doctors

Food Psych #187: How to Make the World More Accessible for ALL Bodies with Alissa Sobo

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Software engineer and Ample co-founder Alissa Sobo joins us to discuss how being fat-shamed at the doctor’s office inspired her to create the Ample app, how to improve the accessibility of public spaces for people in ALL bodies, her journey through disordered eating and recovery, why business reviews are a form of education and advocacy, and so much more! Plus, Christy answers a listener question about whether the principles of intuitive eating and Health At Every Size® still apply for older people.

Alissa is a software engineer and a cofounder of Ample, a review website, like Yelp, for rating doctors, services, and establishments on their accessibility and inclusiveness towards fat, trans, disabled, and BIPOC bodies. Ample has amassed over 700 reviews and recommendations across 10 countries since its beta launch in 2018. Alissa began the open-source, volunteer-led project in 2017 after experiencing fat shaming at the doctor during her pregnancies. While there were some nascent resources for finding fat friendly services at the time, she started Ample with the hope of improving these tools with up-to-date technologies, centralizing the information into one easy-to-find repository, and honoring the intersectional identities of communities. When she’s not coding, she can be found riding bikes and gardening with her family in Portland, OR. Find her online at IsItAmple.com.

Help us and our potential advertisers learn a little bit more about you. Visit podsurvey.com/foodpsych to take an anonymous survey, and you can enter to win a $100 Amazon gift card. Terms and conditions apply.

This episode is also brought to you by NurX, the game-changing company that’s here to make getting birth control easier. Visit nurx.com/foodpsych for a $20 credit, and you can get birth control delivered securely and confidentially to your door in less than a week.

We Discuss:

  • Alissa’s experiences growing up as a larger-bodied child

  • How her relationship with food and her body developed into an eating disorder

  • How she learned about Health At Every Size

  • How where we live can influence our relationship with food and our bodies

  • Body acceptance, and how it can look different for everyone

  • Her experience of being fat-shamed at the doctor’s office, and how it inspired her to start Ample

  • How creating the app helped her to learn more about accessibility

  • Why Ample is for all marginalized identities, not just larger bodies

  • The mechanics behind the app

  • Practical strategies for increasing accessibility, even when space and/or funds are limited

  • Advocating for ourselves, and the work that it can take to be comfortable doing so

 

Resources Mentioned

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

  • Virgie Tovar’s work, and her first, second, and third appearances on Food Psych®

  • Health At Every Size by Linda Bacon (and their Food Psych episode) (CW: Dr. Bacon no longer recommends the book Health At Every Size and instead directs people to their second book, Body Respect)

  • Hot & Heavy by Virgie Tovar

  • Shoog McDaniel’s work

  • The Ample app

  • Corissa Enneking’s work, and her Food Psych episode

  • Fat Friendly Docs

  • Ragen Chastain’s work, and her first and second appearances on Food Psych

  • Ample on Facebook and Instagram

  • Help us and our potential advertisers learn a little bit more about you. Visit podsurvey.com/foodpsych to take an anonymous survey, and you can enter to win a $100 Amazon gift card. Terms and conditions apply.

  • This episode is also brought to you by NurX, the game-changing company that’s here to make getting birth control easier. Visit nurx.com/foodpsych for a $20 credit, and you can get birth control delivered securely and confidentially to your door in less than a week.

     

Listener Question of the Week

Is there any point in Health At Every Size and/or intuitive eating where an older person with health concerns should consider weight loss? Is there an age limit to HAES and intuitive eating? What are the effects of dieting, or any intentional weight loss? What are the consequences of weight cycling and weight stigma? How can a person access healthcare that doesn’t involve weight cycling or weight stigma? What are some things you can prepare ahead of a doctor’s appointment?

(Resources Mentioned:

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Food Psych #171: Healthcare Without Diet Culture with Jennifer Gaudiani

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Physician and eating disorder specialist Jennifer Gaudiani joins us to discuss how healthcare professionals are doing harm by perpetuating diet culture, why people with eating disorders are often missed in our medical system, medical outcomes she has seen in some of her patients who have adopted Health At Every Size®, the role of social justice and acknowledging privilege in our work, and so much more! Plus, Christy answers a listener question about whether it’s a contradiction to be an eating-disorder treatment provider who also does bodybuilding and fitness competitions.

Jennifer Gaudiani, MD, CEDS, FAED, is the Founder/Medical Director of the Gaudiani Clinic. Board Certified in Internal Medicine, she completed her undergraduate degree at Harvard, medical school at Boston University School of Medicine, and her internal medicine residency/chief residency at Yale. From 2008 to 2016, she was one of the leaders of the ACUTE Center for Eating Disorders. She left after serving as its Medical Director to found the Gaudiani Clinic, which provides expert in-person and nationwide telemedicine outpatient medical care to patients of all genders with eating disorders/disordered eating and to those in recovery. The Clinic is a HAES-informed provider and embraces treating people of all shapes and sizes. Through a collaborative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.

She has lectured nationally and internationally, is widely published in the scientific literature as well as on blogs and is a current member of the editorial board of the International Journal of Eating Disorders and the Academy for Eating Disorders Medical Care Standards Committee.

Dr. Gaudiani is one of very few outpatient internists who carries the Certified Eating Disorder Specialist designation. She is also a Fellow in the Academy for Eating Disorders. Find her online at GaudianiClinic.com.

This episode is brought to you by Paribus. Paribus helps you save money by monitoring online retailers to make sure that you get the best price, and will even help you get compensated if your shipment arrives late. Head to GetParibus.com to sign up.

Ready to learn how to cook, make movies, write books, and more from the masters? MasterClass has launched the All-Access Pass – a thoughtful gift for the home cooks or lifelong learners in your life. Food Psych listeners can get the All Access Pass at MasterClass.com/FOODPSYCH.

This episode is also brought to you by TomboyX. Go to tomboyx.com/foodpsych and check out their special bundles and pack pricing. Food Psych listeners will also get an extra 15% off with the code FOODPSYCH.

We Discuss:

  • How her privilege and family background shaped her relationship with food

  • Her sister’s struggle with bulimia, and how that influenced her work in eating disorders

  • Weight stigma in the medical field

  • Recognizing the harm that we as health professionals have done in perpetuating diet culture

  • When she realized ‘calories in, calories out’ doesn’t work

  • How she discovered the Health At Every Size® model and began to use it in her practice

  • Why people with eating disorders are often missed in our medical system

  • What an initial assessment looks like at her clinic

  • Medical outcomes that she has seen in some of her patients who have adopted HAES

  • The importance of having a multidisciplinary, HAES-informed team

  • The links between our healthcare system, the supposed “obesity epidemic,” and diet culture

  • How our bodies adapt to starvation

  • “Survival” genetics vs. “sensitive” genetics

  • How diets can make health issues worse

  • Why she doesn’t recommend moderation (and what she recommends instead)

  • Letting go of diet fads and embracing all foods

  • What draws people to problematic alternative-medicine practices, and what providers can do to help them re-engage in evidence-based healthcare

  • How she’s continuing to learn and integrate HAES into her practice and her book

  • The role of social justice and acknowledging privilege in our work

  • Jennifer’s book, Sick Enough: A Guide to the Medical Complications of Eating Disorders

  • The problems with our current diagnostic criteria for eating disorders

  • Atypical anorexia nervosa, and its high mortality and complication rates

  • How we can stop the spread of diet culture

 

Resources Mentioned

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

  • Submit your questions for a chance to have them answered on the podcast!

  • My online course, Intuitive Eating Fundamentals, which includes monthly listener Q&A podcasts and access to my private Facebook support group

  • Carmen Cool’s work, and her Food Psych® Podcast episode

  • Deb Burgard’s work, and her Food Psych® Podcast episode

  • Hilary Kinavey’s work, and her Food Psych® Podcast episode

  • Desiree Adaway’s work

  • Jennifer’s book, Sick Enough: A Guide to the Medical Complications of Eating Disorders (TW: Contains detailed descriptions of eating disorder behaviors)

  • Gaudiani Clinic

  • Jennifer and the Gaudiani Clinic on Facebook, Twitter, and Instagram

  • This episode is brought to you by Paribus. Paribus helps you save money by monitoring online retailers to make sure that you get the best price, and will even help you get compensated if your shipment arrives late. Head to GetParibus.com to sign up.

  • Ready to learn how to cook, make movies, write books, and more from the masters? MasterClass has launched the All-Access Pass – a thoughtful gift for the home cooks or lifelong learners in your life. Food Psych listeners can get the All Access Pass at MasterClass.com/FOODPSYCH.

  • This episode is also brought to you by TomboyX. Go to tomboyx.com/foodpsych and check out their special bundles and pack pricing. Food Psych listeners will also get an extra 15% off with the code FOODPSYCH.

     

Listener Question of the Week

Is it contradictory for eating disorder professionals to promote body acceptance and intuitive eating alongside bodybuilding and fitness competitions? What is diet culture? Would bodybuilding and fitness competitions exist without it? How are other sports related to diet culture? What if you’re an eating disorder professional with diet culture beliefs? How do you approach someone who is sharing triggering content?

(Resources Mentioned: Sand Chang’s Food Psych® Podcast episode)

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