Speaker 1: This episode has a discussion of the body mass index
Speaker 1: and other medical language related to Wait. If this is
Speaker 1: concerning for you, please take care. I'm fifteen years old
Speaker 1: in a high school gym during the worst week of
Speaker 1: the school year. The Presidential Fitness Test, the yearly sadistic
Speaker 1: ritual where we are forced to perform acts of strength
Speaker 1: and flexibility in front of thirty other fifteen year olds.
Speaker 1: The v sit and reach, the pull up test, the
Speaker 1: sit up test oooh. Then we all line up in
Speaker 1: our polyester uniforms alphabetically by last name and get publicly
Speaker 1: weighed and measured by my pe teacher, mister Lafferty, who
Speaker 1: then yell the numbers to his clipboard toning assistant in
Speaker 1: front of the whole class. The numbers echo ruthlessly into
Speaker 1: the cavernous gym. Tovar, Tovar, tovar. That's how I was
Speaker 1: introduced to the body mass index. The BMI body mass
Speaker 1: index is the number you get when you weigh someone
Speaker 1: and then measure how tall they are. Then take the
Speaker 1: first number and divide it by the second number squared.
Speaker 1: The number is used to determine what weight category you're in.
Speaker 1: If you've ever been to the doctor. You've probably had
Speaker 1: your BMI taken, and whatever advice they give you is
Speaker 1: based on the number you are. You might be asking,
Speaker 1: how can anyone's overall well being be boiled down to
Speaker 1: how tall they are and the number on a scale
Speaker 1: that's two numbers. Surely that can't account for all the
Speaker 1: diversity humankind. Well, it turns out that it doesn't. I
Speaker 1: want to introduce you to someone whose work shows all
Speaker 1: the problems with relying on BMI as a health indicator.
Speaker 1: Her name is Janet Tomi Yama. In fact, her career
Speaker 1: is basically committed to changing how academia thinks of weight.
Speaker 1: My chat with Janet began as so many of my
Speaker 1: favorites do over a bag of crispy, salty mouth watering
Speaker 1: potato chips. Today I have a white truffle and sea
Speaker 1: salt potato chips. So I've never, like, actually had white
Speaker 1: truffle in my life. I think it's fun, a little
Speaker 1: bit out of my price range, so I feel like
Speaker 1: this is a way that I can tap into some luxury.
Speaker 1: Okay should we? Should? We do? Have you already opened
Speaker 1: your eyes? I haven't opened my Okay? Good? Yeah? Oh,
Speaker 1: they're a professional, very good. Okay, here I go. Okay.
Speaker 1: I love the smell. I like the smell coming out.
Speaker 1: Oh it's good. Okay. Should we crunch together? Yes? Okay? Three? Two?
Speaker 1: We got to synchronize. Crunch Janet, this is a good sign.
Speaker 1: We're potato chips sisters. Now. I'm very happy to be
Speaker 1: your potato chips sister. Janet is a professor and a
Speaker 1: health psychologist at UCLA, and she studies how biological, social,
Speaker 1: and psychological factors influence health, in other words, considering the
Speaker 1: whole person, including how you grew up, your mental health,
Speaker 1: your genetics, the kind of community you live in. Janet
Speaker 1: thinks all of that is important. So you may not
Speaker 1: know this, but looking at social and psychological factors that
Speaker 1: influence health and illness is not super popular in medical science,
Speaker 1: the field, and frankly, our culture is obsessed with the
Speaker 1: individual taking full responsibility for their own health period the end.
Speaker 1: It's at the root of some very powerful American ideology
Speaker 1: that mythologizes the possibility of beating the odds and says
Speaker 1: that no matter what, anyone can become anything they want.
Speaker 1: If you just stop eating potato chips, you can be thin,
Speaker 1: if you can just lower your BMI. Maybe you will
Speaker 1: be successful if you learn how to play the numbers right,
Speaker 1: maybe you can even cheat death. It's like a feedback loop,
Speaker 1: and when everyone buys into it, then bam, you have
Speaker 1: a justification for things like diet culture. And I hate
Speaker 1: to say it, but the medical world and the idea
Speaker 1: of quote unquote health perpetuate this feedback loop. I found
Speaker 1: out about Janet because she is one of the few
Speaker 1: academics whose work is disrupting the feedback loop. Her research
Speaker 1: has shown that the hard empirical data says diets do
Speaker 1: not work. Let me just start with the research. So
Speaker 1: we did a study that looked at every single study
Speaker 1: out there that looked at patients or participants who were
Speaker 1: put on a diet and then what happened to their weight.
Speaker 1: What we found over and over again is that diets
Speaker 1: do not lead to long term weight loss. Okay, anyone
Speaker 1: who has ever been on a diet knows that this
Speaker 1: is true. So this doesn't surprise me. But what did
Speaker 1: surprise me is just how much some of her colleagues
Speaker 1: fellow scientists don't give the work the time of day
Speaker 1: because it undermines accepted leaves in the medical world. Janet
Speaker 1: told me about the saga she went through to get
Speaker 1: one of her papers published. And this is important because
Speaker 1: publication is the main way new science gets legitimized and spread.
Speaker 1: The paper reviewed all the existing science behind the question
Speaker 1: do diets work. We submitted it from publication. We didn't
Speaker 1: hear back. We didn't hear back, and the editor in
Speaker 1: chief reached out and said, you know, it's not that
Speaker 1: I'm sending it out for a review and your peer
Speaker 1: reviewers are saying that the quality of the work isn't good.
Speaker 1: He's like, I just can't find anyone who's willing to
Speaker 1: review it. And he's like, I think it's because the
Speaker 1: topic is too dicey. And so he's like, here's what
Speaker 1: I'm going to do, because I think the topic of
Speaker 1: your paper is important. He's like, I'm gonna invite somebody
Speaker 1: to write an opposing piece to your paper, and I'm
Speaker 1: going to write a bridging editorial to kind of like
Speaker 1: create some peace between the two camps and bridge the
Speaker 1: two camps. That was only through this like divine intervention
Speaker 1: by the editor in chief that it ever saw the
Speaker 1: light of day. And you know that even that was
Speaker 1: after many attempts at different different journals, and I was
Speaker 1: presenting this work at a conference and someone came up
Speaker 1: to me and like, I was a grad student at
Speaker 1: the time, and she was like so angry with me,
Speaker 1: and she was like, you have done a huge disservice
Speaker 1: to our field with this paper, Like what the fuck
Speaker 1: is going on now? And she's like, now nobody is
Speaker 1: going to believe that there's anything they can do to
Speaker 1: help their health. Give like given everybody an excuse to
Speaker 1: just eat whatever they want. And you know, so that
Speaker 1: like really shook me. And I still remember very vividly,
Speaker 1: so you can kind of see like how heated. The
Speaker 1: argument is. Here's a secret I learned in grad school.
Speaker 1: Academia is not committed to the pure pursuit of science.
Speaker 1: There are politics, favoritism, and university interests involved. I know, boo.
Speaker 1: It was like finding out that Santa isn't real when
Speaker 1: you're thirty. And that was just Janet's first attempt to
Speaker 1: publish some anti dieting research. When she started studying wait stigma,
Speaker 1: the unequal treatment that people face simply because of the
Speaker 1: size of their bodies, she found herself in the middle
Speaker 1: of a fight over national public health policy. So Initially,
Speaker 1: most of the research was documenting the negative psychological effects
Speaker 1: of experiencing wait stigma. So you know, should come as
Speaker 1: no surprise to anyone that if someone experiences wayte stigma
Speaker 1: or I guess the common and would be fat shaming,
Speaker 1: someone experiences fat shaming, it makes them feel bad. And
Speaker 1: so there's plenty of research showing that meat stigma is
Speaker 1: predictive of and correlated with anxiety, depression, decrements, and self
Speaker 1: esteem and things like that. And that research came at
Speaker 1: a really important time because there was a sort of
Speaker 1: battle going on at the public health and medical ethicis
Speaker 1: level where people were trying to say that, you know,
Speaker 1: actually we should be using weight stigma as a public
Speaker 1: health tool because you know, making people feel bad about
Speaker 1: their size is a great way to motivate them to
Speaker 1: work out and eat healthier. And so, you know, as
Speaker 1: a scientist, I was like, well, we need data on that.
Speaker 1: You know, is weight stigma really going to promote health
Speaker 1: or destroy it? And so what we found in a
Speaker 1: nutshell is when people experience weight stigma, it doesn't lead
Speaker 1: to weight loss. Actually it leads to weight gain. There
Speaker 1: are psychological effects, there are physiological effects, and you know,
Speaker 1: I think any policy that rests on making certain segments
Speaker 1: of your population feel bad because of the way they look,
Speaker 1: I you know, I don't like that as a policy
Speaker 1: strategy in the first place. But this scientific evidence is
Speaker 1: showing it's not even gonna work. It's gonna backfire. I mean,
Speaker 1: you and I have talked about this around. The position
Speaker 1: of the Academy and the medical establishment really is that
Speaker 1: sort of being a fat person is a pathology, is
Speaker 1: something that is inherently understood as a deviation, a failure,
Speaker 1: you know, and as a disease, right, And I'm kind
Speaker 1: of curious about your thoughts on that and what it's
Speaker 1: like doing this research in that environment. Yeah, So what
Speaker 1: motivated us to study this question in particular was because
Speaker 1: the EOC, which is the Equal Employment Opportunity Commission, they
Speaker 1: were about to rule on a law that would make
Speaker 1: it legal for employers to charge higher BMI employees more
Speaker 1: for their health insurance. So the assumption there being anyone
Speaker 1: who has a BMI of thirty and above is unhealthy,
Speaker 1: so they're costing us more, so we have a right
Speaker 1: to charge them more for their health insurance. And so
Speaker 1: we got wind of that and we are like, surely
Speaker 1: not everyone with a BMI of thirty and above is unhealthy.
Speaker 1: Surely it's not fair or justified to charge them more
Speaker 1: for health insurance. And so we did an analysis using
Speaker 1: some of the best data that's available in the United
Speaker 1: States called the ENDHINGS so National Health and Nutrition Examination Survey,
Speaker 1: and they have information on body mass index and they
Speaker 1: also have information on all sorts of health indicators, so
Speaker 1: things like blood pressure, cholesterol, so all those markers that
Speaker 1: indicate poor health. And our analysis is actually pretty simple.
Speaker 1: It was is there anyone with a body mass index
Speaker 1: of thirteen above who look perfectly healthy on all these markers?
Speaker 1: And found that yes, in fact, there are lots of
Speaker 1: people who have an obese BMI who do not show
Speaker 1: any indication of poor health. You know, millions actually of
Speaker 1: Americans fit that bill. And so we concluded it's not
Speaker 1: fair to charge someone more for their health insurance just
Speaker 1: because their BMI is above thirty and so basically we
Speaker 1: were like, EEOC, don't let this happen. Unfortunately, they did
Speaker 1: let it happen, so that is now law in the
Speaker 1: United States. Wow, I did not know about this. I mean,
Speaker 1: that's I'm just I'm just having a moment with that.
Speaker 1: But it's like really indense to kind of it's intense
Speaker 1: to think about it. Janet and her colleagues found that
Speaker 1: was so much emphasis on BMI, one in five of
Speaker 1: all Americans are being misled about their health status. That's
Speaker 1: more than seventy million people. If BMI could do that,
Speaker 1: why use it? We shouldn't. It turns out if you
Speaker 1: look at the history of BMI, it's actually incredibly outdated
Speaker 1: and unscientific. It was invented in the eighteen thirties by
Speaker 1: a Belgian mathematician named Adolf Quetele. Please note he was
Speaker 1: not a physician, and he never intended the BMI to
Speaker 1: be a measure of health. He was, however, kind of
Speaker 1: obsessed with using math to define the average man. And
Speaker 1: by average, I mean literally the average you learned to
Speaker 1: calculate in fifth grade math. Adolt believed that average was
Speaker 1: the ideal, never mind the fact that he was basing
Speaker 1: his calculations on a super limited set of subjects. So
Speaker 1: convinced was he that the hypothetical average white man embodied
Speaker 1: perfection that he once said, and I quote, everything differing
Speaker 1: from his proportion or condition would constitute deformity or disease
Speaker 1: or monstrosity. Yikes. From there, it didn't take long before
Speaker 1: things got super racist. His work was used to underpin
Speaker 1: phrenology and eugenics, the racist science that Nazis used to
Speaker 1: justify the Hall the cost that's also been responsible for
Speaker 1: the for sterilization of people of color and disabled people.
Speaker 1: But the real kicker is that it is still used
Speaker 1: today to make health assessments, and it is not working.
Speaker 1: Let me give you just one example. I want to
Speaker 1: tell you about Rebecca Hiles around twenty ten. She was
Speaker 1: a plus size teen who started having coughing fits and
Speaker 1: shortness of breath. When she went to the doctor, she
Speaker 1: was told these problems were because of her weight, but
Speaker 1: it turned out she had lung cancer and the doctors
Speaker 1: missed it because they didn't check. I've spoken to dozens
Speaker 1: of fat people who have experienced some version of this story.
Speaker 1: Fat people are being prescribed diets every day to solve
Speaker 1: every problem under the sun. I don't know if I
Speaker 1: need to say this, but last time I checked, restricting
Speaker 1: food doesn't cure things like cancer. I remember being an
Speaker 1: eleven year old kid on the cusp of entering sixth grade.
Speaker 1: I had seen every teenage transformation movie, and I wanted
Speaker 1: my final year of elementary school to be epic. All
Speaker 1: I wanted was for the boys at school to stop
Speaker 1: bullying me and to be thin and beautiful so I
Speaker 1: could finally find a boyfriend. I knew I didn't have
Speaker 1: much time, only as long as summer vacation, so I
Speaker 1: basically stopped eating. Whenever I was hungry, I allowed myself
Speaker 1: lettuce toast and a little bit of barbecue sauce to
Speaker 1: flavor it. I did a VHS exercise tape two or
Speaker 1: three times a day, every single day for three months.
Speaker 1: By the time of summer was over, my body was
Speaker 1: really different. But instead of questions or alarm, all I
Speaker 1: got was praise, even from our family physician, who told
Speaker 1: me that if I kept up the good work, I
Speaker 1: might be allowed to date one of his sons. Really
Speaker 1: moral of the story. Medicine can be super fat phobic,
Speaker 1: and fat people can feel it. Janet's work has shown
Speaker 1: that fat phobic medicine makes people avoid going to the
Speaker 1: doctor when they're sick. We change doctors more often too,
Speaker 1: because of how we're treated. When we do go to
Speaker 1: the doctor, we often get weight loss advice which makes
Speaker 1: us feel shame and failure. This is fat phobia at
Speaker 1: its most dangerous. More with Janet after the break. We're back.
Speaker 1: Before the break, I was telling you about how fat
Speaker 1: phobia and medicine has devastating consequences, to the point where
Speaker 1: it sometimes seems like following doctor's orders can cause more
Speaker 1: harm than good. I just want to connect it back
Speaker 1: to weight stigma, where people people sort of hide behind
Speaker 1: concerns for someone's health as a way to kind of
Speaker 1: make it okay for them to stigmatize. So they'll say, oh,
Speaker 1: you know, it's not that I don't like the way
Speaker 1: you look. I'm just really worried about your health, you know.
Speaker 1: And so I think this confusion surrounding what health is
Speaker 1: and whether or not you can be healthy and a
Speaker 1: larger size, it's really making it easy to stigmatize other
Speaker 1: people for their weight. And so I did a study
Speaker 1: where I randomly assign people to diet or not, and
Speaker 1: I measure their levels of the stress hormone cortisol. And
Speaker 1: when I found that, yes, if you cut calories, your
Speaker 1: stress hormone levels go up. And we know that stress
Speaker 1: ironically makes you gain weight, and so that's you know,
Speaker 1: one reason why dieting is just such a feudal endeavor
Speaker 1: to try and try and do. We have this idea
Speaker 1: that dieting and weight loss are or you know, the
Speaker 1: pursuit of weight loss is this health promoting behavior, that
Speaker 1: restricting food is health promoting, But our bodies, they experience
Speaker 1: it as a threat to our survival. As somebody who
Speaker 1: literally made herself ill while dieting and couldn't understand why.
Speaker 1: I couldn't understand why I was ill, and there was
Speaker 1: a lot of cognitive dissonance that led to me continuing
Speaker 1: to diet despite the correlation between the more I restrict,
Speaker 1: the sicker I get, and I just couldn't bridge those
Speaker 1: two realities. You know, if you look in our evolutionary past,
Speaker 1: like our main challenge was getting enough food to eat.
Speaker 1: And so of course your body is not going to
Speaker 1: understand no, no, no, I'm just doing it so I
Speaker 1: can look better in the ISO society, you know. So
Speaker 1: your body does see that as a threat that it
Speaker 1: needs to contend with. And one of the jobs of
Speaker 1: the stress hormone cortisol is to signal your body to
Speaker 1: store fat. I think what you're saying in terms of
Speaker 1: when heavier individuals lose weight, it gets even more complicated
Speaker 1: because all you get when that happens is a ton
Speaker 1: of praise. So, like I see it with my husband, who,
Speaker 1: due to the stress of quarantine and worrying about our
Speaker 1: four year old child and what to do about school
Speaker 1: opening and all that stuff, has lost twenty pounds since March.
Speaker 1: And so when we see other people socially distanced, of
Speaker 1: course they're like, ah, you look great, right, what have
Speaker 1: you been doing? You awesome? And like when I hear it,
Speaker 1: I'm just horrified because of my research, you know where
Speaker 1: I'm like, no, no, it's horrible things that have led
Speaker 1: to this weight loss. You don't need me to tell
Speaker 1: you that COVID has created a huge disruption in our
Speaker 1: patterns and a spike in weight and food anxiety. It's
Speaker 1: made us feel scared for our safety and looking for
Speaker 1: means of control. For a lot of people, including me,
Speaker 1: that has been falling back on old patterns of controlling
Speaker 1: what I ate, which leads to situations like the one
Speaker 1: Janet just described. So I'm just going to say it
Speaker 1: important takeaway from this episode. The question have you lost weight?
Speaker 1: Is not a compliment. We assume that weight and health
Speaker 1: are the same exact thing. If somebody loses weight, then
Speaker 1: that's a success, and if they don't, then that intervention
Speaker 1: was a failure. And so I can give you an
Speaker 1: example of this. This was an amazing study done by
Speaker 1: John Blendell and colleagues where they brought people in and
Speaker 1: had them exercise in the lab in front of everybody,
Speaker 1: and they looked at their actual health indicator, so things
Speaker 1: like blood pressure, and what they found is that regardless
Speaker 1: of whether you lost weight or not, everyone who is
Speaker 1: in this exercise condition improved on their health markers. So
Speaker 1: that's great news because it doesn't matter what the number
Speaker 1: on the scale is, you're still seeing improvements and health.
Speaker 1: And so I read that study as like a super
Speaker 1: good news study, like finally we can get rid of
Speaker 1: this fixation on weight and like really focus on what's important,
Speaker 1: and that the study shows us that we know that
Speaker 1: exercise is going to be helpful. But the reason I
Speaker 1: bring up this study is because the title of the
Speaker 1: study was literally, exercise is not enough. And so even
Speaker 1: in the study author's minds, their study was a failure
Speaker 1: because not everybody lost weight. They just sort of cycled
Speaker 1: right back to that weight centric viewpoint of you got
Speaker 1: to lose weight or else it's a failure. It's I mean,
Speaker 1: I think, what's so what always blows my mind as
Speaker 1: someone who has gone to grad school and and experience
Speaker 1: the rigor of of you know, so many of the
Speaker 1: research protocols and and to just kind of get to
Speaker 1: weight stigma. It's like the precision the science, it just
Speaker 1: goes right out the window. There's like no consideration of data.
Speaker 1: There's no consideration of accuracy, there's no consideration of you know,
Speaker 1: like what, like what bias is going into this what
Speaker 1: you know, how are you defining this term? And are
Speaker 1: there problems with that definition? And it's just mind boggling
Speaker 1: to me. Um, you know, agreed, Um. The whole reason
Speaker 1: why we did that analysis is because in response to
Speaker 1: our dieting doesn't work paper, people said, well, sure, maybe
Speaker 1: it's hard for everyone to lose weight on a diet,
Speaker 1: but you know, the people who do actually manage to
Speaker 1: lose weight, they're so much healthier. And we're like, is
Speaker 1: that even true? And we found that across all the
Speaker 1: studies that we studied that had again long term outcomes
Speaker 1: two years or more, that the amount of weight you
Speaker 1: lose on a diet is not related to any health improvements.
Speaker 1: But the people who who lauged that criticism at us,
Speaker 1: you know, their viewpoint is, sure, maybe that one diet
Speaker 1: didn't get everyone to lose weight, but if we could
Speaker 1: just find the perfect diet, that's the solution. And so
Speaker 1: they're still stuck in diet land. You know when our
Speaker 1: argument is, let's sort of let this thing go. Nobody
Speaker 1: likes doing it, doesn't work, it's increasing levels of your
Speaker 1: stress hormones. But again, as long as you are cementing
Speaker 1: your brain, that weight equals health. It's doing a disservice
Speaker 1: through the public health of our nation. But why are
Speaker 1: we stuck in diet land? I give lectures about this
Speaker 1: all the time to rooms full of smart people. I
Speaker 1: show them the facts of what fat phobia and weight
Speaker 1: discrimination due to people. Fat women make less money than
Speaker 1: than women, a disparity that starts at nine thousand dollars annually.
Speaker 1: Fat people are seen as less intelligent and capable by
Speaker 1: the academics who get to decide who gets a PhD.
Speaker 1: Fat shaming and dieting are connected to eating disorders, anxiety depression,
Speaker 1: devastating numbers of fat people don't leave their homes because
Speaker 1: they're afraid of being abused, and the list goes on
Speaker 1: and on, and then when time for Q and A comes,
Speaker 1: the first question from the audience, without fail is almost always,
Speaker 1: but what about health? As if all that I've just
Speaker 1: shared doesn't matter if the person experiencing these spirit crushing
Speaker 1: things doesn't have a clean bill of health. To me,
Speaker 1: as a person who has always been fat, who almost
Speaker 1: destroyed her health attempting to be the version of healthy
Speaker 1: that I know they're talking about, this question is so
Speaker 1: gravely offensive and hurtful. It's so totally misses the point
Speaker 1: of what I'm arguing for, which is human rights. We
Speaker 1: cannot make health a condition of human rights. Beyond that,
Speaker 1: health is actually not something that people can achieve one
Speaker 1: hundred percent on their own. Literally, the CDC even knows it.
Speaker 1: I want to share with you, in fact, the change
Speaker 1: in my life. The Centers for Disease Control note that
Speaker 1: individual behaviors only account for thirty percent of our overall health.
Speaker 1: That means that a whopping seventy percent of the things
Speaker 1: that determine how long we live and our quality of
Speaker 1: life are social factors that are out of our control,
Speaker 1: like whether we have access to public transportation, whether we
Speaker 1: experience trauma and childhood, or whether we experience discrimination. Why
Speaker 1: please tell me, aren't we as obsessed with shifting what's
Speaker 1: in that seventy percent as we are with vegetables and exercise.
Speaker 1: We do not owe other people our health. All people,
Speaker 1: regardless of size, have the right to feel like they
Speaker 1: have tools to build their definition of their best life
Speaker 1: based on what resources they have access to, and receive
Speaker 1: good medical care when they're sick. Besides, what is more
Speaker 1: health promoting than paying someone equally we're screening them properly
Speaker 1: for medical care. What is more health promoting than treating
Speaker 1: someone like they're a human being? Sadly, right now, I
Speaker 1: don't live in a country where those basic things are
Speaker 1: available to everyone. So the question becomes, how do we
Speaker 1: get there? Okay, here's the ten million dollar question. Because
Speaker 1: the word health has been weaponized against me and people
Speaker 1: I care about and so many people, how do we
Speaker 1: end wade stigma and also create, you know, this possibility
Speaker 1: for people to live the highest quality of life that
Speaker 1: they know they can have. I'm so glad we're talking
Speaker 1: about this because I still struggle with what's the best
Speaker 1: way to talk about it, even with my paper that
Speaker 1: we talked about earlier showing that there are you know,
Speaker 1: millions of Americans with a BMI and the obese range
Speaker 1: who are healthy. You know, I've been criticized for that
Speaker 1: work for saying that there are good fatties and bad fatties,
Speaker 1: and the bad fatties are the ones who have poor
Speaker 1: health markers, as if they're like worth less. And I
Speaker 1: totally hear that I and I think it's a valid
Speaker 1: criticism of this work. It's still putting health as like
Speaker 1: this holy grail that we're trying to achieve at all costs. Yeah,
Speaker 1: I mean, and I think, you know, for me, it's
Speaker 1: like I do believe that every single person, especially in
Speaker 1: a culture that is so focused like that, doesn't have
Speaker 1: universal healthcare. I mean, I'm like, if you don't have
Speaker 1: universal healthcare, you don't have shit to say to anybody.
Speaker 1: I'm sorry, Like that's just like it's just done. Like
Speaker 1: you clearly have shown that you're not willing to put
Speaker 1: money behind people's lives, so you get to shut up forever.
Speaker 1: Now that's my opinion, But like, you know, it's so
Speaker 1: specifically right, there are people who literally you cannot access health,
Speaker 1: whether it's because of the fact that they don't even
Speaker 1: have space for that the bandwidth, right for somebody who's
Speaker 1: in survival mode, that is not a priority. Survival is
Speaker 1: a priority, or you're in survival mode. And there are
Speaker 1: so many people, by virtue of how our society, our
Speaker 1: culture is structured, who are living in that reality every
Speaker 1: single day. And then I think about somebody like my
Speaker 1: own family who you know, I grew up in the suburbs.
Speaker 1: My family is an immigrant family. There was a huge
Speaker 1: amount of intergenerational trauma. And I remember having this conversation
Speaker 1: with my mother about how much she loved like strawberry
Speaker 1: soda or something like that, you know, she liked the
Speaker 1: color and all this stuff. And then but she specifically said,
Speaker 1: it makes me feel happy, and I can feel it,
Speaker 1: like when it's entering my body, that it's giving me happiness.
Speaker 1: And she didn't have a lot of access to joy
Speaker 1: for so many reasons, right, like kind mental illness, and
Speaker 1: she's a fat person, and she's a woman, and you know,
Speaker 1: and all these different layers. And I think there are
Speaker 1: people who would look at that and pathologize her. But
Speaker 1: but there's another side of her story where's she is
Speaker 1: doing the most intuitive natural thing in the world, which
Speaker 1: is to find things that make her feel good that
Speaker 1: offset experiences of suffering. And that is genius, That is brilliant.
Speaker 1: That is exactly how the body was designed to interact
Speaker 1: with the world. And I'm so deeply aware. For me,
Speaker 1: food symbolizes freedom from that life where I felt like
Speaker 1: trash and my because I wasn't thin, and food represents
Speaker 1: that to me. It's like, it's not only this this
Speaker 1: like experience of joy and love and sharing and community,
Speaker 1: which I have the privilege of having that experience, but
Speaker 1: it also has this other layer where I'm like, you
Speaker 1: will not tell me how to eat, and that is
Speaker 1: how I maintain dignity, and dignity is significant for a
Speaker 1: person's mental health. And I think for me, I'm just like,
Speaker 1: how gorgeous, right, Like, how gorgeous is it that someone
Speaker 1: who is against so like has so many odds stacked
Speaker 1: up against them, is able to sort of say, like,
Speaker 1: I know exactly how to get that little thing that's
Speaker 1: going to make this moment feel okay, or it's going
Speaker 1: to give me dignity, you know, And I just I
Speaker 1: feel like there's not room for this conversation. Janet, You know,
Speaker 1: I resonate with so much of what you just said,
Speaker 1: and in fact, some of it sounds like a non
Speaker 1: scientific version of what I've written in some of the
Speaker 1: introductions to my scientific papers. It makes me think of
Speaker 1: a story that Rob Lesstig, who's a very famous endercnologist
Speaker 1: at UCSF, told me once, which was he went to
Speaker 1: Baybew Hunter's Point, which you probably know is sort of
Speaker 1: a lower income, majority racial minority area of San Francisco,
Speaker 1: and he did sort of his classic spiel of like,
Speaker 1: this is what nutrition is, and here are the foods
Speaker 1: you should be eating, and here are the foods you
Speaker 1: shouldn't be eating. And at the end of his nutrition
Speaker 1: lecture of a woman raised her hand and she was like,
Speaker 1: I work two jobs. The one pleasure I have in
Speaker 1: life is my Snickers bar that I get to eat
Speaker 1: at the end of the day. And are you saying
Speaker 1: you're going to take that away from me? Yes? And
Speaker 1: it's like, yeah, who are we to say that that
Speaker 1: is so wrong and shake our finger at this woman
Speaker 1: for coping in the way that, as you said, is
Speaker 1: very beautifully adapted to her environment because it's available and
Speaker 1: cheap and is consistent. It's going to work every time. Janet,
Speaker 1: I want to say thank you for being on Rebel
Speaker 1: Eaters Club and for your incredible work and for illuminating
Speaker 1: us about so many amazing things. Thank you. I'm so
Speaker 1: excited to actually get to talk to you. And this
Speaker 1: is the definitely the best part of my day. Hundreds
Speaker 1: of years of scientific inquiry went into creating a world
Speaker 1: where we have so called good food and bad food,
Speaker 1: good bodies and bad bodies. But just because that work
Speaker 1: is filed under science doesn't mean it shouldn't be scrutinized,
Speaker 1: because yes, even doctors and scientists like us live in
Speaker 1: diet culture too. I'm not telling you all this just
Speaker 1: so you know that there are serious problems with our culture,
Speaker 1: though that's important. I'm telling you all this because we
Speaker 1: have to face it if we're going to fix it.
Speaker 1: The day of data existing and being gathered in the
Speaker 1: name of creating the right body and the wrong body
Speaker 1: has to end. Data that ends up becoming the basis
Speaker 1: for people not getting care. It's got to come to
Speaker 1: a close. Science not only should do better, it can
Speaker 1: do better. Janet is proof that there is hope and
Speaker 1: She's proof that we can get in the trenches and
Speaker 1: fight for the right thing, even if it's unpopular. It's
Speaker 1: going to take a lot for us to get the
Speaker 1: world we deserve, one that's more free and fair and
Speaker 1: hello fun. But the pleasure we get when we bite
Speaker 1: down on the perfect potato chip, that honest, innocent, purely
Speaker 1: human pleasure. I have a feeling it's going to help
Speaker 1: us figure out how to bring the whole thing down. Okay,
Speaker 1: there's one truly amazing fact in my research that I
Speaker 1: saved for you for the very end. I found it
Speaker 1: in the Journal of Texture Studies, which publishes articles with
Speaker 1: truly magical titles like effect of pect and content on
Speaker 1: flow properties of mango pulp. What I want to share
Speaker 1: comes from one entitled analysis of food crushing sounds during mastication.
Speaker 1: Researchers foul that the sound of chewing aka mastication on
Speaker 1: potato chips gives people pleasure, and in fact, we maximize
Speaker 1: the sound our mouths make. Participants who wore headphones weren't
Speaker 1: as into their chips as those who could hear themselves,
Speaker 1: and that one tiny little act of crunch joy, I think,
Speaker 1: means there's still hope for US yet. Rebel Eaters Club
Speaker 1: is produced by Transmitter Media. Our lead producer, Jordan Bailey
Speaker 1: loves sour cream and Anita potato chips. Lacy Roberts is
Speaker 1: our managing producer and she can't live without those crinkle
Speaker 1: kettle chips with salt and pepper. Sarah nix edits the
Speaker 1: show and she loves ketchup chips because she's Canadian. And
Speaker 1: our executive producer, Gretta Cohen loves a Dill pickle chip,
Speaker 1: specifically with beer. I'm your host, Virgie Tobar and I
Speaker 1: love salton vinegar. Ben Shano is our mixed engineer. Special
Speaker 1: kudos to James T. Green and Jessica Glazer for the
Speaker 1: production assist and Nitaco Guessuzala, who wrote some of the
Speaker 1: music we use in the show. If you love Rebel
Speaker 1: Eaters Club, tell your friends and share the love by
Speaker 1: writing a review on your favorite podcast app. See you
Speaker 1: next week.