Spring is coming

The past year and a half have been difficult for all of us, myself included. I have struggled to figure out how to continue doing this podcast and still manage to care for myself and my patients. Of course, the podcast was the thing that had to give, much to my dismay.

I have two episodes that I recorded almost 2 years ago now, that I have yet to release. It is sort of like one of those situations when you don’t respond to an email right away and then too much time passes and you have to pretend that you have died or something to get out of the embarrassment of responding. That’s where I am because Fiona Willer and Amy Pershing were so kind to spend their time talking to me and they had such important things to say, but now I am just embarrassed. My plan continues to be to release the episodes because, ultimately, they are timeless, but getting it done is still proving to be a personal challenge.

In good news, there are some behind the scenes conversations that might help to revive the podcast. I am not going to get ahead of myself, but I do have some hope, something I had kind of given up on recently.

I’m not sure how many people will read this (are blogs even a thing anymore???….I need to get on TikTok I guess), but I wanted to put something out there. I love this podcast and the work that we all have done on it so far. I don’t want it to stop, but it is difficult to feel like I am speaking into a void much of the time.

Thank you to everyone who listens, who continues to listen and share past episodes. Thank you to the few of you who also reach out and remind me that this is needed. I appreciate you all.

Long time no hear!

I am not sure how many people keep up with this blog since I know I don’t! I wanted to do a quick update though here before I get a chance to do an update on the podcast itself soon.

My life has been a bit topsy turvy the past 5-6 months. I mentioned on the last episode that I was having some health issues and it turned into a situation that needed surgery and then recovery time. I have been so grateful for the help of my mother and that she could fly out to Portland for four months to take care of me prior to the surgery and support my recovery after.

Recovery physically is going well, which I will go into on the next episode probably, though it is taking a lot of mental space too, so most of my capacity to get things done has been focused on my recovery and getting back to work to take care of my patients. The podcast has, understandably I hope, had to be put to the side as I figure things out and get better.

It is my plan to do an episode about my experience in the hospital, and around my care in general as a superfat patient. Fortunately, it was, and continues to be, a story of what to definitely do with large patients and I know that will be instructive. I also have two interviews that I did last year that did not make it to the editing room or release. I will get those out soon as well.

I appreciate those of you who are still listening and sharing the work I have already done. My unique downloads haven’t gone to 0 in quite a while and are usually in the double digits. Not famous podcast numbers by any measure, but not bad considering I effectively dropped off the face of the podcast earth for half a year! I am particularly grateful to my Patreon subscribers who are sticking with me! Ya’ll have made it possible to keep the podcast lights on (so to speak) by covering the basics.

We will see how 2020 goes for the Do No Harm Podcast. I plan to do what I can at the pace that works best for me. There are a couple of things that are in the works as well, but I will wait to announce them until they are more substantial.

Thank you again for everything. If you have an idea of a topic you want to hear, please let me know at donoharmpodcast@gmail.com.

Wake Up Weight Watchers

There are times when I would like to discuss a topic, but it might be too short or too long to put into a podcast episode. A blog allows me to address these things as well as providing a different medium for the podcast information. 

A great example of something that was timely, but wasn't enough info for a full episode was when, recently, Weight Watchers decided to provide free memberships to teens. This is such a problematic thing, but many people, medical providers included, might not consider the long term ramifications of starting a food restriction program during a period of significant body changes. Weight Watchers has spent a long time creating a reputation of being a "lifestyle" change. It has become their brand. Because of this, it can be difficult to see that they are still a restrictive diet. I will grant that they have become less restrictive, but there is still a focus on certain foods being "allowed" freely and other foods only being "allowed in certain qualities, i.e. however many points the person has in that day. 

The main issue with a point system is that it does not allow for people to stay in touch with their bodies hunger and satiety signals. People who eat according to internal cues tend to have fewer issues around food, tend to be weight stable (often at lower weights, but not necessarily), and are more relaxed and flexible around food, which can lead to eating more of a variety of foods. People who are lead by external food cues, such as point systems, tend to be more anxious around food, may be more prone to weight cycling, and, for those who are susceptible, may develop eating disorders. Additionally, many diets and "lifestyle changes" moralize food, separating it into "good" and "bad" foods. Doing this creates guilt and shame around eating, which is unhealthful.

Additionally, because significant, sustainable weight change is nearly impossible, when someone focuses on it in a program such as Weight Watchers, the individual is ultimately going to fail. When people regain the weight they have lost, as the majority end up doing, they will often feel shame around it, causing them to be less likely to continue any healthful habits they may have started, and often leading to continued dieting/weight cycling. The individual does not realize that the diet is the failure, not them.

This is what can happen with adults on even fairly flexible plans such as Weight Watchers. Teens to not have the cognitive maturity to understand the finer points of dieting and weight cycling. There is often a great deal of external pressure on them to look a certain way and weight is a significant part of that. Something that many teens and parents do not know, and maybe something that medical providers forget, is that it is normal for teens to gain 30-40 lbs (13-18 kgs) as they mature. For girls, this is particularly important as they enter their fertile years. Young women who do not gain sufficient weight, or who end up with an eating disorder, can end up infertile as adults. Even young women who are larger in size can have their fertility affected by not eating sufficient calories and variety of foods. Another thing to consider is that larger teens who are susceptible to eating disorders are less likely to be diagnosed early, which may lead to  significant health issues. 

These are all significant things to consider when thinking about weight and teens. Weight Watchers was  more interested in their bottom line and long term future customers than the health and wellness of teens. Historically, Weight Watchers has been happy to take money from the parents of children and teens, but their long term results continue to be dismal. Many of those children and teens then return, over and over, to lose and regain weight for decades. Their current ploy seems magnanimous on the surface, free memberships to teens to help them "get healthy", but that is not what it is about.

It is only about money, not health.

In other news, the blog will serve to keep listeners up to date between episodes. I currently need to reduce the frequency of episodes for a while. I plan to continue to do them, but they will not be as regular as they have been. I hope to get back into a schedule, but the podcast takes a lot of time and effort and I need to focus more attention on my business at Watershed Wellness in Portand, Oregon. I am hoping that this information is important enough to everyone to not lose the amazing momentum that we have developed over the past six months!

That being said, stay tuned for another interview in March.

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