One of the most articulate and reasonable pieces I have read. Weight bias and stigma are so widespread and persistent despite us knowing their harm. I’m so glad you are taking on this topic directly. We can, in fact, find a middle ground between body acceptance and weight health. Thanks for helping spread the word!
Thank you for taking the time to write this article, and the last one, regarding Ozempic. I am on my 6th week of using it for weight loss, and appreciate your viewpoints. I’ve used food to numb my emotions since childhood. While I was never overweight until the past few years, I’ve always known that I have an unhealthy relationship with food. I got really scared when I gained 15 pounds this past winter. Breast cancer and the fallout emotionally from my newly mutilated body put me over the edge as the scale read OBESE. It’s interesting to be able to observe my thoughts and emotions as I’m on this drug. Sometimes it feels like I have an itch that I can’t scratch when I want to turn to food for comfort while simultaneously being unable to overeat. It gives me space to ask myself what I’m feeling, pay attention, and practice better coping skills. It’s been a real journey for me as I am doing my damndest to learn portion control, eat more protein, and exercise faithfully. And be kind to myself.
I mean, wow. What could be better for your health than the emotional space to explore feelings and then NOT to engage in behaviors you used to employ to self-soothe the difficult ones. That, to me, is the definition of health. Bravo to you for being kind to your body and mind.
Wow. Some of these reactions are in a wholly different galaxy. I am amazed. I don’t take the drug but I have struggled with weight for 55 years. Nothing about the struggle is morally superior or inferior to anything.
By the way, perhaps it won’t last but I have lost 46 pounds since I started having horrible pains during the first pandemic summer (when I was eating more rich, sensory
-stoking foods) my MD ultimately diagnosed as gallstones (‘your gallbladder is a mess’). She told me surgery on horizon when they could schedule surgery due to backups for pandemic protocols. I begged for a chance to alter diet, exercise even more, etc. etc. She was not optimistic but I simply stopped eating all of the time. That is it. I eat three meals a day, the smallest at dinner so I have also been able to end acid reflux which was also terrible because I was so full all of the time. I never feel deprived and eat whatever item appeals except super rich food (which I understand I likely would have had to eliminate even if they took out my gallbladder). I do have a cupcake from Magnolia when I go to NYc but I don’t do that often. I don’t eat rich food as that hits the gallbladder but I most definitely am not on a diet as traditionally defined. I eat, I walk, I enjoy life. I know it is a lifelong change of behaviour (as noted earlier, I have been at this for 55 years with too many hopes dashed). I eat pretty much the same daily but I rather like my smoothie with 12 fruits and plant milk, two slides of good bread with hummus and green plus some almonds, and dinner. I have been strict vegetarian for 28 years, evidence one can do it for extended period but also proof it doesn’t stop one from consuming too many calories for one’s body’s needs. In short, my body needs not to consume meds but eat fewer calories than I burn, as Isaac Newton would have told me four hundred years ago according to the laws of physics.
This is a very nuanced discussion on the pros and cons of this medication. As a healthcare professional, I am very aware of how our bias influences how people can achieve their health goals. The shame and stigma for those who try to achieve weight loss with some kind of medical assistance is still too high. It is a multifaceted that needs much support. Thank you Dr. McBride!
Thank you for reading! And I hope you share this with your medical colleagues if you are so inclined.. patients have suffered so much stigma (not just around weight but about other behavioral health issues) and it's time for us all to speak up! :)
Really good responses here. So much dogma and prejudice in the chat! I appreciate that you leave comments open to dialogue with troll-ish POVs.
I left a doctor’s appointment with the suggestion to lose weight last month to deal with high cholesterol for what felt like the millionth time in my life. I am a personal trainer and a health guru in my own right. I don’t need lifestyle advice. As an overweight person I am saturated with it online, in media, from my community- everywhere I go. Lifestyle advice regarding weight loss is inescapable.
The thing I go to the fucking doctor’s office for is medicine. That is the one thing the doctor can provide that a nosy relative, a personal trainer and a nutritionist can’t. So, that’s what doctors should provide- medical solutions to medical problems. I made a follow-up appointment so I can tell him: lifestyle advice from you is off the table. If you think I am afflicted with a medical problem, let’s talk prescriptions. Let’s talk statins. If my situation doesn’t warrant a statin, then say that! But don’t tell me to lose weight like that advice from a doctor has EVER worked as well as an actual pharmaceutical.
To the anti-medical trolls, you get the same advice as the anti-abortion crowd: you don’t want a medical solution to a medical problem, don’t seek one. But this era of injecting public opinion into private medical decision-making has totally eroded public respect for bodily autonomy and medical privacy, and it also erodes public support for healthcare access which is what we all really need.
Fantastic article that is well balanced and compassionate. I’ve noticed a great many advantages of taking Ozempic but thought they were coincidental. Even though the weight loss has been minimal so far, I’ve been baffled by the normalization of my bp and the dramatic difference in knee pain. Ozempic is by no means cheating or the easy way out, but it has given me the motivation to eat better and consume more protein. I’m able to let go of things that bothered me to distraction just six months ago. It must be an Ozempic kind of day. I just ran across this article that might interest your readers.
So glad to hear. And yes, it's not cheating; in your case it's strategically employing modern pharmacology in conjunction with lifestyle changes to be healthier, physically and emotionally. It's also entirely up to YOU - not anyone else - to define what health means to you.
I have been told that Ozempic or it's counterparts are beneficial in preventing heart disease. Is that because the weight is gone or is it the drug itself? I need to lose 20 lbs and I have done this in the past with the Bariatric diet plan. Which is basically bars, shakes and powdered meals that are full of preservatives and unhealthy additives. So I wonder if Ozempic would work for me. I am 75 yrs old, extremely active. Take blood pressure med & Synthroid for hypothyroidism. Thoughts??
Yes, there is data to suggest that the GLP1s can improve heart disease. Intuitively it makes sense that weight loss would help with heart health, but I don’t think we yet know if it’s *also* due to the drug itself. I am going to wager a guess that heart disease improves through the mechanism of improved metabolic efficiency due to these medications, however I could be wrong! We just don’t know. However we are learning more every day about these medications
And so delicate! Both personally and professionally, I see health and wellness as things that always take time and effort to find and grow. I always teach my students (and am giving a workshop tomorrow to paid subscribers to The Healthy Jew!) about how living healthy is a journey "from here to there," that is from where I am right now to the greater destination that lies ahead and beyond.
That makes me nervous about any quick fixes that do the hard work for us, because we won't own the results, which means eventually the whole thing will probably come crashing down (or we'll discover that the drug is dangerous, as I read recently on The Atlantic about the scary parallels between now and the fen-phen excitement of almost 30 years ago).
All that being said, as you wrote beautifully, we've gotta use whatever tools we've got to help folks get to the beginning of the trail going "from here to there." I hope these drugs will turn out to be similar to antidepressants enabling alcoholics to get to AA, which is of course a wonderful thing.
With my GYN's permission, I cut my HRT in half (literally with a pill splitter) because I was experiencing insatiable hunger, but it wasn't necessarily coming from my stomach. There was a chatter going on that was only there the first day of my period back when I had them. (That Day 1 I'd be insatiably hungry and then it would be gone Day 2, so I never fought it, just accepted it. That's hard to do every day for a couple of years.) Reducing that already-low dose of hormones helped me almost immediately. My brain is no longer telling me to eat something, eat something, we need to eat something NOW. It's the strangest thing. So, if that what Ozempic is doing, bless it. Because if that's what some people are dealing with all day, every day, it's torture. xo
This is so well-written and reasoned. Of course it’s unwise to pop a pill and expect all life’s problems to disappear. Health solutions need to be as multi-layered and changeable as health problems. That’s why I take Monjauro and Effexor, AND I see a therapist, go to AA meetings, exercise regularly, meditate (I try, anyway!), stay current with my friends and family, and after 23 years of workaholism shifted to a job with a respectable work-life balance.
Thank you for that articulate explanation. I totally agree.
My experience with Ozempic has been through my best friend who was obese. She was horrified to learn, once she started taking it, that it worked on her as a "chemical castrator"! She went to her GP who told her that it was a little-known side-effect of the drug. She is now off it, but her libido has not come back after several months.
So when my husband considered using it to lose some weight, I argued him out of it, instead he goes for a daily walk around the neighbourhood with me and concentrates on his diet.
You mention that Ozempic is for diabetics ie those trying to lower their glucose. Those interested in losing weight are taking other variants- eg Mounjaro or Wegovy. Ozempik is not FDA approved for losing weight and it’s administered in different doses than the others. Your points more aptly apply to the non Ozempic.
I am a total fan of these drugs that seem to miraculously put obese and overweight people on the real road to better health and less suffering. But I'm also reminded of how, like antidepressants, they can be prescribed so easily and there is no actual therapy required. So- another bandaid? No delving into a way to actually deal with the problems that got the patient into such trouble in the first place? Any end in sight for how long the patient is safe taking the prescription? I hear the big pharma cash registers clanging.
Yes, some people take Ozempic without adopting a healthy lifestyle or getting at the root cause(s) of their metabolic problems.
Yes, some doctors readily prescribe medications without sufficiently counseling the patient on lifestyle modifications that would help them.
But here are my questions :
1. Do you have the same fears about people taking statins for high cholesterol or blood pressure medication for hypertension (both of which have modifiable elements related to lifestyle and habits)?
2. Should a patient not take a medication that the pharmaceutical industry profits from?
3. Who should make the decision about when a medication is appropriate for a medical/health condition when lifestyle changes haven’t worked?
4. Where do we draw the line between personal responsibility and asking for help?
These are honest questions. There are no right/wrong answers! I welcome your thoughts.
I think these are all good questions that get at uncovering the underlying bias that folks have around weight.
I did have a reaction to reading question #1 -- about having the same fears about people taking statins or BP medication. Because, for me, the answer is yes -- I do have those fears. Not because I think people are moral/immoral/superior/lazy. But because it makes me ask: What is happening to us, collectively? I feel like the story I've been hearing is that people are getting cancer younger, are more depressed and anxious, substance misuse is on the rise, "lifestyle" diseases -- which is obviously a very unhelpful term -- are on the rise, etc. Like we're living longer, but sicker.
I'm glad for all of the pharmaceutical innovations we have that can alleviate suffering. I guess I'm just wishing there wasn't so much suffering to alleviate in the first place. We've figured out how to address many of the communicable diseases -- maybe addressing the noncommunicable ones is the next frontier? Here's to less suffering.
Your reasoning makes so much sense to me. I could not agree more that diseases of despair need to be addresses like we do *any* other medical condition. (Note: this is the subject of my forthcoming book with Simon & Schuster .. and is the reason I write this newsletter every week.) It does feel like the medical industrial complex is coming up with solutions for issues that would be better solved with less despair in the first place. And I agree w you that we need to address the suffering head-on (i.e, what is driving the obesity, opiate, and mental health epidemics in the first place), however I think we can do both at the same time.
To my mind, that includes (in the order of individual to societal): 1) redefining health as more than a number on the scale or a perfect cholesterol score .. and instead as a process of awareness, acceptance and agency 2) educating ourselves on *what is truth* and *what is a convenient lie* when it comes to messaging in the public space about health and when it comes to our own narratives about health (ie cognitive bias) 3) finding trustworthy guides to help us separate fact from fiction and support us in our unique health goals, using evidence and fact over biased information and false internal narratives 4) facing unpleasant facts about who we are, the choices we make, and the realities of our lives and deciding what we can change and what we cannot depending on core values and mission 5) doing the best we can with self compassion and compassion for others who are trying to live authentic and healthy lives and also do good in the world 6) lobby your local, state and federal govts to reform health care such that EVERY American has access to primary care and most importantly where primary care medicine includes behavioral and mental health services in addition to routine screenings and counseling on preventative health 7) VOTE for anyone who sees health is a fundamental right, not a privilege and who understands that health includes more than a quick checkup with a doctor who is glued to his/her computer and doesn’t have time to address the person 8) VOTE for anyone who understands how broken the medical system is in this country and how broken doctors are for participating in a system that treats ppl as a number on the scale or a set of boxes to check instead of a whole person 9) pray for the souls and lives of people who are suffering from poverty, discrimination, and ideological capture who may be voting and arguing against their own best self interest without knowing it and 10) remain humble about what we do not know.. and keep learning.
Thank you, Tamara, for being a thought partner in this conversation. You have helped me. ❤️
1. In a word: absolutely. I personally know of scripts that were written for both of these dx's without discussion of how and why one can go about a lifestyle change OR what potential side effects might bring.
2. Well no, of course not.
3. A meaningful discussion between the pt and the provider, with the provider offering data from actual, high quality studies AND possible alternatives would go a long way.
1. Yes it happens all the time. It also happens in liquor stores where ppl with addiction are buying alcohol against their own self interest. All of it is sad and tragic. The solution, though, is what I am most interested in—and to me it’s not about hand wringing or gate-keeping; it’s about a) education b) access to resources to address mental/behavioral health c) less shame and more compassion. I am assuming you agree 😊
2. I humbly agree.
3. Yes, yes and yes. Scream it from the hilltops.
4. Amen again.
Thanks for your honest replies and engagement. This is what I am here for. ❤️
One of the most articulate and reasonable pieces I have read. Weight bias and stigma are so widespread and persistent despite us knowing their harm. I’m so glad you are taking on this topic directly. We can, in fact, find a middle ground between body acceptance and weight health. Thanks for helping spread the word!
Thank you - and please share this widely! I am trying to change the narrative and it's like pushing a boulder up a mountain 😩 😭 😊
Thank you for taking the time to write this article, and the last one, regarding Ozempic. I am on my 6th week of using it for weight loss, and appreciate your viewpoints. I’ve used food to numb my emotions since childhood. While I was never overweight until the past few years, I’ve always known that I have an unhealthy relationship with food. I got really scared when I gained 15 pounds this past winter. Breast cancer and the fallout emotionally from my newly mutilated body put me over the edge as the scale read OBESE. It’s interesting to be able to observe my thoughts and emotions as I’m on this drug. Sometimes it feels like I have an itch that I can’t scratch when I want to turn to food for comfort while simultaneously being unable to overeat. It gives me space to ask myself what I’m feeling, pay attention, and practice better coping skills. It’s been a real journey for me as I am doing my damndest to learn portion control, eat more protein, and exercise faithfully. And be kind to myself.
I mean, wow. What could be better for your health than the emotional space to explore feelings and then NOT to engage in behaviors you used to employ to self-soothe the difficult ones. That, to me, is the definition of health. Bravo to you for being kind to your body and mind.
Wow. Some of these reactions are in a wholly different galaxy. I am amazed. I don’t take the drug but I have struggled with weight for 55 years. Nothing about the struggle is morally superior or inferior to anything.
You said it!
By the way, perhaps it won’t last but I have lost 46 pounds since I started having horrible pains during the first pandemic summer (when I was eating more rich, sensory
-stoking foods) my MD ultimately diagnosed as gallstones (‘your gallbladder is a mess’). She told me surgery on horizon when they could schedule surgery due to backups for pandemic protocols. I begged for a chance to alter diet, exercise even more, etc. etc. She was not optimistic but I simply stopped eating all of the time. That is it. I eat three meals a day, the smallest at dinner so I have also been able to end acid reflux which was also terrible because I was so full all of the time. I never feel deprived and eat whatever item appeals except super rich food (which I understand I likely would have had to eliminate even if they took out my gallbladder). I do have a cupcake from Magnolia when I go to NYc but I don’t do that often. I don’t eat rich food as that hits the gallbladder but I most definitely am not on a diet as traditionally defined. I eat, I walk, I enjoy life. I know it is a lifelong change of behaviour (as noted earlier, I have been at this for 55 years with too many hopes dashed). I eat pretty much the same daily but I rather like my smoothie with 12 fruits and plant milk, two slides of good bread with hummus and green plus some almonds, and dinner. I have been strict vegetarian for 28 years, evidence one can do it for extended period but also proof it doesn’t stop one from consuming too many calories for one’s body’s needs. In short, my body needs not to consume meds but eat fewer calories than I burn, as Isaac Newton would have told me four hundred years ago according to the laws of physics.
This is a very nuanced discussion on the pros and cons of this medication. As a healthcare professional, I am very aware of how our bias influences how people can achieve their health goals. The shame and stigma for those who try to achieve weight loss with some kind of medical assistance is still too high. It is a multifaceted that needs much support. Thank you Dr. McBride!
Thank you for reading! And I hope you share this with your medical colleagues if you are so inclined.. patients have suffered so much stigma (not just around weight but about other behavioral health issues) and it's time for us all to speak up! :)
Really good responses here. So much dogma and prejudice in the chat! I appreciate that you leave comments open to dialogue with troll-ish POVs.
I left a doctor’s appointment with the suggestion to lose weight last month to deal with high cholesterol for what felt like the millionth time in my life. I am a personal trainer and a health guru in my own right. I don’t need lifestyle advice. As an overweight person I am saturated with it online, in media, from my community- everywhere I go. Lifestyle advice regarding weight loss is inescapable.
The thing I go to the fucking doctor’s office for is medicine. That is the one thing the doctor can provide that a nosy relative, a personal trainer and a nutritionist can’t. So, that’s what doctors should provide- medical solutions to medical problems. I made a follow-up appointment so I can tell him: lifestyle advice from you is off the table. If you think I am afflicted with a medical problem, let’s talk prescriptions. Let’s talk statins. If my situation doesn’t warrant a statin, then say that! But don’t tell me to lose weight like that advice from a doctor has EVER worked as well as an actual pharmaceutical.
To the anti-medical trolls, you get the same advice as the anti-abortion crowd: you don’t want a medical solution to a medical problem, don’t seek one. But this era of injecting public opinion into private medical decision-making has totally eroded public respect for bodily autonomy and medical privacy, and it also erodes public support for healthcare access which is what we all really need.
AMEN! SING IT, sister!
I also love your bio in The Deadlift Contessa. I suspect we would be fast friends. 😉
Thank you! I’m sure we would! 💪🏻
Fantastic article that is well balanced and compassionate. I’ve noticed a great many advantages of taking Ozempic but thought they were coincidental. Even though the weight loss has been minimal so far, I’ve been baffled by the normalization of my bp and the dramatic difference in knee pain. Ozempic is by no means cheating or the easy way out, but it has given me the motivation to eat better and consume more protein. I’m able to let go of things that bothered me to distraction just six months ago. It must be an Ozempic kind of day. I just ran across this article that might interest your readers.
https://apple.news/A8aK6sBWqS_SIcyqnoY9ecg
So glad to hear. And yes, it's not cheating; in your case it's strategically employing modern pharmacology in conjunction with lifestyle changes to be healthier, physically and emotionally. It's also entirely up to YOU - not anyone else - to define what health means to you.
Superb analysis worthy of broader readership. Consider WPost or NYT.
Thanks, Lila! Please share it widerly if you are willing!
I have been told that Ozempic or it's counterparts are beneficial in preventing heart disease. Is that because the weight is gone or is it the drug itself? I need to lose 20 lbs and I have done this in the past with the Bariatric diet plan. Which is basically bars, shakes and powdered meals that are full of preservatives and unhealthy additives. So I wonder if Ozempic would work for me. I am 75 yrs old, extremely active. Take blood pressure med & Synthroid for hypothyroidism. Thoughts??
Yes, there is data to suggest that the GLP1s can improve heart disease. Intuitively it makes sense that weight loss would help with heart health, but I don’t think we yet know if it’s *also* due to the drug itself. I am going to wager a guess that heart disease improves through the mechanism of improved metabolic efficiency due to these medications, however I could be wrong! We just don’t know. However we are learning more every day about these medications
So insightful and sensitive, as always.
And so delicate! Both personally and professionally, I see health and wellness as things that always take time and effort to find and grow. I always teach my students (and am giving a workshop tomorrow to paid subscribers to The Healthy Jew!) about how living healthy is a journey "from here to there," that is from where I am right now to the greater destination that lies ahead and beyond.
That makes me nervous about any quick fixes that do the hard work for us, because we won't own the results, which means eventually the whole thing will probably come crashing down (or we'll discover that the drug is dangerous, as I read recently on The Atlantic about the scary parallels between now and the fen-phen excitement of almost 30 years ago).
All that being said, as you wrote beautifully, we've gotta use whatever tools we've got to help folks get to the beginning of the trail going "from here to there." I hope these drugs will turn out to be similar to antidepressants enabling alcoholics to get to AA, which is of course a wonderful thing.
Hey, nobody ever said life isn't complicated.
So true!! It's all so complicated, we should all remain humble about the vast amount of things we know nothing about - including me!
With my GYN's permission, I cut my HRT in half (literally with a pill splitter) because I was experiencing insatiable hunger, but it wasn't necessarily coming from my stomach. There was a chatter going on that was only there the first day of my period back when I had them. (That Day 1 I'd be insatiably hungry and then it would be gone Day 2, so I never fought it, just accepted it. That's hard to do every day for a couple of years.) Reducing that already-low dose of hormones helped me almost immediately. My brain is no longer telling me to eat something, eat something, we need to eat something NOW. It's the strangest thing. So, if that what Ozempic is doing, bless it. Because if that's what some people are dealing with all day, every day, it's torture. xo
👏
This is so well-written and reasoned. Of course it’s unwise to pop a pill and expect all life’s problems to disappear. Health solutions need to be as multi-layered and changeable as health problems. That’s why I take Monjauro and Effexor, AND I see a therapist, go to AA meetings, exercise regularly, meditate (I try, anyway!), stay current with my friends and family, and after 23 years of workaholism shifted to a job with a respectable work-life balance.
Thank you for that articulate explanation. I totally agree.
My experience with Ozempic has been through my best friend who was obese. She was horrified to learn, once she started taking it, that it worked on her as a "chemical castrator"! She went to her GP who told her that it was a little-known side-effect of the drug. She is now off it, but her libido has not come back after several months.
So when my husband considered using it to lose some weight, I argued him out of it, instead he goes for a daily walk around the neighbourhood with me and concentrates on his diet.
You mention that Ozempic is for diabetics ie those trying to lower their glucose. Those interested in losing weight are taking other variants- eg Mounjaro or Wegovy. Ozempik is not FDA approved for losing weight and it’s administered in different doses than the others. Your points more aptly apply to the non Ozempic.
I am a total fan of these drugs that seem to miraculously put obese and overweight people on the real road to better health and less suffering. But I'm also reminded of how, like antidepressants, they can be prescribed so easily and there is no actual therapy required. So- another bandaid? No delving into a way to actually deal with the problems that got the patient into such trouble in the first place? Any end in sight for how long the patient is safe taking the prescription? I hear the big pharma cash registers clanging.
Yes, Ozempic can be prescribed quite easily.
Yes, some people take Ozempic without adopting a healthy lifestyle or getting at the root cause(s) of their metabolic problems.
Yes, some doctors readily prescribe medications without sufficiently counseling the patient on lifestyle modifications that would help them.
But here are my questions :
1. Do you have the same fears about people taking statins for high cholesterol or blood pressure medication for hypertension (both of which have modifiable elements related to lifestyle and habits)?
2. Should a patient not take a medication that the pharmaceutical industry profits from?
3. Who should make the decision about when a medication is appropriate for a medical/health condition when lifestyle changes haven’t worked?
4. Where do we draw the line between personal responsibility and asking for help?
These are honest questions. There are no right/wrong answers! I welcome your thoughts.
I think these are all good questions that get at uncovering the underlying bias that folks have around weight.
I did have a reaction to reading question #1 -- about having the same fears about people taking statins or BP medication. Because, for me, the answer is yes -- I do have those fears. Not because I think people are moral/immoral/superior/lazy. But because it makes me ask: What is happening to us, collectively? I feel like the story I've been hearing is that people are getting cancer younger, are more depressed and anxious, substance misuse is on the rise, "lifestyle" diseases -- which is obviously a very unhelpful term -- are on the rise, etc. Like we're living longer, but sicker.
I'm glad for all of the pharmaceutical innovations we have that can alleviate suffering. I guess I'm just wishing there wasn't so much suffering to alleviate in the first place. We've figured out how to address many of the communicable diseases -- maybe addressing the noncommunicable ones is the next frontier? Here's to less suffering.
Tamara -
Your reasoning makes so much sense to me. I could not agree more that diseases of despair need to be addresses like we do *any* other medical condition. (Note: this is the subject of my forthcoming book with Simon & Schuster .. and is the reason I write this newsletter every week.) It does feel like the medical industrial complex is coming up with solutions for issues that would be better solved with less despair in the first place. And I agree w you that we need to address the suffering head-on (i.e, what is driving the obesity, opiate, and mental health epidemics in the first place), however I think we can do both at the same time.
To my mind, that includes (in the order of individual to societal): 1) redefining health as more than a number on the scale or a perfect cholesterol score .. and instead as a process of awareness, acceptance and agency 2) educating ourselves on *what is truth* and *what is a convenient lie* when it comes to messaging in the public space about health and when it comes to our own narratives about health (ie cognitive bias) 3) finding trustworthy guides to help us separate fact from fiction and support us in our unique health goals, using evidence and fact over biased information and false internal narratives 4) facing unpleasant facts about who we are, the choices we make, and the realities of our lives and deciding what we can change and what we cannot depending on core values and mission 5) doing the best we can with self compassion and compassion for others who are trying to live authentic and healthy lives and also do good in the world 6) lobby your local, state and federal govts to reform health care such that EVERY American has access to primary care and most importantly where primary care medicine includes behavioral and mental health services in addition to routine screenings and counseling on preventative health 7) VOTE for anyone who sees health is a fundamental right, not a privilege and who understands that health includes more than a quick checkup with a doctor who is glued to his/her computer and doesn’t have time to address the person 8) VOTE for anyone who understands how broken the medical system is in this country and how broken doctors are for participating in a system that treats ppl as a number on the scale or a set of boxes to check instead of a whole person 9) pray for the souls and lives of people who are suffering from poverty, discrimination, and ideological capture who may be voting and arguing against their own best self interest without knowing it and 10) remain humble about what we do not know.. and keep learning.
Thank you, Tamara, for being a thought partner in this conversation. You have helped me. ❤️
👏👏👏 Thank you. And excited to hear more about your book when it’s ready.
Thanks for your insight and questions!
1. In a word: absolutely. I personally know of scripts that were written for both of these dx's without discussion of how and why one can go about a lifestyle change OR what potential side effects might bring.
2. Well no, of course not.
3. A meaningful discussion between the pt and the provider, with the provider offering data from actual, high quality studies AND possible alternatives would go a long way.
4. See #3 above. 🤝
Amen. I hear you.
1. Yes it happens all the time. It also happens in liquor stores where ppl with addiction are buying alcohol against their own self interest. All of it is sad and tragic. The solution, though, is what I am most interested in—and to me it’s not about hand wringing or gate-keeping; it’s about a) education b) access to resources to address mental/behavioral health c) less shame and more compassion. I am assuming you agree 😊
2. I humbly agree.
3. Yes, yes and yes. Scream it from the hilltops.
4. Amen again.
Thanks for your honest replies and engagement. This is what I am here for. ❤️