WELCOMING THE BODY I LIVE IN

I freaking LOVE my Wednesday night group. LOVE it. One night, we were peeling back the layers what gets in the way of nourishing our bodies and giving them what they need. So much of our relationship with food isn’t about food. That was the case the night I gave this assignment. I gotta be honest, I’m constantly right on the line of my scope of practice because of this. What I love about my work is that I get to coordinate client’s care with their therapists. Let them know what came up, sometimes tell the clients to dive in deeper to an issue with their therapist, or get the “OK” from a therapist to discuss body image on a deeper level with a client so the therapist can do even deeper work (like trauma stuff) with the client. This journal prompt got taken back to many therapists. It was a hard one. Some are having a hard time working on theirs. This shit is hard! It’s REAL hard if you’re in a bigger body! Below, is what one of the women wrote. Shared with permission.

Welcoming the body that I live in.
There’s a disconnect between you and me. But there’s really not. I just say that sometimes when i get too into my head. Because people have made me feel like you’re “other” and not worthy and somehow not as good. But you and I are the same. You’re my home and I’m grateful to have you.
I’ve been kind of a bitch to you for a long time in my thoughts and in my actions and you’re just trying to keep a girl alive. Just trying to have fun and keep feeling. There’s so much judgment about you and it’s so weird because people talk about you and judge you as if I weren’t connected to you. As if we weren’t the same thing. I’ve internalized that and sometimes feel like I don’t really know what you look like and I try not to feel what you feel like.
That’s not our fault. The clothes that fit us don’t feel good, don’t look like what we’re “supposed to look like” in some way. It’s not our fault that people judge and make assumptions about our health and our character. But that doesn’t mean that we have to be dicks to each other. You’re what I’ve got and I’m all you’ve got and frankly, it could be so much fucking worse! You’re a good body and I’m trying to shed all the bullshit and be grateful for you. Imperfections are unique and interesting… while perfection is actually kind of creepy and scary… I don’t want to look like I’m made out of plastic.
You’re actually kind of a good time, when I stop thinking so much about how I’m supposed to think about you so much. I love the fun adventures we go on, I love that your help me do crafty things really well. You and I would totally kick ass in an apocalypse too! I’ve got super storage powers, I’ve got my own personal bunker and it’s you! We also have some pretty sweet skills and a rather durable physique.
I’m going to try and think of you now on like I do about puppies and kittens, fat cats in general, and lots of squishy stuffed animals. You’re so comfy and snuggly. And you’re so resilient, adaptable, and in spite of the whole weight stigma thing that we get from all sides, have so many traits and qualities that I fucking care about and find desirable beyond some ever changing, unattainable aesthetic.

Curious about my Wednesday group? Shoot me an email! There is a short wait list for the group geared to those in bigger bodies.

Wanna know where I got my photos? The first one is from Representation Matters, the best high-resolution, royalty-free stock image collection focusing on inclusion and diversity! The cat is my friend’s, sent in a message, used without permission. Cat treats to be provided upon next visit.

Interns don’t go way…

Until they do (two weeks later).

My brother sent a text awhile back asking how I was doing. I told him I was pretty exhausted from being busy and having an intern. He said, “Haha. Are they annoying?”

I said, “Nope. They just don’t go away.

They don’t. They’re ALWAYS there. It can be pretty tiring giving background before a client comes in, discussing the client after, giving background on the next and then seeing another client and repeating that cycle 4-6 times. I’ve gotten better at balancing it. I go for walks by myself, leave them to work on a project while I run an errand and once I said, “I’m going to take a nap.” And that’s precisely what I did while my intern did who knows what (I think she was working on a project but didn’t care, TBH).

While it’s tiring, IT’S SO WORTH IT. I have them read Body Respect before they start, answer questions I ask clients and take the weight implicit bias on weight questionnaire. For many of them, it’s their first real exposure to Health at Every Size®. I get to blow their fucking minds and I love it. I have them for two weeks. My goal isn’t to have them memorize important labs or eating disorder diagnoses. My goal after blowing their minds is to show them how to break up with “being professional” and be a real person, a REAL, authentic person to clients. We weren’t taught that in school. I’ve told each intern that they are free to write about their experience for this here blog o’ mine. I have a couple others on deck but am waiting to get photos with them because I want my clients reading to remember who is who.

THANK YOU TO MY CLIENTS. Thank you for trusting me enough to bring in interns. I always say that I wouldn’t be the RD I am if I didn’t get to sit in on sessions when I started and now these interns get to say the same thing. Thank you, thank you, thank you. I love you all.

Kendra was a real treat. She did some invaluable work for the non profit I’m trying to start. Like, seriously, I’m SO thankful for her help. Also, she laughed at my jokes and sarcasm so obviously, I enjoyed her.

To Amy and her clients: Thank you for opening my eyes.
 
“Nutrition Sciences” is the degree I needed to become a dietitian. Nutrition classes taught me
how to determine a person’s nutrition needs, analyze nutrients to plan menus, use foods to
help treat diseases, manage food service operations, help our communities with nutrition, and
so much more. In school, everything seemed so cut and dry: If you do this thing, then you
get that result. Calories in, calories out. Science.
 
What nutrition classes DIDN’T teach me is that the rules aren’t always true. Nutrition classes
didn’t teach me how much damage believing in those rules can do to a person’s health, sense
of worth, and the way they experience the world around them. They didn’t teach me how
believing that these rules are universally true inflicts a sense of failure and shame for everyone at some point in their lives.
 
Something inside of me has never felt right about telling people what to eat because people
usually only want to be told what to eat when they want to lose weight. After spending
two weeks with Amy and her clients, I understand why that has never felt right. I saw each of
Amy’s clients as a brave, brilliant, and vulnerable individual in pursuit of uncovering their true self. I was impressed with the courage it took for them to look inward at parts of themselves they despised… and to share it with another person… in front of a random intern!
 
While I was continually impressed with her clients, I was also continually heart broken. These
wonderful human beings felt so much shame and failure. Because they live in a society where
people are taught to believe the nutrition rules and that having a certain type of body is a sign of success. If they could only see themselves the way I saw them, they would know the kind of courage they have is exactly what this world needs: authentic individuals who can speak their mind and share their truth.
 
My experience with Amy has changed how I see, hear, and communicate with others. It has also inspired me to look within and be courageous and vulnerable just like Amy and her clients, both as a human and as a future dietitian.
 
To Amy and her clients: Thank you for opening my eyes.

THEY CALLED ME WEREWOLF.

“Werewolf.”

“Monkey.”

“Hairy.”

“You have man arms.”

“Your sideburns make you look like Elvis.”

“Why are your arms so hairy?”

“How did you get so hairy?”

“Why are you so hairy?”

My earliest body hatred memory is around age five. Sadly, that’s about the age most girls have their first body hate thoughts.  I remember shaving one arm. Yes, ONE arm. Just one. I don’t know why just one. Six year olds don’t always make sense. I remember being in the entryway to my Grandma Bohot’s kitchen, her grabbing my arm and saying, “Oh honey, why did you do that?” I remember feeling such sadness about it. I felt such shame and embarrassment that she noticed. I also remember feeling like I had no choice, like I HAD to get rid of it. It’s such a clear memory.I started shaving my legs before everyone else in school.  I think I was nine years old. I just went for it. Razors weren’t what they are now. I was constantly nicking myself.

I loved school. I was always the teacher’s pet and wanted to be a teacher myself (I even made lesson plans for my brother and the neighbor kids. I took playing school seriously. I took damn near everything seriously back then. See serious first grade photo below) but I remember wailing to my mom, begging her to let me stay home. Bullying is no joke. It stole joy from the thing I loved the most.

In high school I used different products to bleach the hair on my arms. Did you know arm hair grows? I didn’t know that then. So I had grow out. Not what I wanted at all. Thanks to being regularly reminded that it wasn’t acceptable, my hatred of my hairiness carried on for years. In college, I remember being in the cafeteria and a kid Zach saying, “Oh my god! Your arms are SOOOO hairy.” A dude named Tyler piped up and said, “Do you think she didn’t know that or that you’re the first one to point it out?” I loved Tyler. Warm spring days were the worst. I’d have anxiety over exposing my arms.  There were always a period of adjustment as the weather got nicer.

I mentally made plans to one day save up and laser it all off. In my twenties, a friend’s boyfriend looked at my arms and said, “When are you going to take care of that?” I told him I was waiting to see if I had a daughter because I would feel awful if she was hairy and went through what I went through. I wanted to keep it to support her through the bullying.

And then I lost my fucks. I got exposed body acceptance. For something that doesn’t sound that radical, it definitely is. I was at my first Health at Every Size®  training at Be Nourished  when they asked us to think back to our first body hatred memories. They pointed out that they are often not feelings we develop on our own, but feelings we let other choose for us. YUP. I let the little shits at school decide how I should feel about my body. I also realized that if I was really honest with myself, I was worried about not feeling accepted by those who thought my hair was gross. And then I realized I didn’t want to be accepted by those people, that my worth far exceeded how I looked and if someone wasn’t going to hang with me because of my hair, they could fuck off. If I wanted body acceptance and liberation for my clients, I had to find it too. There was NO way I could become a dietitian and try to help clients accept their bodies if I had plans to laser the hell out of mine.

A couple years ago, I drastically changed my hair color and sent the photo to a handful of peeps. An older woman I’m very close to responded and told me that I was beautiful but suggested I take care of the hair on my upper lip. She told me to not be mad and that I could tell her to get botox. In the past, that sort of thing would have completely crushed me but with no fucks about that kind of thing left in my bucket,  I responded and said something like, “Here is why I will never tell you to get botox. Because your wrinkles have no effect on the kind of relationship we have or the kind of mother, sister and friend you are. Because I value how you listen, give advice, laugh with me.” I asked her to never ask me to change anything about my body, that the if and when of me waxing my upper lip is completely up to me and not up for discussion. EVER. I told her that this body of mine with all it’s hair is just the vessel of one powerhouse of a woman, dedicated to changing the lives of those around her, something that can be done with or without hair on my upper lip.

I used to be an anxious little mouse. Clients are shocked when I tell them how timid I used to be. Losing all your fucks doesn’t happen overnight. It’s painfully hard at first. Sometimes I would drop them and then pick them back up when I was say, going on a first date. But the more I lost them, the better I felt. A neural pathway of body hatred had been created in my brain and it took work to make a new one. But I did. You can too.

I want to acknowledge that the bullying I received is nothing compared to the stigma and bullying that others face. I’m thin. If you have never listened to the experiences of those in bigger bodies or of those who are any color but white, you will likely hear things worse that what I have shared. I’ve also had the privilege of having family, friends and coworkers who have helped me to lose my fucks about things that aren’t important as well as the finances to be in therapy over the years. Oh, and I work in an amazing field and am reminded daily how much space body hatred can take up in someone’s life. I refuse to make space for it in mine. I am also reminded daily that others don’t have the journey as easy as I have had it but I’m determined to walk with them through it and closer to the freedom that I now experience.

My newest tattoo is from Christopher Poindexter. I stumbled across his poem on instagram over a year ago and knew immediately I’d get it inked at some point.

Love y’all. –Ames

How to help doctors not be dicks

I’m probably breaking some sort of blog rule by not posting for years and then posting so close together. I think the people (you know, THE people) would tell me to wait a week to post this since I just posted yesterday and if you want to increase followers… blah, blah, blah. But I don’t really care about getting more followers and I don’t really care about blog rules or any rules I think are dumb and I’m real excited to share what I did with a client today. This was inspired by a talk given by Shiloh George at the 2018 Association for Size Diversity and Health Conference.

All too often (OK, most of the time. Like, seriously most of the time) providers, especially doctors don’t know what they are doing with my clients. They say triggering things on the regular. They recommend weight loss to clients at heavier weights who have restrictive eating disorders. Remember in my last post when I said I have clients in larger bodies starving themselves? Yeah, it’s a thing. Oh and doctors shouldn’t be prescribing weight loss for anyone because um, if it worked, everyone would be thin  but that’s for another post. Back to my clients with eating disorders. I’d say at least 75% of them have stories of doctors harming more than they are helping. So in addition to me sending starting to send eating disorder crash course letters to providers,  I’m making this option available to clients as well. We come up with what that specific client needs from their provider, they show up with a letter to their first appointment, ask the receptionist to have the doctor read it before they see the client (as Shiloh says, “to not mess with the power dynamic) so when the doctor enters the room they know the client means business. Below, the the first letter composed. I love what we came up with. I love that the client’s personality shows through. We mean business y’all. We mean business.

 

Dear Dr. —-

I have some complex mental health disorders. The following list is what I need for our time together to be the most helpful and least harmful to me. If you feel you are unable to meet these expectations please inform me so that I can find a new provider.

  • If possible, please have a female nurse in our appointments.
  • Please ask before you touch me in any way.
  • I have an eating disorder. Please don’t ask to weigh me. Do not discuss my weight with me. You can discuss any weight concerns with my dietitian. I have provided her information below. If you try to discuss my weight with me, I will find a new provider.
  • Do not make any comments about my eating habits. Again, if you have concerns, please discuss with my dietitian.
  • I expect to get the same recommendations you would give to a thin person if they had the same health issue as me.
  • If you don’t evaluate me the same way you do with someone in a thin body, I fill find a new PCP.
  • Please educate yourself on Health at Every Size principles if you do not already know them.
  • Shame is bad for my health. I would like for you to first do no harm and provide me with shame-free health care.
  • I have a compulsion to do personal research on my personal health. I need you to give enough information and explanation on my care to help me in avoiding WebMD. For example, I need to be told why labs are being ordered.
  • I have heard you are a badass doctor and this is me being a badass patient.

Thank you so much for your cooperation. Now let’s establish some badass care!


 

I fucking love what I do. I just love it.

I’m pissed and shit is getting real

I’m done hearing stories of eating disorders being overlooked because of how a client looks. I’m DONE. This is my first real experience with it happening to one of my current clients in such an impactful way. This doctor jumped on the higher level of care train way too late in the process, once she found out we were pushing forward with it. She asked me what she could do to help the client get IOP. Too bad NONE of her notes support anything we are trying to do. This letter is only the beginning.

Practitioners: I’ll be putting together a crash course type letter that will be going to all doctors. Please provide input. With the letter, I will explain that I will be reporting them if they don’t give the client proper care and if they violate the Hippocratic oath.

Clients: This letter was not just for my specific client. It was for all of you who have been overlooked and mistreated by the medical system. I’m fighting for you and really, I’m just getting started.  I wish I didn’t have to feel such rage over poor care some of you have been given but I’m happy to channel it into making things better for you. You are loved. You are worth this.

Everyone else: if you want to know how you can help, hit me up. I’ve got some ideas brewing.

Hello Dr. ——-

We got your notes on —– and I have to say, they are extremely disappointing and appalling.  You noted that the client looks well nourished. There is nothing about her intake. Did you ever ask? It is standard with clients who have eating disorders to ask about their intake. Did you ever ask how her eating disorder is impacting her life? What her activity level is? This client is begging for a tube feeding. She’s reporting being so depleted that she can barely shower, can’t prepare food, doesn’t have the energy to eat, much less get to her appointments.  I can get her to drink one boost in session but not more because it makes her feel so full.  I went to the grocery store with her once and she barely made it through, she was so exhausted. She’s terrified of most foods, and hasn’t been able to increase her intake, despite all my efforts. I sent her in worried that she was dehydrated she reported to me that you told her that she didn’t look dehydrated and you did nothing to test for that.  I do not fault you for not being familiar with eating disorders if you haven’t dealt with them much but I do expect a practitioner to educate themselves so that they can offer the best care to their patients.  I believe your negligence with this client has needlessly caused her harm. Your notes carry the most weight with insurance companies and assessment teams at treatment centers and from your notes, it shows the client is not in need of a higher level of care. Both her therapist and I specialize in eating disorders. We have both worked at treatment centers. I exclusively see clients with eating disorders and we both know when this level of care is not appropriate. I wouldn’t necessarily expect for you to know that but again, educate yourself. We are not getting her assessed for IOP. That is a half day, half week program. It is not the slightest bit appropriate. We believe she needs residential. This client reports eating under 400 kcals a day for months. MONTHS. Usually, it is in the form of gummy candy because that’s all she feels she can do. It is not uncommon for clients with anorexia to have normal weights, labs and vitals. It is not uncommon for all of these things to be fine and then for the client to drop dead. You asked what you can do to help get this client a higher level of care. You can send an email or call her caseworker telling her that while your notes don’t reflect it, you believe this client needs a residential level of care. If you need to see the client for an appointment, I’m happy to take her in to see you so that you can hear from her mouth how she is doing. I HAVE to believe that these things weren’t in your note because you didn’t ask, not because you neglected to leave them out. This client is not well nourished. She needs residential as soon as possible.  As a doctor, you can recommend a higher level of care even when a client “looks nourished.” I have clients in larger bodies who are starving themselves and hope that you don’t have any doing the same. Please look past what you see with this client. If she was your family member, you would ask more questions. You would want increased care for them based on their reports. Please do better by this client. She deserves it.
Please advocate on this client’s behalf to her case manager and make this right. Her email is below. I also cut and pasted the last email we received from her.
Amy

FOR THE FAT HATERS (and everyone else)

Finally a blog from Amy. I know, it’s weird. Many of you didn’t even know blogging was a thing for me. It really hasn’t been but I hope to be doing more of it as we head into the less sunny months.  Today it’s sunny and I should be doing other things like tracking down money that insurance companies owe me but I really wanted to shared this AD I’m kinda cheating because my friend Shoog basically wrote this blog through their instagram post.  So, thanks Shoog for your words that propelled me to want share past just instagram, twitter and facebook. And thanks for giving me the “OK” to post this on my blog.

I have some things to say.

I know many reading this think I’m out of my mind for being a fat positive dietitian, think I’m not actually helping people be healthy, think we need to eradicate the “obesity epidemic” and on and on. I get it, I really do. I had plans of being weight loss dietitian back in the day, so I know damn near every thing you could be thinking on fat. I used to have those thoughts and beliefs too.  I’ll be sharing a video in the next couple months that will go through  all the “yeah but what about diabetes and heart disease…? fat kills… it’s healthier to be thin…” stuff. But for now, you can think I’m crazy and disagree with anything you want.

That’s your choice.

If you want to assume that all people who are fat are lazy and just don’t care about themselves or their health, fine. You’re wrong, but fine. What really hurts my heart is how your views and beliefs on this translate. It translates to people, real people with SOULS JUST LIKE YOURS feeling unworthy, feeling unseen, feeling lonely.

I’ve followed Shoog’s work (amazing art and photography) for awhile but recently became friends and got to hang with them at my place. We had connected over several things but it was when I was explaining my composting toilet (you know, basic new friend chitchat) that they said something like, “We are the same!” It was so fun to learn all the things we had in common. Shoog is a gem of a soul and I wouldn’t have seen their soul back in the day when I had all my judgments about fat and people with it. I would have been distracted with trying to figure out how to “fix” them and make them “healthy.”

Today they shared a post that they were photographed in. How could you not be touched by this story in some way? I’ve heard the first part of this story MANY times in sessions with my clients.  They have all been harmed by this mean, ruthless, fat phobic culture we live in. I often say that feel like a mama hen, wanting to take all my clients under my wings and protect them from all shit they face. It is my hope that each one of them can get to a place where like Shoog, they feel that worthiness and belonging that Shoog mentions. Please join me in judging less, saying less and listening more to marginalized folx. Let’s make more nests. IMG_1357
・・・
“I had a very lonely childhood.
I was kind of a weirdo.
It was either fat stuff or gender stuff.
People would always say “you’re gay, you’re a dyke” and I was not into being labeled. So, I would distance myself from them.
A memory that I often return to as a way to illustrate my childhood is….. ….It’s a Saturday morning and a lot of kids my age ( 9 or 10 ) are meeting up with their friends to hang out and play basketball. And, because I didn’t have any friends, I would go outside and fill my hands up with bird seed and sit next to the bird feeder perfectly still and I would wait. And, I just stayed out there waiting. And, on many Saturdays, I would sit next to that bird feeder just hoping a bird would land in my hands.
It was a deep loneliness.
I really wanted to feel some kind of acceptance.

I wanted to feel worthy.
I wanted to be seen as something natural.

I thought, if I stand here long enough, I’m going to prove to these birds that I’m not a harm. And, maybe one day they will come and trust me completely.
I really wanted to be something that would bring comfort for others.

And, I feel like I got to become that.
Not with birds….but with people. I have a lot of people around me now and that feels really special.
The people that reach out to me as a friend, artist, and photographer are people who have struggled just like me. I think that people can look at me and the way I express myself and see that I am someone that is easy to work with and I could relate to them.
Fat Folks want to be seen too and not by people who have once judged them. And, that’s all I really wanted as a young kid….was for someone to show me that I wasn’t freaky or weird, or unlovable. I’m trying to be that for myself and others now.
Being in the Nest was like being able to open my eyes and look around and see that I was completely surrounded by something that was holding my whole body. And, having a few moments of giving myself permission to feel really held and really special.” – Shoog @shooglet

If you wanna be a cool kid like me, support Shoog on Patreon! You’ll get some great stuff coming your way!