size acceptance

Food Psych #150: Disordered Eating & Gender Identity with Sand Chang


Psychologist and trans-health educator Sand Chang joins us to talk about the complex experience of body acceptance for trans folks, the intersections of trans advocacy and Health at Every Size work, the growing body of research around trans folks and eating disorders, the shape-shifting nature of fatphobia and diet culture, and so much more! Plus, Christy answers a listener question about how food restrictions to try to cure acne can exacerbate an eating disorder.

Dr. Sand Chang is a Chinese American clinical psychologist, educator, and writer based in Oakland, CA. Sand identifies as queer, nonbinary, and genderfluid and uses they, them pronouns.

Sand currently divides their time between working at Stanford University’s counseling center, Northern California Kaiser Permanente Transgender Services, and a private practice specializing in trans health, relationships and sexuality, trauma, EMDR, eating disorders, and addictions. As a psychotherapist, trainer, and advocate, Sand is invested in healing and empowerment within marginalized communities and disrupting systems of oppression.

Sand co-authored the 2015 APA Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients and is the past Chair of the APA Committee on Sexual Orientation and Gender Diversity. They regularly present at conferences and provide trainings on a wide number of topics for health care systems, educators, and organizations. Sand’s upcoming book, A Clinician’s Guide to Gender-Affirming Care: Working with Transgender and Gender Nonconforming Clients, which they co-authored with their colleagues Drs. lore dickey and Anneliese Singh, will be published by New Harbinger in late 2018.

Outside of their professional work, Sand is a dancer, avid foodie, punster, and pug enthusiast. They live in Oakland, CA with their pug Zelda Sesame. Find them online at



  • Sand’s relationship with food growing up, including how their Chinese-American heritage influenced how they related to food

  • Sand’s first exposure to diet culture and fatphobia, including how unconscious and covert diet mentality was while they were growing up

  • How being involved in dance negatively influenced Sand’s body image

  • Sand’s experience with an eating disorder and over-exercise, and how trauma and coping played a role in the development of their disordered behaviors

  • How positive feedback from weight loss egged on Sand’s disordered relationship with food and the issue with body appraisals

  • Sand’s process of seeking recovery, including the ways in which healthcare practitioners both help and harm individuals attempting to heal

  • How weight bias prevents folks from getting the proper care for their eating disorder

  • Sand’s discovery of size acceptance and fat liberation, and struggling with applying body acceptance to our own bodies

  • Trans healthcare and body image, including the fatphobia and binaries embedded in queer communities and body norms within the trans community

  • Sand’s experience discovering their gender non-conforming identity

  • The growing body of research around trans folks and eating disorders

  • How the minority stress around being misgendered feeds into disordered eating

  • The current limitations within the healthcare field around trans identity and barriers to care for trans folks

  • Gender dysphoria vs body dysmorphia

  • The limitations of the current DSM mental-health diagnoses for eating disorders and for the trans experience

  • The complex experience of body acceptance for trans folks

  • The intersections of trans advocacy and anti-diet, Health at Every Size work

  • Why gender-affirming surgery isn’t a cosmetic surgery and why it saves lives

  • Sand’s experience finding their way back to inclusive eating disorder work

  • The need for the HAES movement and eating disorder work to become more intersectional and move away from the gender binary

  • “White feminism” vs intersectional feminism

  • Sand’s experience with orthorexia, how their experience navigating their gender identity within the healthcare system reinforced their disordered experience, and their path to breaking out of diet culture for good

  • Sand’s path to finding intuitive eating, joyful movement, and body acceptance

  • How diet culture keeps up in the limbo period between disordered and recovered

  • Moving away from the perfectionism around the idea of recovery

  • The positive and negative takeaways from Sand’s time in Overeaters Anonymous

  • How valuable it is to have a community by your side during healing



Some of the links below are affiliate links. Affiliates or not, we only recommend products and services that align with our values.




Can eating in certain ways and cutting out certain foods help cure cystic acne? What are the dangers of trying to heal our skin through food restriction? Can disordered eating contribute to hormonal acne issues?

(Resources Mentioned: Dr. Steven Bratman’s work on orthorexia, Julie Duffy Dillon’s anti-diet resources for PCOS, the Certified Intuitive Eating Counselors Directory, the Health at Every Size Registry)

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Food Psych #132: Diet-Culture Recovery, Body Trust, and Plus-Size Representation with Meredith Noble

Meredith Noble

Certified Body Trust Provider and life coach Meredith Noble comes on the show this week to talk about how intuitive eating becomes intuitive living, the importance of finding a Health at Every Size, fat-positive community for finding body acceptance, the problem with diet culture and how it’s embedded within the medical community, giving ourselves space to feel our feelings, and much more! PLUS, Christy answers a listener question about how to get started with this podcast.

Meredith Noble is a Certified Body Trust® Provider and life coach who helps plus-size people find food and body peace. Her practice combines Health at Every Size®, Body Trust® and intuitive eating philosophies with feminism and fat acceptance. With her compassion and expertise, her clients learn how to feel more comfortable in their skin, be at ease around food, and leave toxic diet culture behind. Find her online at

Grab Christy's free guide, 7 simple strategies for finding peace and freedom with food, to start your intuitive eating journey. You can also text "7STRATEGIES" to the phone number 44222 to get it on the go :)

Get Christy's BRAND NEW online course for fellow health & wellness pros, Master Your Anti-Diet Message, at


We Discuss:

  • Meredith’s relationship with food growing up, including the limitations put on candy and learning about dieting and food restriction from a young age

  • Bingeing and overeating in response to the scarcity mentality

  • Puberty, weight gain, and how Meredith’s relationship with her body was integrated into her relationship with food

  • The social experience of shopping, the struggles of being plus size at a young age, and burgeoning body dissatisfaction

  • How the endorsement of weight loss efforts and restrictive diets from medical professionals feeds into disordered eating

  • Meredith’s experience with Weight Watchers, including the idea of community and support around dieting

  • The effect of doctor authority, and remembering that medical professionals are influenced by diet culture as much as the rest of us

  • Shame and isolation around bingeing and emotional eating

  • Feeling out of control around food

  • How effective the victim blaming of the diet industry is

  • The investments we make into diet culture

  • How important community is in the Health at Every Size, body acceptance, disordered-eating recovery journey

  • Meredith’s transition into the “clean eating” world

  • Meredith’s stepping stones to the Health at Every Size paradigm

  • The importance of mental readiness to integrate the Health at Every Size, size acceptance movement

  • Food insecurity as a risk factor for eating disorders

  • Acknowledging our privilege and embracing intersectionality

  • Learning about emotional restriction, giving up on the pursuit of weight loss, and embracing intuitive eating

  • Finding body acceptance through finding a fat-positive community

  • The parallels between compassion and body respect

  • Meredith’s experience of being hyperaware of her body, and how being surrounded by other people in larger bodies allowed her to no longer by hyper-vigilant

  • Creating diet-culture-free spaces, both online and in-person

  • Balancing being aware of your body in order to heal it with forgetting about your body in order to embody healing

  • Intuitive eating, how the mental effort required to tap into your inner wisdom decreases over time, rooting out the diet mentality with our food behaviors, and how body image factors into healing our relationship with food

  • Giving yourself space to feel your feelings and grieve the thin ideal

  • Somatic experiencing techniques, feeling emotions through the body, and working with a therapist to find healing

  • Meredith and Christy’s professional transitions into Health at Every Size work

  • How intuitive eating spills into intuitive living


Resources Mentioned

Some of the links below are affiliate links. Affiliates or not, we only recommend products and services that align with our values.


Listener Question of the Week

Where does a Food-Psych-Podcast newbie start? Are there some Food Psych episodes that are helpful to return to in order to give us an anti-diet refresher and to remind us how diet culture embodies “The Life Thief” role? How has the podcast evolved since its inception in 2013?

(Resources Mentioned: Food Psych Podcast Episode #127 with Ashley Seruya, Food Psych Podcast Episode #106 with Ijeoma Oluo, Food Psych Podcast Episode #121 with Emily Contois, Food Psych Podcast Episode #99 with Lindy West, Food Psych Podcast Episode #94 with Alan Levinovitz, Isabel Foxen Duke’s first Food Psych episode, Katie Dalebout’s first Food Psych episode, and gain access to Season One of Food Psych Podcast with a Food Psych Premium Membership here!)


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