeah,
same here. It's it's so being able to tell them
(12:13):
to eat you know, polly unsaturated fatty acid? What to
polly unsaturated fatty acid? Telling him to eat? What? What? Veg? Right?
It did a lot easier to say all you gotta
do is lose weight and your your hemoglobe and a
want to see your blood sugar your marker for diabetes
will just you know, go go down easier. But but
it doesn't. It doesn't work. So as you know, there's
no point doing the easier thing if the outcome isn't
going to be successful, you know, And it doesn't have
(12:36):
to be that complicated, Like I don't talk to people
about poly unsaturated fats. I talked to people about you know,
where they're getting their sources of fat from, so fish,
olive oil. It doesn't have to be fancy. That's not
my role either. I'm not a dietitian, right, So if
I start going into the actual kind of fancy, in
depth details of nutrition, I'm starting I'm stepping out my
(12:56):
bounds in the first place, which is one of the
reasons why I said about burning books on diet written
by doctors, because they're just not helpful. We're not the
experts in this stuff in because to specific nutrition advice,
and we need to stop pretending that we are. But
there are some very basic things that we can advise on,
especially when we just stop blaming everything and weight. So actually,
this next conversation here is how does the way doctors
(13:19):
have been educated about weight carry into the patient experience
and how do you fight against this in the work
you do. I assume you're up against the lot every day. Yeah,
I mean so I I remember back at medical school
not being taught about wait stigma in any way, shape
or form. So not not being taught about the negative
(13:39):
health effects of stigmatizing people for their weight, even though
as far as I'm concerned, it's incredibly relevant in pretty
much all specialties and all practices, be that out in
the community or be that in the hospital. And so
we get taught about the risk factors, but without any
of the caution of how the man know in which
(14:00):
we approach it, or the way we talk about it
can have from a negative side of things on the patient.
So I don't think personally that that doctors necessarily mean
badly when they're when they're saying these things. I think
that actually we're you know, and I'd say this from
personal experience as well. You know, we we think that
it's the correct advice to be giving or the correct
(14:21):
way to be speaking, because without without thinking about it
in a slightly novel way to a way we haven't
thought about it before, it makes sense to advise weight
loss if you don't think about the success rate of
all of it. We we have been taught an awful
lot about how way equals health, and I think we
need to start on learning some of it, and it does,
(14:43):
I remember what you said, So it does. It does
massively negatively affect the patient experience. Doctors and medical students
have some of the highest rates of weight stigma when
they're when they're polled, and when they're kind of questioned
about whether or not they assume. So for example, one
way that wait stigma shows itself is by assuming that
somebody who's over a certain body weight is lazy, you know.
(15:04):
So it's a it's an assumption, and it leads to
all sorts of things that leads to lower hiring rates
of people of a larger size because employers think they're
not going to do their job properly. It goes far
and beyond the actual kind of health fare specifically, but
looking at it in terms of the doctor's office, it
means that there are other things that also come up.
So doctors assume that somebody is going to be more lazy.
(15:26):
Doctors assume that if they say they're doing something they
may not be. They assume that they're not eating fruit
and veg even though that's not necessarily true, you know.
They assume that they're not exercising, although again that may
not be true either. So there's a lot of assumptions
that take place, and when you have such a short
time for a consultation, those assumptions unfortunately end up sticking
(15:48):
because you don't necessarily have the time to answer to
kind of check every single assumption, even though you should
do um So it does it massively negatively impacts the
kind of advice that gets given, a kind of care
that people receive, and on top of that, it also
impacts people's willingness to come back. So unless that weight
stigma is internalized, which you know, we can talk about
(16:09):
it a bit if you want, the actual impact on
the patient who goes in for something unrelated to their
weight and yet again gets told that they should lose
weight means that they're not going to want to come
back again, and it leads to lower seeking, lower rates
of care seeking by patients, And it just adds to
that whole reduced care for people of a higher body
(16:30):
size because they end up not going back to their
doctor as quickly as they should do for other medical
health problems that in itself is a real is a real,
real problem. Just something you said triggered a memory in
me where there's been times in my life that I
have avoided going to the doctor or the O, B.
G U I in or wherever be simply because I
(16:50):
did not want to step on a scale and I
was terrified to see what I weighed because I wasn't
weighing myself at home and I didn't want to, or
maybe even if I was, I just didn't want their
scale to be different than my scale at home and
it be higher and then send me into some weird
thing just because of the number I saw on the
(17:10):
scale the doctor like, And there's probably people listening that
have had that same exact fear, and so do you
have any thoughts on that for people? Yeah, well, so
I get messages like that all the time on my Instagram,
and it is it's quite heartbreaking some of them because
people are going into quite extensive detail about some of
the harm that they've come to because they haven't gone
(17:31):
soon enough for certain things and they just haven't wanted
to go to the doctor. And the difficulty is because
doctors in general don't really have an understanding of this
impact of not just stigma, but the impact psychologically that
people's body image has. It means that there's no real
(17:53):
there's no real second thought. You know, there's a tick
box on on some of the on some of the
forms that's just you know, well, what's the patient's way
pipe in tick box, I will tell them to his weight,
and it means that there's there's just no there's no
thought process there. That's the stuff that needs to change.
I get people, and I'm assuming this is kind of
the question you're asking as well. I get people ask me, well,
what can I do because I don't want to avoid
(18:13):
my doctor because I have things that I need to
get checked out, but I can't bring myself to go
because I know, yet again, there are going to be
they're going to weigh me, or they're going to tell
me to lose weight, or they're going to blame my
my symptoms on my weight. And the thing that I
tend to advise not and again not that I'm the
necessarily the expert on this, but this just tends to
(18:34):
be something that I feel would have prompted me to
to to take more thought before I before I ever
started looking to some of this stuff. Is actually just
having a conversation right at the beginning about again, if
it's true about disordered eating and just saying, look, I
have quite harmful thoughts to me psychologically about my my
(18:54):
body image, about my weight. The impact of dieting attempted
dieting in the past led to me having quite disordered
eating behaviors, and because of that, I really don't want
to have discussions around my way today. And I really
feel uncomfortable being weighed because I feel like that would
actually be quite detrimental to me psychologically. And so I'm
(19:18):
just wondering whether we could avoid that today and having
that conversation. I know, I know that so no one,
no one's ever said that to me ever, not and
I hadn't been a doctor very long before I started
looking into this kind of stuff. But I would still
argue that for the majority of doctors, they will never
have had anyone say that to them, and that would
(19:38):
if somebody had said that to me, that would have
you know, the doctors do have an element of compassion
in them, that's the point, And that would have been
something that really would have taken me aback and gone like,
hang on a second, what what what is this here?
Like that's that's quite a big deal. And I know
that that's probably also quite a big deal for people
to say and for people to bring up the courage
(20:00):
to say that kind of stuff. But that kind of
comes under the the whole element of advocating for yourself
when other people can't. And that would have brought up
so many questions for me that I would have googled,
looked into, had conversation with my colleagues about and for
a doctor to after you said that to them, for
a doctor to then go, yeah, I don't care, get
on the scale. I think that's a that's a pretty
(20:21):
good reason to find a different doctor if you've actually
said that to them and they still completely ignore you.
Whereas up until then it's more of this learned behavior
that is that is just commonplace in medical practice. Whereas
once you once you say that to them, if they
ignore you, then then that's no longer you can't you
can no longer blame that and learned behavior. That's then
them not listening to the patient. And you don't want
(20:43):
to be seeing a doctor that's not listening to you.
And I think that's like a really good point. And
I'm all about really trying to recognize that things are
in generalization, so not like oh, all doctors suck, are
all Western doctors suck, you know, because they don't Wanever.
Your point there is that like anybody who went through
the training to become a doctor is a compassionate, kind
(21:04):
human being who cares about others more than they care
about themselves. That being said, they're also very analytical and
taught to find what is wrong, to find the diagnosis.
So I think oftentimes they come into the room kind
of like on a scavenger hunt, right like, looking for
what the problem is, and lose the compassion element because
(21:24):
they're so driven to find the problem. But when the
patient comes in and says, hey, I'm a patient, I'm
a human, I have these feelings, I think that the
patient actually has incredible power to bring them back to
human and have themselves advocate, to be heard better, louder, clear,
and that that compassionate thing is really important because I've
seen I've seen people being given advice around Just take
(21:46):
this piece of paper in and give it to the doctor,
and you know it says in this paper, you know
I refuse to be weighed. Would you would you give
this advice to a thin person? And all of those
things are valid questions, but they start personally. They start
off on the wrong first, because the act would I know, yeah,
I know, it would make me feel like, you know,
I'm I'm not really being asked my opinion. I'm not
(22:07):
really here as a doctor. I'm just being used to
get something at that point. And it and it it's
that compassion element. It's it's not forgetting that they are
human too and they actually want to help. It just
sometimes they go about it in the wrong way. We're
in the midst of a big change right now. I
I don't know if it's only happening in my tiny
corner of the internet, but I can't help but see
(22:29):
how social media becomes the real world and we are
talking about these things. So for women and men that
are afraid of the doctor to recognize that, I think
we're in the middle of a change. So don't get
so frustrated. If you find a doctor that doesn't hear you,
then it's time to find another doctor that may better
be able to listen to your needs. Yeah, and I
(22:52):
know not everyone can do that, but but for people
that can, I think that's quite a good plumb line
to have. If you've had that conversation with them and
they still ignore you, I think it's time to it's
time to perhaps find somebody who's willing to listen to you,
because otherwise, you know, I listen to you on that
and they don't have to agree with you, right, So
it's not that you say this and they suddenly go, oh,
you're right weight. It's got nothing to with you know.
(23:13):
Weight should never be mentioned in a consultation because that
kind of stuff is going to take time. But it's
if they listen to you and they understand the frustrations
and the concerns that you have, that's a start, and
that's something that can trigger more thoughts from them, and
you may actually even end up preventing the same kind
of behavior with other patients. Josh, I want to shift
(23:33):
to a little bit of a different topic and another
thing that I saw you post about. I would definitely
just encourage you for to check you out on Instagram
because you do put up stuff that's very thought provoking
and for me has been good to see that. This
is a post from back in December where I'm assuming
these are your words. You can correct me if I'm wrong,
(23:55):
but you said shortsighted idiots. If everyone exercised in an
attempt to undo the food they ate, the population would
die of starvation. We need food to stay alive and function.
We need food for health. The use of grossly inaccurate
exercise calorie labels to encourage the earning of food only
serves to encourage eating disorder behaviors. It's so blanking stupid,
(24:18):
it's unreal. Exercises a celebration of what you can do,
not a punishment for what you ate. Yeah, I think everything,
but that last sentence was mine. I think I've heard
that last sentence before. But well, and you did highlight that.
You highlighted that part in yellow, so maybe you credited
it somewhere. But yeah, I mean, but for me, I
had never you know, those words. Exercises a celebration of
(24:41):
what you can do, not a punishment for what you ate.
And I think for a lot of us, just that
mentality of having to relearn. I feel like it's just
a part of life, and it's very natural to be like, oh,
well I'm gonna eat this, A better go work out,
or I ate that, I better go for a run,
or if I'm going to go to that dinner, I'm
gonna work out beforehand, or worse, I can't eat that
(25:02):
because then I'd have to work out. Yeah, so it's
like yeah, or I haven't been to the gym today,
so therefore I should change why I've eaten for dinner.
Things like that. And and Amy and I always we
have these conversations about food and movement, right like they're
the two things that were meant to eat, were meant
to have relationships with. We need food to survive, and
(25:22):
we're inherently made to move. We're not changing our relationship
to not eat or to not move, but how can
we shift the relationship for the positive so that food
is not earned and that exercise movement is a celebration.
Such an important conversation to be having. The reason I
posted that in December because I think there was some
talk in the UK at least around the potential of
(25:45):
changing the calorie labels on food items to exercise labels.
Instead of just having written on the packet how many
calories was in a food item, it actually had written
on the packet you know how many minutes of running
it would take. And just for me, that was just
so so shortsighted. It was unbelievable, just how damaging some
(26:05):
government person and probably person well, but I mean seriously,
whether it's implemented at a government level. I mean there's
still damaging stuff just on social media, Like when it's
Halloween time and people are trick or treating, all kinds
of articles come out of like if you eat ah,
you know, fun sized KitKat, If you do you know,
(26:26):
three hundred jumping jacks and ten burpies, you burned it off.
So like then there, I mean, and they do it
for all. It's a standard conversation, isn't it. It's a
it's it's rife. And the only reason that they even
considered it with the food labels is because the fact
that it's such a common thing for people to talk about. Remember,
all these people that make these decisions are human too,
(26:48):
and they're all subject to the same damaging rhetoric that
that just it's insidious. It just happens, and people don't
think twice about it, and I just the frustration for
me is that when you start treat eating, exercise is
just something to undo food. You know, we we know
that that food and activity are intrinsically linked. We know that,
(27:08):
we know that. You know, if you're an elite athlete,
you're you know, having a having a nutritionus or a
dietician work with you and and you prep your food
and it's going to make you, you know, run faster
or jump further. Like we we know that those two
are intrinsically linked, but unless you're a professional athlete, always
linking the two becomes really harmful psychologically because it means
(27:31):
that you are just spending your whole time worrying about
whether you've earned something, and when you when you put
something in that bracket, it leads to a feeling of
guilt and shame because if you eat and you don't
think you've earned it, then you feel guilty straightaway. Right
if you if you do something that you don't think
you've earned, you feel shamed that you've that you haven't
earned till you so you've done the wrong thing. And
(27:54):
it just it creates this moralistic attitude around food where
it's it's a it like and it's on the same
vein of when I talk about labeling foods good and bad,
which I think is really really unhealthy and unhelpful as well.
It means that you you start thinking that you're a
bad person if you've done the wrong thing. And it's
all of these rules that we start instigating and implementing
(28:17):
on ourselves because we see other people doing it and
we see people talking about it in that way. It's just,
I mean, I can't really put into words how frustrating
it is when I see it, and how damaging I
feel that it that it ends up being, and also
just how unfair it is to what exercise actually is
and what exercise can actually do, and how how good
(28:37):
exercise can be and how important exercise is for our health.
It just ruins the whole flipping things not just ruins
when you make it about food, it becomes unsustainable. It's
like the first week, the first the second week of
living that way of of seeing your food as you know, okay,
well I'm going to the gym more, I'm being healthy.
It starts as like this inner motivation, and then it
(28:58):
fizzles because on the day that you can get to
the gym that day, now what it's like. It starts
on this that builds the morality I'm good because I'm good,
because I'm okay, because I'm okay because and then the
day the cycle pivots, which it will because life you're
faced with yourself and a negative relationship to food and exercise,
so we need to not don't give yourself flexibility, like
(29:21):
you know, exercise should be flexible. There are going to
be certain weeks that you can exercise more. There are
going to be certain weeks that you can't. There are
gonna be certain times in your life where something is
going on and you get and you get too busy
to be able to actually have regular activity in your life.
And there are going to be weeks when you have
loads of time to do it. And if if everything
has to be so rigid and so structured, that flexibility
(29:42):
is lost and it and it makes you feel really
bad that you can't do it quickly. Just before we wrap,
being that your doctor that's on here, and I feel
like that gives you some credibility and a least he's
touched on this too. But even when it comes to
working out or burning off the calories, since we're on
that topic, which I think we'll dig into it some
more later, but it it's not even accurate. So can
(30:02):
you touch on what like we're getting these food labels.
I don't know what it's like in the UK, but
in the US it's like, okay, you just say this,
it's a hundred calories and twenty three carbs, and you
know this is what you need to do to burn
it or track it or whatever. But all of our
bodies are so different, Like I'm not breaking food down
the way you're breaking food down. No, no, no, there's
I mean, you know, you know it's more, probably more
(30:24):
than I do. But the actual amount of avanergy that
we absorbed from food is going to vary from person
to person. It's going to vary based on how that
food is prepared, It's going to vary on all sorts
of things. Not only is the actual kind of measurement
of of how much energy we burn when we exercise
going to be so vastly different from person to person
(30:45):
because of their size and how intense they do the
activity and all sorts of things. But whether or not
it's it's relevant at all, or how people then implement
it when it comes to food is so off anyway.
So you've just got two completely inaccurate things. You're putting
together that and then judging your entire well being and
how good you feel that day and how proud you
(31:05):
are of yourself, and you're judging all of it on
something that is just nonsense and it's it's a recipe
for disaster. And there's no wonder that all of this
fails time and time again, and no wonder that people
hate the thought of cardio and hate the thought of
exercise because it's just so frustrating, And no wonder people
hate the thought of having you know, the wrong in quotes,
(31:28):
meal at the wrong in quotes time of day because
then they've got to go and work out and figure
out I was that correct, and they've probably got to
do more than it says on their watch because it
didn't work last time. And it's just it's a spiral
of nonsense. And so if we can start, if we
can start just talking about exercise in terms of well
it's going to improve your health. Forget food, forget calories
(31:51):
for a second, go and go and lift some weights
and get stronger. It's a really really cool achievement to
be able to do a pull up that you couldn't do,
Like I know this. I could never do a pull
up and now I can. And it's like one of
the coolest feelings in the world. Like, you know, that's
got nothing to do with my food or your or
your self worth. It might build yourself, but it makes
you feel good and strong. Yeah, I forget my self
(32:14):
worth but it but it, you know, but it's a
good it's a good way of knowing that actually I
have objectively become healthier because I have become stronger. It's
got nothing to do with with anything that is so
spirits as well, I've changed one point on the BMI
scale and now I'm in a different bracket and so
I can stop now like I'm good. Like it's it's
(32:34):
just it just makes no sense. Well, thank you so
much for coming on. I think we learned so much.
I think, well, we have a better ability to communicate
with our doctors and remember that we can and should
continue to see our doctors even if it comes with
some fear, because they truly are compassionate people that want
the best for us. Yeah, thank you josh for coming on.
(32:56):
Follow him at doctor Joshua wal Rich and they for
coming home. We're so happy we got to speak with you. No,
thank you for having me. It was a lovely chat. MH.
I won't let my body out out well everything that
I'm made do. Won't spend my life trying to change.
I'm learning to love who I am. I get I'm strong,
I feel free, I know who every part of me.
It's beautiful and now will always out wait if you
(00:24):
feel it with yours in the here, she'll love to
the boom. I am there. Let's say good day and
time did you and die out? Happy Saturday? Outweigh fam.
It's Amy here and today we're gonna be recapping the
dangers of a statement like you need to lose weight.
I'm gonna share with you a conversation we had with
(00:45):
Dr Joshua Woolrich, who explains what weight stigma is and
the dangers of it. He actually challenges the statement you
need to lose weight and shares how weight stigma negatively
impacts patient care, being that he's a doctor. This is
a conversation that lives in episode four of the o
G four part Outweigh series from on the Four Things
(01:06):
with Amy Brown podcast. If you haven't listened to all
four parts, we highly encourage you to check it out.
But for now, here is our conversation with Dr josh
We are so excited to have doctor Joshua will Rich
here with us, all the way from the u K
where he works as a surgical doctor at the n
h S. Hey, josh you're all about fighting Waite stigma,
(01:30):
which is awesome. And if people want to find you
on Instagram at Dr Joshua l Rich w O L
R I c H, you will not be dissorry. I
just I just laughed because of the way you said
NHS that was all. Did I say it wrong? And
apopping anyone say slowly before such a common phrase. Here
you say, well, we are so excited to have you here.
(01:54):
Thanks for your time. I know we've got quite the
time difference going on here. I found you over Instagram.
I have no idea how I've started a few months ago.
And it's always a treat because you question everything we've
been told that the plan, so sometimes get in trouble
for it. But it's more fun that way, of course,
(02:15):
And that's what I love about you. You have more
than passion. You have the confidence to speak for what
you believe in without worrying about the haters. For lack
of a better word, I feel like you're one of
those people that never says, Oh, well, what will happen
if I say this? You just say it, but it's
with conviction and most importantly, with evidence behind it. I Well,
(02:39):
to be fair, I do hold back on quite a
lot of stuff. You probably just don't see it. But yeah, no,
I agree, there's I think I'm less afraid to speak
out about stuff than a lot of people are. I'm
not entirely, entirely sure why, and I will probably get
myself in trouble for it at some point, but I'd
rather get myself in trouble for doing something like that
(03:00):
than kind of just sit by and watch it will happen.
Really well, Josh, we wanted to specifically, have you wanted
to talk about weight and how it is not equal
health and we'll just fire off some questions to you
and then you can give us your answer. Yeah. So,
I mean you're always talking about weight stigma, and this
is a brand new series. It's not a topic that
(03:22):
we've spoken about before. So could you actually just define
for everybody what weight stigma is. It's it's discrimination of
someone based on their size, and that can go and
buy the way. It can be due to someone having
a higher body weight or due to someone having a
lower body weight, but more typically it tends to be
the format, So it tends to be assumptions and discrimination
(03:43):
because of somebody at a higher body weight, usually without
any good basis behind it, but just purely because of
their size. And what are the dangers of weight stigma
on our actual health? So I guess, you know, starting
with the bigger body, which you're saying gets discriminated. So
this this was something that at one point obviously was
new to me as well. It wasn't something I'd ever
(04:04):
thought about. But it's the more I looked into it,
the more kind of concerned I was about just how
much of an impact it does have, not just on
the mental side of things, things which would be the
more would would be the more obvious things to think about,
you know, the whole psychological impact of people discriminating against you,
(04:24):
But it's also the physical side, so we know that
the people's physical health actually ends up worse off after
they've been subject to discrimination for a period of time.
It is quite all encompassing, and it's quite concerning, especially
when you look at the fact that it's it's often
completely ignored, and so just how much of an impact
it's having on someone's health is really really hard to define,
(04:47):
but we know that it's nothing but negative. Right. So
one of the things, you know, I'm a registered dietitian,
and one of the things that I've had to unlearned
over the past few years is that most people, most Americans,
I could at least infinitely say, I think that higher
weight means you will get disease, and therefore it is
your life's purpose, your duty to lose weight so that
(05:12):
you don't have disease. So what would be a more
correct way to talk about weight in a way that
propels us to help people actually achieve better health. So
one of the things, and I just wanted to clarify,
that's the UK as well, by the way, it's not
not just the US. But one of the things that
i'd kind of heard a bit more recently that struck
(05:34):
a chord with me that I thought was really interesting
was somebody kind of comparing it to age. So if
you if you take somebody's age, as we get older,
we're more at risk of certain things, right, We're you know,
we're we're more at risk of getting cancer. As we
get older, we're more risk of getting arthritis, as we
get older, and that's just a risk that we acknowledge,
and we we put certain things in place to try
(05:56):
and minimize that risk or to try and kind of
pick up on on certain health conditions, So for example,
screening programs increasing frequencies we get older, and things like that.
And I found it really interesting thinking about weight in
a similar way. So not not pretending that there is
no potential health consequences from being at a higher body weight,
(06:18):
just like there are at being in a much lower
body weight as well, but it's more the manner in
which we talk about them, and the manner in which
we think about whether they're actually changeable or whether they're
just something that we need to be aware of and
need to improve our healthcare around. And a lot of
that is around whether or not deliberate weight loss is
actually sustainable and whether or not the process of deliberate
(06:42):
dieting is actually overall positive or negative for our health.
And I'd argue it's the latter. I'd argue that for
the majority of people going on diets and deliberately restricting
calories for the purpose of losing weight tends to end
up as a as a net negative effect on their health.
And so instead of just treating somebody of a high
(07:04):
body weight and saying, well, you're at risk of disease,
you need to lose weight, it's more a case of
looking and treating those people with compassion, but also with
knowledge of how just how unsuccessful deliberate weight loss is,
and therefore not stigmatizing, but in fact looking at ways
of supporting and helping, just like we would in healthcare
(07:27):
with anything else. I just think we've we've completely started
from the wrong angle when it comes to weight. So, Josh,
I saw something that you posted on Instagram. But I
don't normally advocate burning books, but I think we should
make an exception for one's written by medical doctors claiming
to have discovered the perfect diet. Whatever you do, don't
regift them. And then in your caption you put accurate
(07:50):
diet advice isn't sexy. It doesn't really sell books despite
being pretty straightforward. And you said, prioritize vegetables and fruit,
prioritize comp carbohydrates, prioritize polly unsaturated fat, prioritize lean sources
of meat, get plenty of fiber, and so you want
to expand on that just for a second, because I mean,
(08:11):
I'm sure people like it's this weird we're in this place,
so we want to tell people, Okay, don't join this
diet culture and don't be a part of this world.
But there may be someone genuinely listening. What if a
patient is coming to you and they do need to
lose weight, Like, is this how you would handle that?
The thing that flags in my mind and I really
want to hear your response, Joshua, is the what I'm learning, right,
(08:35):
is like, they need to lose weight, but what is
the behavior that they need to change? Because weight lass
is not a behavior, right, So we've been telling people
to do something that's not a behavior. But how can
we better communicate to get them to where they need
to go? Which is essentially I think Amy's questions. Yes,
there are kind of two questions there. I would go
(08:56):
start with that second one. So I firstly, I just
challenge the statement of somebody needs to lose weight. I
challenge that statement at the beginning because I think what
people actually me and when they say that is people
need to improve their health or people are wanting to
improve their health, And the issue is that we put
all of that down to weight when actually there's a
(09:18):
lot of evidence that healthy behaviors play a much bigger
role in our health than the actual number on the scales.
And so when we've got this attitude from the from
the get go of you know, well, this patient needs
to lose weight, how can I actually kind of approach
this in a in a more compassionate manner. I think,
actually we need to start reframing that conversation going Okay, well,
(09:39):
this patient is coming in and my job as a
doctor is to help them get healthier. So how can
I actually advise them to do certain things that I
know are guarantees for their health? And so, you know,
when when I'm when I work in the hospital at
the moment, I don't actually I can't think of the
last time I actually told a patient that they needed
to lose weight, because I don't actually think that that's
(10:00):
particularly relevant or helpful advice to be giving people. Instead,
it's those behaviors such as improving the frequency of exercise,
improving sleep, improving their intake of nutritious fruit and veg
and and food in general. Like you talked about one
of my posts earlier, Having that kind of advice to
people is not only obviously depending on on privilege and
(10:23):
ability to do so, and not only relatively achievable, but
they're not damaging and they're not harmful. If somebody attempts
to exercise more frequently, the odds of that actually being
harmful for them is very low. Whereas if you tell
somebody they need to lose weight, not only if they
actually end up doing so, not only is that not
guaranteed to improve their health, but the potential for that
(10:44):
actually leading to them, you know, ending up with a
disordered eating, ending up with the worst body image. All
of that kind of stuff is very is very true,
and is very real, and so just personally, I would
just challenge that that first statement of a patient comes
needing to lose weight. I would always us, well, why
what what what do you mean by needs to lose weight?
Does that make sense? And it's the perfect example of
(11:06):
how language matters. Yes, And one of the things that
I've I've been so astounded to learn, which of course
you know, is that weight stigma is an independent risk
factor for disease. And one of the things that I
think you say is that weight is we're not saying, okay,
weight has nothing to do with your health, just like
age has nothing to do with you know, getting risk
(11:29):
of disease. But what we've oversimplified, shrunk down, you know,
boiled it down to, is that weight equals disease, higher
weight equals disease. Whereas there's it's it's correlated, but it's
not caused by So what are the other factors that
we can break down? Like feeling shameful and having the
(11:52):
stigma of how you're being perceived, or having your doctor
tell you that you're losing weight is actually backfiring, which
is like, oh my, I'm gosh, I'm terrified because doctors
one of the things that they don't have again this
in the US, is time with their patients. So oh yeah,
same here. It's it's so being able to tell them
(12:13):
to eat you know, polly unsaturated fatty acid? What to
polly unsaturated fatty acid? Telling him to eat? What? What? Veg? Right?
It did a lot easier to say all you gotta
do is lose weight and your your hemoglobe and a
want to see your blood sugar your marker for diabetes
will just you know, go go down easier. But but
it doesn't. It doesn't work. So as you know, there's
no point doing the easier thing if the outcome isn't
going to be successful, you know, And it doesn't have
(12:36):
to be that complicated, Like I don't talk to people
about poly unsaturated fats. I talked to people about you know,
where they're getting their sources of fat from, so fish,
olive oil. It doesn't have to be fancy. That's not
my role either. I'm not a dietitian, right, So if
I start going into the actual kind of fancy, in
depth details of nutrition, I'm starting I'm stepping out my
(12:56):
bounds in the first place, which is one of the
reasons why I said about burning books on diet written
by doctors, because they're just not helpful. We're not the
experts in this stuff in because to specific nutrition advice,
and we need to stop pretending that we are. But
there are some very basic things that we can advise on,
especially when we just stop blaming everything and weight. So actually,
this next conversation here is how does the way doctors
(13:19):
have been educated about weight carry into the patient experience
and how do you fight against this in the work
you do. I assume you're up against the lot every day. Yeah,
I mean so I I remember back at medical school
not being taught about wait stigma in any way, shape
or form. So not not being taught about the negative
(13:39):
health effects of stigmatizing people for their weight, even though
as far as I'm concerned, it's incredibly relevant in pretty
much all specialties and all practices, be that out in
the community or be that in the hospital. And so
we get taught about the risk factors, but without any
of the caution of how the man know in which
(14:00):
we approach it, or the way we talk about it
can have from a negative side of things on the patient.
So I don't think personally that that doctors necessarily mean
badly when they're when they're saying these things. I think
that actually we're you know, and I'd say this from
personal experience as well. You know, we we think that
it's the correct advice to be giving or the correct
(14:21):
way to be speaking, because without without thinking about it
in a slightly novel way to a way we haven't
thought about it before, it makes sense to advise weight
loss if you don't think about the success rate of
all of it. We we have been taught an awful
lot about how way equals health, and I think we
need to start on learning some of it, and it does,
(14:43):
I remember what you said, So it does. It does
massively negatively affect the patient experience. Doctors and medical students
have some of the highest rates of weight stigma when
they're when they're polled, and when they're kind of questioned
about whether or not they assume. So for example, one
way that wait stigma shows itself is by assuming that
somebody who's over a certain body weight is lazy, you know.
(15:04):
So it's a it's an assumption, and it leads to
all sorts of things that leads to lower hiring rates
of people of a larger size because employers think they're
not going to do their job properly. It goes far
and beyond the actual kind of health fare specifically, but
looking at it in terms of the doctor's office, it
means that there are other things that also come up.
So doctors assume that somebody is going to be more lazy.
(15:26):
Doctors assume that if they say they're doing something they
may not be. They assume that they're not eating fruit
and veg even though that's not necessarily true, you know.
They assume that they're not exercising, although again that may
not be true either. So there's a lot of assumptions
that take place, and when you have such a short
time for a consultation, those assumptions unfortunately end up sticking
(15:48):
because you don't necessarily have the time to answer to
kind of check every single assumption, even though you should
do um So it does it massively negatively impacts the
kind of advice that gets given, a kind of care
that people receive, and on top of that, it also
impacts people's willingness to come back. So unless that weight
stigma is internalized, which you know, we can talk about
(16:09):
it a bit if you want, the actual impact on
the patient who goes in for something unrelated to their
weight and yet again gets told that they should lose
weight means that they're not going to want to come
back again, and it leads to lower seeking, lower rates
of care seeking by patients, And it just adds to
that whole reduced care for people of a higher body
(16:30):
size because they end up not going back to their
doctor as quickly as they should do for other medical
health problems that in itself is a real is a real,
real problem. Just something you said triggered a memory in
me where there's been times in my life that I
have avoided going to the doctor or the O, B.
G U I in or wherever be simply because I
(16:50):
did not want to step on a scale and I
was terrified to see what I weighed because I wasn't
weighing myself at home and I didn't want to, or
maybe even if I was, I just didn't want their
scale to be different than my scale at home and
it be higher and then send me into some weird
thing just because of the number I saw on the
(17:10):
scale the doctor like, And there's probably people listening that
have had that same exact fear, and so do you
have any thoughts on that for people? Yeah, well, so
I get messages like that all the time on my Instagram,
and it is it's quite heartbreaking some of them because
people are going into quite extensive detail about some of
the harm that they've come to because they haven't gone
(17:31):
soon enough for certain things and they just haven't wanted
to go to the doctor. And the difficulty is because
doctors in general don't really have an understanding of this
impact of not just stigma, but the impact psychologically that
people's body image has. It means that there's no real
(17:53):
there's no real second thought. You know, there's a tick
box on on some of the on some of the
forms that's just you know, well, what's the patient's way
pipe in tick box, I will tell them to his weight,
and it means that there's there's just no there's no
thought process there. That's the stuff that needs to change.
I get people, and I'm assuming this is kind of
the question you're asking as well. I get people ask me, well,
what can I do because I don't want to avoid
(18:13):
my doctor because I have things that I need to
get checked out, but I can't bring myself to go
because I know, yet again, there are going to be
they're going to weigh me, or they're going to tell
me to lose weight, or they're going to blame my
my symptoms on my weight. And the thing that I
tend to advise not and again not that I'm the
necessarily the expert on this, but this just tends to
(18:34):
be something that I feel would have prompted me to
to to take more thought before I before I ever
started looking to some of this stuff. Is actually just
having a conversation right at the beginning about again, if
it's true about disordered eating and just saying, look, I
have quite harmful thoughts to me psychologically about my my
(18:54):
body image, about my weight. The impact of dieting attempted
dieting in the past led to me having quite disordered
eating behaviors, and because of that, I really don't want
to have discussions around my way today. And I really
feel uncomfortable being weighed because I feel like that would
actually be quite detrimental to me psychologically. And so I'm
(19:18):
just wondering whether we could avoid that today and having
that conversation. I know, I know that so no one,
no one's ever said that to me ever, not and
I hadn't been a doctor very long before I started
looking into this kind of stuff. But I would still
argue that for the majority of doctors, they will never
have had anyone say that to them, and that would
(19:38):
if somebody had said that to me, that would have
you know, the doctors do have an element of compassion
in them, that's the point, And that would have been
something that really would have taken me aback and gone like,
hang on a second, what what what is this here?
Like that's that's quite a big deal. And I know
that that's probably also quite a big deal for people
to say and for people to bring up the courage
(20:00):
to say that kind of stuff. But that kind of
comes under the the whole element of advocating for yourself
when other people can't. And that would have brought up
so many questions for me that I would have googled,
looked into, had conversation with my colleagues about and for
a doctor to after you said that to them, for
a doctor to then go, yeah, I don't care, get
on the scale. I think that's a that's a pretty
(20:21):
good reason to find a different doctor if you've actually
said that to them and they still completely ignore you.
Whereas up until then it's more of this learned behavior
that is that is just commonplace in medical practice. Whereas
once you once you say that to them, if they
ignore you, then then that's no longer you can't you
can no longer blame that and learned behavior. That's then
them not listening to the patient. And you don't want
(20:43):
to be seeing a doctor that's not listening to you.
And I think that's like a really good point. And
I'm all about really trying to recognize that things are
in generalization, so not like oh, all doctors suck, are
all Western doctors suck, you know, because they don't Wanever.
Your point there is that like anybody who went through
the training to become a doctor is a compassionate, kind
(21:04):
human being who cares about others more than they care
about themselves. That being said, they're also very analytical and
taught to find what is wrong, to find the diagnosis.
So I think oftentimes they come into the room kind
of like on a scavenger hunt, right like, looking for
what the problem is, and lose the compassion element because
(21:24):
they're so driven to find the problem. But when the
patient comes in and says, hey, I'm a patient, I'm
a human, I have these feelings, I think that the
patient actually has incredible power to bring them back to
human and have themselves advocate, to be heard better, louder, clear,
and that that compassionate thing is really important because I've
seen I've seen people being given advice around Just take
(21:46):
this piece of paper in and give it to the doctor,
and you know it says in this paper, you know
I refuse to be weighed. Would you would you give
this advice to a thin person? And all of those
things are valid questions, but they start personally. They start
off on the wrong first, because the act would I know, yeah,
I know, it would make me feel like, you know,
I'm I'm not really being asked my opinion. I'm not
(22:07):
really here as a doctor. I'm just being used to
get something at that point. And it and it it's
that compassion element. It's it's not forgetting that they are
human too and they actually want to help. It just
sometimes they go about it in the wrong way. We're
in the midst of a big change right now. I
I don't know if it's only happening in my tiny
corner of the internet, but I can't help but see
(22:29):
how social media becomes the real world and we are
talking about these things. So for women and men that
are afraid of the doctor to recognize that, I think
we're in the middle of a change. So don't get
so frustrated. If you find a doctor that doesn't hear you,
then it's time to find another doctor that may better
be able to listen to your needs. Yeah, and I
(22:52):
know not everyone can do that, but but for people
that can, I think that's quite a good plumb line
to have. If you've had that conversation with them and
they still ignore you, I think it's time to it's
time to perhaps find somebody who's willing to listen to you,
because otherwise, you know, I listen to you on that
and they don't have to agree with you, right, So
it's not that you say this and they suddenly go, oh,
you're right weight. It's got nothing to with you know.
(23:13):
Weight should never be mentioned in a consultation because that
kind of stuff is going to take time. But it's
if they listen to you and they understand the frustrations
and the concerns that you have, that's a start, and
that's something that can trigger more thoughts from them, and
you may actually even end up preventing the same kind
of behavior with other patients. Josh, I want to shift
(23:33):
to a little bit of a different topic and another
thing that I saw you post about. I would definitely
just encourage you for to check you out on Instagram
because you do put up stuff that's very thought provoking
and for me has been good to see that. This
is a post from back in December where I'm assuming
these are your words. You can correct me if I'm wrong,
(23:55):
but you said shortsighted idiots. If everyone exercised in an
attempt to undo the food they ate, the population would
die of starvation. We need food to stay alive and function.
We need food for health. The use of grossly inaccurate
exercise calorie labels to encourage the earning of food only
serves to encourage eating disorder behaviors. It's so blanking stupid,
(24:18):
it's unreal. Exercises a celebration of what you can do,
not a punishment for what you ate. Yeah, I think everything,
but that last sentence was mine. I think I've heard
that last sentence before. But well, and you did highlight that.
You highlighted that part in yellow, so maybe you credited
it somewhere. But yeah, I mean, but for me, I
had never you know, those words. Exercises a celebration of
(24:41):
what you can do, not a punishment for what you ate.
And I think for a lot of us, just that
mentality of having to relearn. I feel like it's just
a part of life, and it's very natural to be like, oh,
well I'm gonna eat this, A better go work out,
or I ate that, I better go for a run,
or if I'm going to go to that dinner, I'm
gonna work out beforehand, or worse, I can't eat that
(25:02):
because then I'd have to work out. Yeah, so it's
like yeah, or I haven't been to the gym today,
so therefore I should change why I've eaten for dinner.
Things like that. And and Amy and I always we
have these conversations about food and movement, right like they're
the two things that were meant to eat, were meant
to have relationships with. We need food to survive, and
(25:22):
we're inherently made to move. We're not changing our relationship
to not eat or to not move, but how can
we shift the relationship for the positive so that food
is not earned and that exercise movement is a celebration.
Such an important conversation to be having. The reason I
posted that in December because I think there was some
talk in the UK at least around the potential of
(25:45):
changing the calorie labels on food items to exercise labels.
Instead of just having written on the packet how many
calories was in a food item, it actually had written
on the packet you know how many minutes of running
it would take. And just for me, that was just
so so shortsighted. It was unbelievable, just how damaging some
(26:05):
government person and probably person well, but I mean seriously,
whether it's implemented at a government level. I mean there's
still damaging stuff just on social media, Like when it's
Halloween time and people are trick or treating, all kinds
of articles come out of like if you eat ah,
you know, fun sized KitKat, If you do you know,
(26:26):
three hundred jumping jacks and ten burpies, you burned it off.
So like then there, I mean, and they do it
for all. It's a standard conversation, isn't it. It's a
it's it's rife. And the only reason that they even
considered it with the food labels is because the fact
that it's such a common thing for people to talk about. Remember,
all these people that make these decisions are human too,
(26:48):
and they're all subject to the same damaging rhetoric that
that just it's insidious. It just happens, and people don't
think twice about it, and I just the frustration for
me is that when you start treat eating, exercise is
just something to undo food. You know, we we know
that that food and activity are intrinsically linked. We know that,
(27:08):
we know that. You know, if you're an elite athlete,
you're you know, having a having a nutritionus or a
dietician work with you and and you prep your food
and it's going to make you, you know, run faster
or jump further. Like we we know that those two
are intrinsically linked, but unless you're a professional athlete, always
linking the two becomes really harmful psychologically because it means
(27:31):
that you are just spending your whole time worrying about
whether you've earned something, and when you when you put
something in that bracket, it leads to a feeling of
guilt and shame because if you eat and you don't
think you've earned it, then you feel guilty straightaway. Right
if you if you do something that you don't think
you've earned, you feel shamed that you've that you haven't
earned till you so you've done the wrong thing. And
(27:54):
it just it creates this moralistic attitude around food where
it's it's a it like and it's on the same
vein of when I talk about labeling foods good and bad,
which I think is really really unhealthy and unhelpful as well.
It means that you you start thinking that you're a
bad person if you've done the wrong thing. And it's
all of these rules that we start instigating and implementing
(28:17):
on ourselves because we see other people doing it and
we see people talking about it in that way. It's just,
I mean, I can't really put into words how frustrating
it is when I see it, and how damaging I
feel that it that it ends up being, and also
just how unfair it is to what exercise actually is
and what exercise can actually do, and how how good
(28:37):
exercise can be and how important exercise is for our health.
It just ruins the whole flipping things not just ruins
when you make it about food, it becomes unsustainable. It's
like the first week, the first the second week of
living that way of of seeing your food as you know, okay,
well I'm going to the gym more, I'm being healthy.
It starts as like this inner motivation, and then it
(28:58):
fizzles because on the day that you can get to
the gym that day, now what it's like. It starts
on this that builds the morality I'm good because I'm good,
because I'm okay, because I'm okay because and then the
day the cycle pivots, which it will because life you're
faced with yourself and a negative relationship to food and exercise,
so we need to not don't give yourself flexibility, like
(29:21):
you know, exercise should be flexible. There are going to
be certain weeks that you can exercise more. There are
going to be certain weeks that you can't. There are
gonna be certain times in your life where something is
going on and you get and you get too busy
to be able to actually have regular activity in your life.
And there are going to be weeks when you have
loads of time to do it. And if if everything
has to be so rigid and so structured, that flexibility
(29:42):
is lost and it and it makes you feel really
bad that you can't do it quickly. Just before we wrap,
being that your doctor that's on here, and I feel
like that gives you some credibility and a least he's
touched on this too. But even when it comes to
working out or burning off the calories, since we're on
that topic, which I think we'll dig into it some
more later, but it it's not even accurate. So can
(30:02):
you touch on what like we're getting these food labels.
I don't know what it's like in the UK, but
in the US it's like, okay, you just say this,
it's a hundred calories and twenty three carbs, and you
know this is what you need to do to burn
it or track it or whatever. But all of our
bodies are so different, Like I'm not breaking food down
the way you're breaking food down. No, no, no, there's
I mean, you know, you know it's more, probably more
(30:24):
than I do. But the actual amount of avanergy that
we absorbed from food is going to vary from person
to person. It's going to vary based on how that
food is prepared, It's going to vary on all sorts
of things. Not only is the actual kind of measurement
of of how much energy we burn when we exercise
going to be so vastly different from person to person
(30:45):
because of their size and how intense they do the
activity and all sorts of things. But whether or not
it's it's relevant at all, or how people then implement
it when it comes to food is so off anyway.
So you've just got two completely inaccurate things. You're putting
together that and then judging your entire well being and
how good you feel that day and how proud you
(31:05):
are of yourself, and you're judging all of it on
something that is just nonsense and it's it's a recipe
for disaster. And there's no wonder that all of this
fails time and time again, and no wonder that people
hate the thought of cardio and hate the thought of
exercise because it's just so frustrating, And no wonder people
hate the thought of having you know, the wrong in quotes,
(31:28):
meal at the wrong in quotes time of day because
then they've got to go and work out and figure
out I was that correct, and they've probably got to
do more than it says on their watch because it
didn't work last time. And it's just it's a spiral
of nonsense. And so if we can start, if we
can start just talking about exercise in terms of well
it's going to improve your health. Forget food, forget calories
(31:51):
for a second, go and go and lift some weights
and get stronger. It's a really really cool achievement to
be able to do a pull up that you couldn't do,
Like I know this. I could never do a pull
up and now I can. And it's like one of
the coolest feelings in the world. Like, you know, that's
got nothing to do with my food or your or
your self worth. It might build yourself, but it makes
you feel good and strong. Yeah, I forget my self
(32:14):
worth but it but it, you know, but it's a
good it's a good way of knowing that actually I
have objectively become healthier because I have become stronger. It's
got nothing to do with with anything that is so
spirits as well, I've changed one point on the BMI
scale and now I'm in a different bracket and so
I can stop now like I'm good. Like it's it's
(32:34):
just it just makes no sense. Well, thank you so
much for coming on. I think we learned so much.
I think, well, we have a better ability to communicate
with our doctors and remember that we can and should
continue to see our doctors even if it comes with
some fear, because they truly are compassionate people that want
the best for us. Yeah, thank you josh for coming on.
(32:56):
Follow him at doctor Joshua wal Rich and they for
coming home. We're so happy we got to speak with you. No,
thank you for having me. It was a lovely chat. MH.
Feeling Things with Amy & Kat News
Host
Amy Brown
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.