What sucks so bad is the fact that discussions of trauma—especially early childhood trauma— and how it impacts every single aspect of human development forever are almost never mentioned in these important conversations.
I grew up in a brutally abusive environment. Not a single change I attempted to make with my physical or mental health as an adult worked when I still believed shaming myself out of bad habits was possible. Understanding and doing the exceptionally hard, expensive, and time-consuming work of processing my childhood trauma has completely transformed every aspect of my health. And I know I got extremely lucky since not a single doctor has ever asked me about my childhood trauma unless I bring it up mySelf.
I have an older sister who experienced all of the same abuse that I did—only the ways she was sexually violated when she was very little tremendously impacted her weight. She’s extremely overweight and feels intense shame around her appearance every single day, not to mention terror that she may not live long enough to see her two beautiful kids grow up (she isn’t diabetic “yet,” so her doc can’t prescribe Ozempic!). But as her sister, I know on some deeper level, she would rather feel ashamed and afraid of the future than unsafe with no escape in the present. She would rather live in a body she knows others are disgusted by than to experience the utter repeated powerlessness she did when she was violently exploited as small child ever again. How the fuck could anyone who understands that blame her?
People—especially most academics and doctors who’ve seldom viscerally experienced violent trauma—think people like me and my sister are outliers. We are not. Because of the shame-motivation permeating our entire culture, the many, many people who’ve had horrible things happen to them in childhood have seldom learned to speak openly about them, especially not with powerful, authoritative figures like doctors. Furthermore, we don’t need sociopathic alcoholic dads or repeated experiences with violent child abuse to be fueled by trauma responses. Our entire domination-brainwashed, war-obsessed, racist, patriarchal culture is buried under so many layers of intergenerational trauma and profitable systems of overt abuse that most of us are too dissociated to even see the reality around us clearly.
The greatest gift of understanding and processing trauma is that one must come to understand the paradoxical extent to which something can be entirely NOT her fault and simultaneously also her most important lifelong responsibility. But if we don’t get the NOT our fault part first, the shame of believing it is will always lead us to believe we don’t truly have the ability to respond with any real agency. That is how trauma breeds—and that is why we are still stuck in the massive health crisis we’ve collectively inherited despite so much progress.
I regret not adding more in this piece about social-emotional health and the clear causal relationship btw ACEs (adverse childhood events) and metabolic disorders, obesity and cardiovascular disease. (Though I have written extensively about childhood trauma elsewhere). There is no shortage of data on trauma and its effects on health.
Thank you for this thoughtful and well written set of comments. You are not alone. Trauma is more widespread than people think, and it's wonderful you can talk about it - and to help others while doing so.
I love your work and I’ve learned more from you than I can say. Annnd I likely wouldn’t have been able to discern the wisdom of your perspective and begin following your Substack had it not been for my personal experiences with processing trauma and understanding its impact on my health more deeply, etc. I would absolutely LOVE to read and share any and every future work of yours digging into these connections even more deeply.
Thank you so so much for being such a Healing Badass💥🖤
"Understanding and doing the exceptionally hard, expensive, and time-consuming work of processing my childhood trauma has completely transformed every aspect of my health."
Yes! This. And not all (or many)of us have the resources to help us do that work
I am not obese. I could stand to lose a few pounds created when my activity slowed because of atrial flutter and medications for slowing the heart. However, that is not why I’m commenting.
What I’m watching is a change in the tenor of medical treatment as more women become physicians. There appears to be, in my view, strong correlation between a higher percentage of female doctors and medical treatment with more care and sensitivity.
I recognize correlational evidence can be impacted by other variables and that I should not over-generalize, however, my experience goes all the way back to being a Navy Corpsman during the Vietnam war when the male doctors often acted as if they inhabited Mt. Olympus, as the population of the sick and/or injured received care from the angels of care, the female nurses.
Good and thoughtful article that I like because it eschews the simplistic, recognizing the reality of complexity. So, thank you.
I am a devotee of the Center for Science in the Public Interest ( CSPI) and read their health newsletter religiously. Devoted to health, they are trustworthy, informative, and pertinent. Everyone should subscribe to their newsletter Nutrition Action!
Thanks Dr Lucy - yes to all of this. And I am far from anything resembling a fan of Big Pharma but I wholly support making GLP-1s available to those on Medicare. It is, in my experience, a remarkable tool that should not be withheld based upon bank balance. The Medicare population is a great place to start.
As a 25-year veteran of the food industry (retired and unaffiliated), your post is among the most reasonable, concise, and balanced that I've seen on the topic of obesity. There are too many grifters in this space peddling everything from conspiracy theories to fad diets about food companies and products and unfairly demonizing pharma companies (although they deserve some demonization for other behaviors) when they produce life-saving medicines that help people who (like me) struggle with lifestyle changes alone. Ultimately, consumers are the ultimate drivers, not the ultimate "victims," of our obesity crisis. The market will respond with changes when consumers demand them.
This is an excellent piece, Lucy!! Thank you for your thoughtful and evidence based work to educate us all. After a lifetime of struggling with my weight and alcoholism, ozempic has helped me to lose 20 libs and counting and to not want to drink at all. I feel healthy and lighter and stronger, and unburdened by a daily challenge of controlling cravings and self criticism. I am somehow freed of so much daily trauma of not being able to lose the weight I needed to lose. Both, and. All opinions are valid but each of us now has a new tool. This tool will help me to live longer for my family and be a healthier, more stable person. Thank you, Lucy!
Short story - metformin helps with insulin resistance but has a completely different mechanism of action from the GLP1s and does not promote weight loss or changes in appetite
Grace, I am so sorry for what you have/are going through. I'm a physician, and what you say here is so important (and well stated). Decades ago, there was a study at Kaiser in California with thousands of people who were 100lbs+ overweight, and there was a 50% self-reported incidence of childhood sexual abuse. That means the true amount was even greater. Roxanne Gay writes well about this. Wishing you well. As simple as it is, I so often think of the scene in Good Will Hunting where Will is simply told, "it's not your fault".
This is the best take I’ve read on weight loss solutions. I ageee that there’s no easy solution—no one size fits all—and I love the way you think about this complex medical issue.
What sucks so bad is the fact that discussions of trauma—especially early childhood trauma— and how it impacts every single aspect of human development forever are almost never mentioned in these important conversations.
I grew up in a brutally abusive environment. Not a single change I attempted to make with my physical or mental health as an adult worked when I still believed shaming myself out of bad habits was possible. Understanding and doing the exceptionally hard, expensive, and time-consuming work of processing my childhood trauma has completely transformed every aspect of my health. And I know I got extremely lucky since not a single doctor has ever asked me about my childhood trauma unless I bring it up mySelf.
I have an older sister who experienced all of the same abuse that I did—only the ways she was sexually violated when she was very little tremendously impacted her weight. She’s extremely overweight and feels intense shame around her appearance every single day, not to mention terror that she may not live long enough to see her two beautiful kids grow up (she isn’t diabetic “yet,” so her doc can’t prescribe Ozempic!). But as her sister, I know on some deeper level, she would rather feel ashamed and afraid of the future than unsafe with no escape in the present. She would rather live in a body she knows others are disgusted by than to experience the utter repeated powerlessness she did when she was violently exploited as small child ever again. How the fuck could anyone who understands that blame her?
People—especially most academics and doctors who’ve seldom viscerally experienced violent trauma—think people like me and my sister are outliers. We are not. Because of the shame-motivation permeating our entire culture, the many, many people who’ve had horrible things happen to them in childhood have seldom learned to speak openly about them, especially not with powerful, authoritative figures like doctors. Furthermore, we don’t need sociopathic alcoholic dads or repeated experiences with violent child abuse to be fueled by trauma responses. Our entire domination-brainwashed, war-obsessed, racist, patriarchal culture is buried under so many layers of intergenerational trauma and profitable systems of overt abuse that most of us are too dissociated to even see the reality around us clearly.
The greatest gift of understanding and processing trauma is that one must come to understand the paradoxical extent to which something can be entirely NOT her fault and simultaneously also her most important lifelong responsibility. But if we don’t get the NOT our fault part first, the shame of believing it is will always lead us to believe we don’t truly have the ability to respond with any real agency. That is how trauma breeds—and that is why we are still stuck in the massive health crisis we’ve collectively inherited despite so much progress.
I cannot agree more with you.
I regret not adding more in this piece about social-emotional health and the clear causal relationship btw ACEs (adverse childhood events) and metabolic disorders, obesity and cardiovascular disease. (Though I have written extensively about childhood trauma elsewhere). There is no shortage of data on trauma and its effects on health.
Thank you for this thoughtful and well written set of comments. You are not alone. Trauma is more widespread than people think, and it's wonderful you can talk about it - and to help others while doing so.
I love your work and I’ve learned more from you than I can say. Annnd I likely wouldn’t have been able to discern the wisdom of your perspective and begin following your Substack had it not been for my personal experiences with processing trauma and understanding its impact on my health more deeply, etc. I would absolutely LOVE to read and share any and every future work of yours digging into these connections even more deeply.
Thank you so so much for being such a Healing Badass💥🖤
Thank you so much, Grace!
"Understanding and doing the exceptionally hard, expensive, and time-consuming work of processing my childhood trauma has completely transformed every aspect of my health."
Yes! This. And not all (or many)of us have the resources to help us do that work
I am not obese. I could stand to lose a few pounds created when my activity slowed because of atrial flutter and medications for slowing the heart. However, that is not why I’m commenting.
What I’m watching is a change in the tenor of medical treatment as more women become physicians. There appears to be, in my view, strong correlation between a higher percentage of female doctors and medical treatment with more care and sensitivity.
I recognize correlational evidence can be impacted by other variables and that I should not over-generalize, however, my experience goes all the way back to being a Navy Corpsman during the Vietnam war when the male doctors often acted as if they inhabited Mt. Olympus, as the population of the sick and/or injured received care from the angels of care, the female nurses.
Good and thoughtful article that I like because it eschews the simplistic, recognizing the reality of complexity. So, thank you.
:)
I am a devotee of the Center for Science in the Public Interest ( CSPI) and read their health newsletter religiously. Devoted to health, they are trustworthy, informative, and pertinent. Everyone should subscribe to their newsletter Nutrition Action!
Thanks for this - I noodled around on their site for a little while & love it already
Thx for this!
Nice!
Thanks Dr Lucy - yes to all of this. And I am far from anything resembling a fan of Big Pharma but I wholly support making GLP-1s available to those on Medicare. It is, in my experience, a remarkable tool that should not be withheld based upon bank balance. The Medicare population is a great place to start.
As a 25-year veteran of the food industry (retired and unaffiliated), your post is among the most reasonable, concise, and balanced that I've seen on the topic of obesity. There are too many grifters in this space peddling everything from conspiracy theories to fad diets about food companies and products and unfairly demonizing pharma companies (although they deserve some demonization for other behaviors) when they produce life-saving medicines that help people who (like me) struggle with lifestyle changes alone. Ultimately, consumers are the ultimate drivers, not the ultimate "victims," of our obesity crisis. The market will respond with changes when consumers demand them.
Thank you and this is an excellent point.
This is an excellent piece, Lucy!! Thank you for your thoughtful and evidence based work to educate us all. After a lifetime of struggling with my weight and alcoholism, ozempic has helped me to lose 20 libs and counting and to not want to drink at all. I feel healthy and lighter and stronger, and unburdened by a daily challenge of controlling cravings and self criticism. I am somehow freed of so much daily trauma of not being able to lose the weight I needed to lose. Both, and. All opinions are valid but each of us now has a new tool. This tool will help me to live longer for my family and be a healthier, more stable person. Thank you, Lucy!
Thank you for your honesty and for sharing this.
I'm curious how Ozempic or other GLP-1 drugs compare to Metformin?
Short story - metformin helps with insulin resistance but has a completely different mechanism of action from the GLP1s and does not promote weight loss or changes in appetite
Grace, I am so sorry for what you have/are going through. I'm a physician, and what you say here is so important (and well stated). Decades ago, there was a study at Kaiser in California with thousands of people who were 100lbs+ overweight, and there was a 50% self-reported incidence of childhood sexual abuse. That means the true amount was even greater. Roxanne Gay writes well about this. Wishing you well. As simple as it is, I so often think of the scene in Good Will Hunting where Will is simply told, "it's not your fault".
Amen. Thank you, Aparna.
I don't know how people feel while on Ozempic, but I do know that eating healthy (when I can manage it) feels amazingly better than not.
This is the best take I’ve read on weight loss solutions. I ageee that there’s no easy solution—no one size fits all—and I love the way you think about this complex medical issue.
Thank you, JH! Please share it with your peeps~!
Fantastic take
Thank you!
Great post, well done 👏👏👏
Ozempic is the semaglutide dose for T2D...Wegovy is the dose for obesity
Yes, I’m aware :)
I’m using Ozempic as shorthand for all GLP-1s.
This is a great look at the issue. I have posted about fat cell memory and Ghrelin. A complicated issue indeed.
Great newsletter, Lucy! I wish everyone could read it!
Thank you, Bonnie!
Really well said, thanks for this.