S4E2 - Dr. Katharine Oyster, Navigating Healthcare, + Complicated Vaccine Feelings- Transcript

Released on April 28th, 2021. For complete episode info, visit this page!

[THEME MUSIC FADES IN, FADES OUT]

Cat Polivoda: Welcome to Matter of Fat, a body positive podcast with Midwest sensibilities. Hi, I'm Cat Polivoda, a local fat feminist shop owner. And though it can be a bit of a hypochondriac, I don't really go to the doctor as much as I could, or maybe should. I'm joined by my co-host and producer Saraya Bogani. 

Saraya Boghani: Hi, I'm Saraya Boghani. Yeah, I'm a fat multiracial Minneapolitan millennial who still doesn't truly know how to hit her deductible.

CP: On Matter of Fat, we're here to talk about the cultural politics of fat liberation with a Midwest perspective. 

SB: But first, The Fat Dish!

CP+SB: Sike!

SB: It’s Season Four and much like our own little fat child, the Fat Dish is growing up.It's its own episode now. 

CP: Pinch those chubby cheeks!

SB: You can get a full Fat Dish, basically us chatting about all things fat and pertinent in our lives, every other episode. Um, so what are we going to talk about today, if not the Fat Dish? 

CP: Well, in this episode, we're focusing on navigating healthcare as a—

Both: —Matter of Fat.

CP: And just a note, we're talking about medical care doctors, some not great experiences at the doctor mentions of quote, unquote obesity and weight loss, and just like want to give you a heads up before we get into it.

SB: So we've talked about being fat at the doctor before, and it's still incredibly important, but if you'd like to check it out, you can see our interview with Jessica Zaldivar in Season One. 

CP: It's honestly one of the most talked about topics consistently among fat folks. And it's even come up recently in our Friends and Fans Facebook group.

SB: I was so excited to see that. Honestly, if you haven't been over to our Friends and Fans Facebook group, yet pop in there, bring some topics up, maybe healthcare, be a good one. Um, and you know, healthcare is just a huge topic generally. And then considering what it means for those systematically oppressed, uh, it's just such a keen topic because either those who are practitioners or those who are trying to be seen by practitioners have lots to say about it, lots of things come up. I think it's a pretty vulnerable space for you to be in when you're figuring out your health. And we just needed to talk about it more with someone who knows what they're talking about.

CP: And we did! So in addition to Saraya and I chatting a little bit about this, our interview is with my doctor, Dr. Katherine Oyster, who is going to share a bit about her story as a Matter of Fact, and also talk about her experiences as a fat practitioner. 

SB: Yeah, but before we hear from Katherine, why don't we just like, have a little chat about our experiences at the doctor?

CP: I love it. And I think we should go way back. Saraya, what can you remember about going to the doctor when you were young? 

SB: When I was young, I don't love the way back, but every year I'm getting older, but okay. Yeah, we can go way back. That's fine. That's fine. So I think I had a good GP growing up, but I just. Yeah. I've always been taller, bigger than other kids my age. And I don't remember there being like a lot of emphasis on losing weight, at least when I was a young kid. And I wonder if a, maybe like GPs are just nicer to children or they think that they'll grow out of it, or they're just not as rigid with some of those things.

Or maybe I was just ignoring it and oblivious. I feel like when I went to the doctor as a kid, I'm like, yes, I'm talking to this person. I get a sucker and a sticker. I'm out. Like, that's all I needed to do here. My part is finished. My mom's got some papers she's handling this. 

CP: Right. 

SB: Um, so yeah, 

CP: So mostly good experiences, would you say? Yeah. 

SB: Yeah. For sure. How has your experience as a kid? 

CP: You know, I think like mostly fine, but I really would kind of talk that up to me. Just like not having a lot of health issues throughout my life. I do think for me at the doctor, even starting as a kid, there's been a little bit of like, uh, I feel a little on the defense, not as like a young child, but, you know, as an adolescent, like I remember, I don't think I don't, I remember weight being an issue.

Maybe not as big of an issue. I wonder if it was more of like, okay, we're going to talk to you about this and we're going to talk to your mom about how we really think about this, you know, that kind of thing. Um, I remember seeing a nutritionist and not being very, um, like not really understanding okay, well, I don't really eat that much anyway, so I don't understand why I'm here with you right now, but overall I think mostly fine is how I felt about or how I felt about Dr.

Stefan. I was young. But yeah, like I said, I think part of that is that nothing really big has ever happened. So I haven't had any major, um, issues come up. 

SB: That's interesting. As you were saying that, like there was, so I have—this is a really fun, like, very specific fact for lots of people that I might never meet to know about me—but I have, uh, like a benign tumor on my pituitary gland and actually it's quite common.

Um, cause I'll tell people and they're like, yeah, me too. And was like, okay, well, where were you in late middle school? When I thought, I would say only one who had this, I know I'm unique, but not in this way. But I think seeing a practitioner for that over like many years and monitoring that for many years was like a good baseline because otherwise it was just like general physicals and whatnot.

And I will say that I didn't really notice it until I kept getting older and older, but there was always a constant conversation about like weight and weight loss. And like much to your point. I was like, okay, but I'm in like two sports plus training and I'm like a busy kid. So I don't know what you want me to do about my weight.

CP: Right. 

SB: When I'm already doing all this over here. So yeah, and I think that's probably when I started to feel, you know, most shameful about going to the doctor because every year I'd go back and it's like, look, nothing's new surprise, surprise, but you know, I'm doing what you told me to do. So. I don't know how to show up here and feel like I took your guidance and I'm doing the most for my health. So I think it was that adolescence, that shift into adolescence where I, my relationship with the doctors started to change. 

CP: That makes a lot of sense. And I imagine that that will ring true for a lot of, uh, our audience members as well. Yeah. So then, okay. Adolescents moving into like kind of some weirdness around doctor stuff as we kind of came into adulthood, um, I don't know about you, but for me it felt like things changed maybe quite a bit.

SB: Hmm, how so? 

CP: I think so, like I said, I've always felt like a little on the defense. Um, and I think that showed up a lot, like in my twenties, um, in the ways that like nurses and doctors I could tell were making assumptions about me and then like not always holding back their surprise when they were wrong or when like something surprised them.

I have two examples. Um, one is maybe, well, one is very much like weight-related. I think that, um, there's always been surprised around like my numbers in terms of, I guess, well, I guess, why am I mincing words? People always think I have diabetes. Like they're always doing the tests, you know like the A1C.

SB: Yes ma'am!

CP: I’m fat, I have hyperpigmentation. There's like other things that might lead them to believe that. But like, how's the, the surprise and shock from someone when my numbers are good, you know? 

SB: I sure do know every time I get my blood pressure, like, this is great. I was like, have you checked the chart? Because it's been great. Why are you so excited?

CP: Yeah. And for me, blood pressure is a different story, but most other things like my numbers kind of consistently have always been really, really normal. Um, and then also, so like, like I said, I think defensiveness is a bit of a theme for me, but then also there's like some weird pride that happens where it's like, you think that something's wrong with me, but nothing is, um, ha-ha! On like on the one hand, like, you know, I'm challenging assumptions, but on the other hand, that feeds into a lot of like, health, kind of, moralizing health, right?

Like a lot of the things that are healthy about me are like purely luck, you know? So it's not anything that I am doing differently. So there's a lot of like complicated thoughts around that for me. Okay. But I said more about numbers surprises. The other thing that has like another doctor experience that really sticks with me.

I was just like, you know, when you go, when you are a woman, um, in your teens and twenties, you, at some point you start getting pap smears, many of us do. Right. Um, and it was always the question of like, are you sexually active or not? And it's always like asked in such a, I dunno, like hush tone, like as they're going through the things.

And for me, like I knew when they said sexually active, they meant like, um, intercourse in it P and V sex. Right. And like, I wasn't sexually active by that definition for a really long time. And I remember nurses being like, oh, wow, well, you're such a beautiful girl. And it was just like, what? What are you saying right now? It was like, meant to be, I don't know a compliment, but there were just like so many assumptions in that that were really just very icky.

Um, and that's one of the, so I share both of those things. It's not as if those are the only things that have happened, but those type of things, it feels like throughout my twenties, just a lot of shock and awe on the part of a doctor or nurse and not a lot of interest in like, kind of holding back those assumptions, which I, which haven't been good for me, you know?

SB: Yeah. I think, I particularly felt vulnerable in my early twenties. Well, honestly, into my late twenties too, because like I said earlier, before I would go to the doctor and I was fortunate enough to have a parent who was on top of that for me, they were keeping track of vaccinations. They're keeping track of medications. Like that was really great. And I was very fortunate for that. And then when that transition happened into college and after that, I was like, yeah, make a doctor's appointment on the phone? Me? No, no. And so it was a little bit rocky to find a general practitioner and then when I would go there, I'm like, oh, they're the professional.

I have to listen to everything. They say, everything they say is, um, The absolute truth. And I didn't know how to advocate for myself and granted, I wasn't in a precarious situation where I needed, you know, help help with my health beyond the physical. I was pretty lucky, but even in those situations, I always felt really bad.

I'd come out of those appointments, feeling shameful. Like I couldn't lose weight. They would tell me the same thing every single time. And I'm like, I'll show them next year. And it actually got to the point where I'm like, oh my gosh, I'm never losing this weight. I feel so ashamed to go back to them and still be at this weight or even higher that it's almost easier for me not to go back.

So there were many years that I just didn't go back because I always like walked away feeling shamed. 

CP: Yeah. 

SB: And I guess couldn't decouple or uncouple that from the health care that I was being provided apart from that shame, too. 

CP: Saraya, I think that experience is something that a lot of people identify with. Like just saying like, okay, well you want these things of me. I don't know if that's, I mean, you know, time has told that that's not possible, so why am I coming back to you? 

SB: Yeah. And even if the provider wasn't going to actively do that, it's like kind of the defensive thing that you were saying, I was going to read into anything no matter what, because of those previous experiences. So that's the detriment to my own health, you know, that, that are human. That inevitably comes up when people are trying to say, “Oh, I care about your weight because that's a cost to our society as a whole.” It's like, well, it may be maybe that's on your mind, but let me tell you about all the fat people who aren't going to get care on a regular basis.

And so that when they finally need it, um, it's even more expensive or it's even more difficult for them to work through that just because there hasn't been that care for so many years. 

CP: Yeah. Yeah. 

SB: Um, but yeah, so that was, uh, up until a few years ago, that was kind of my experience. And also that's, you know, me as a person who has always had access to insurance too, so I'm really lucky to have that.

CP: Yeah. So for me, I will, I think that like where I'm at today with doctor stuff is different than even where I was maybe three years ago. And a big part of that is related to insurance. In my later twenties, early thirties, you know, working for myself. I didn't have insurance for a couple of years. We didn't have health insurance, which is like a huge privilege because I didn't like—everything was fine.

You know, there's a lot of folks that just like cannot function without health insurance because they just, you know, there's regular medications I need to take, um, or regular care they need. Um, and I was okay without that, which I recognize is a huge privilege. And also like, this is maybe an aside, but hi, universal health care helps everyone, including small business owners.

Like there's just so, um, I know that's not probably where this whole conversation should be today, but that's something that I think a lot about, um, how insurance plays a role. But that being said, like nowadays, um, I'm feeling a lot better about doctor stuff. And I think for me, it's because I finally decided like, okay, I need to prioritize paying for good insurance and I need to find a doctor and kind of sort through this like, list of low-level issues that I think I have that I sort of like, well, I need some things figured out, you know?

SB: The self-proclaimed hypochondriac

CP: I like—I think maybe a year and a half ago, I started seeing a doctor more regularly. Um, and I felt like I needed like a full Dr. House moment of like, okay, these are the things, these are my ailments, what could it mean?

SB: Oh, wow!

CP: Spoiler alert, like I just have high blood pressure, not anything, you know what I mean? Like I'm thinking like it could be this random thing I saw on Web MD and it's like, oh no, you're just one of the few people who actually have symptoms of high blood pressure. Here, you take a pill you're done, you know?

So, um, that's been kind of a fun. Fun or if I, you know, it's, it's feeling good to get stuff sorted out, but it felt like, uh, all these things are wrong, but like, no, there's like nothing acute, just like a few little, like low-level things that, um, I'm now like working to get addressed. And it feels really nice.

SB: Isn't that wild though. Like, especially if it's a blood pressure situation that you're nervous or anxious or stressed about the diagnoses, you're finding on Web MD, right. But you’re resorting to that. Because like going to the doctor feels like so much more work for whatever reason. 

CP: Right. 

SB: Or the outcomes could be so hard. And so that's just like a self-fulfilling prophecy, the vicious circle situation, but yeah. Um, yeah, I'm glad you did that. I think that's true for me as well. I will say, like being able to talk to people like Jessica Zaldivar in our first season actually helped me get some perspective on how to be an advocate for myself, um, at the doctor.

CP: I love that.

SB: So, yeah. And, you know, I realized that, okay, you can keep going and having these bad experiences or you can actually try other doctors. So I tried to do some research. I went to a new GP and it was a really bad experience, so, so bad, but because I had psyched myself up in my mind ahead of time to know what I wanted to look for, to know what questions to ask, I got to ask my questions and I got answers and I didn't like those answers.

And so I was like, okay, well, I got my physical done. Now I can find another person. And I was actually asked to do a survey afterwards and I shared out exactly what happened, why it was not helpful, why it was concerning. And they hooked me up with another GP who was fabulous. So, yeah!

CP: I'm so, yeah, I'm sorry you had to go through that, but I'm so happy you were able, that they asked you to give feedback. You were able to give that feedback and then that allowed you to be connected with somebody who actually really has your health in mind.

SB: For sure. And also just like, I don't know, recognizing that I can try different things out has felt really empowering too. Like at one point I was like, “Yeah, I don't want to be weighed today.” And the nurse practitioner was not—like she was flummoxed. She's like, “Excuse?” I was like, “Yeah, not today. I'm good thanks.” So she was like, “Oh, okay.” I was like, listen, I'm just trying. I know my agency at this point, I am a baby when it comes to the doctor. And so let me try some things. And um, yeah, I think I feel empowered in a way that I had never felt before at this point in my life and trying to seek healthcare. And it is still hard. 

CP: Yeah. It is still hard. And also, um, it's something that we can do and we can navigate, especially when we're able to kind of be equipped to advocate for ourselves. I'm so glad that that's the situation you're in, and I love the example you shared about, um, declining to be weighed, because I think I've also done that too. And actually when I, when I started with my new doctor, I don't really actually care that much for me about being weighed at the doctor, but I declined just to see how the nurse would, would respond, you know, like it was like, I'm really like, y'all are being interviewed right now.

Like I'm testing you. Um, and so that was the purpose, um, for me doing that. But, you know, I will say, I think for a lot of fat folks, when we understand that we can kind of say no to whatever we, you know, we're in control. We can say no to what we're not comfortable with. I, I think that, um, It's like a bit of an aha moment.

And I don't know about you Sariah, but like, there are many people who have shared with me. Like I went to the doctor and I didn't get weighed. And I said, no, and it felt really good. And I just needed to share that I did it. And like, this is, makes me feel good about the care that I'm getting. Um, and that just is a, I don't know, I think a really cool thing to be able to help people, um, celebrate.

SB: Yeah. It's a wild thing about the psychology of getting health care. Um, at least from, you know, in this country, in the clinics that I've gone to, but, you know, really is how can I assert my agency in a system that does not want me to have agency or is not built for that. And so that was what I used it for to as a litmus test to see how is this going to go?

How's this clinic going to feel? What are the reactions? Are you going to center me as an individual in my care? And, um, Maybe that's all it takes for you to feel a little bit more empowered in a little bit more comfortable getting into some really, really difficult and vulnerable things when you're talking to someone about your healthcare. So cool. 

CP: We're so excited about this interview today with Dr. Katherine Oyster, because a lot of the things that we've shared, um, also come up from the practitioner side in our interview and spoiler alert. Um, Katherine’s my doctor. Uh, the one that I found kind of in the last two years here, um, and has really helps me kind of get care that I need around, you know, like I said, my Dr. House level list of things, I was like, something's wrong. I'm really, it ends up not being that big of things anyway. Um, so yeah, excited to share this interview with Katherine.

[MUSIC FADES IN, MUSIC FADES OUT]

CP: Katherine, we're so excited you're here with us today. 

Katherine Oyster: Well, thank you. I'm super excited to be here!

CP: Wonderful. Well, we're going to get started with a question we ask all of the folks on our podcast, which is: what is your story as a matter of fat? 

KO: All right. Well, first off, um, I'm a family medicine physician, um, which to me means that I provide womb to tomb care. I see, uh, babies through most of my youngest patient, uh, is a little over a week old. Um, and my oldest patient is in their mid-nineties. Um, I see, um, low-risk obstetrics as well. Um, so I can take care of, um, well, low to moderate risk. I can basically take care of your pregnancy, um, and delivery as long as it does not involve surgery.

Um, I can see anyone, but you know, since family medicine basically literally covers everything, you kind of have to know a little bit about everything. Um, you can get into kind of niches. So things that like really speak to you, you get really good at, because you're really interested in them. Um, my niches are, uh, like women's health and obstetrics, like I talked about before. I also do a lot of LGBT health, um, specifically gender affirming, hormone care, um, as well as for me, body positive doctoring.

And the body positive doctoring, uh, is largely shaped on my personal experiences, um, as a fat person, as well as, um, my medical experiences during my medical education. Um, I myself have been fat since late childhood, at least. Um, and like I'm sure many of the listeners out there had a lot of the same classic, awful experiences at the doctor's office. “Are you in here for a sinus infection? Why don't you try some weight loss too?”

CP: Yeah.

KO: Unhelpful, absolutely unhelpful. Um, when I was in college, I was a women's studies major, which means I got to see some, some kind of interesting perspectives. Um, I learned about thin privilege in one of my classes and was really interested in that. And then I did learn vaguely at that point about health at every size, but I—the HAES movement—but I didn't get into a ton of detail about it. Uh, just kind of learned about it more in passing. Um, but I still, I learned it, but I didn't necessarily ascribe to it at that point.

Um, and so I really had a year between college and medical school. I had kind of that gap year. Um, and I was really worried about how my fatness would be perceived in medical school, how it might hold me back. Um, and I was—the biggest thing I was worried about is, um, we have to wear scrubs in a lot of our clinical rotations, and I was worried they were not going to be able to have the right size scrubs for me to wear, and so I was going to have to scramble for that. ‘

Um, and so honestly that was a big impetus for me to lose a ton of weight in that gap year. Um, I, I was unfortunately like—as far as the scrubs go, I was wrong. You can get very, they're very generous with the sizes of scrubs. This is very—was a very nice surprise.

But as far as the medical education piece, um, unfortunately I was not wrong there. Um, there is a lot of, or at least where I did my medical training and at the time that I did my medical training, which was the late 2000’s, late aughts, early 2010'‘s, um, there was a very, a decent amount of fatphobia.. Um, and it's just kind of a difficult place to be if you identify as a fat person or as a person who thinks fat people should be treated with dignity, um, especially on clinical rotations.

So medical school is split up the first two years are usually all about like studying books. You don't really get to see that many actual people. And then the last two years are clinical rotations, which are, you know, you, you kind of travel along with, um, certain kinds of doctors. So surgeons, family medicine physicians, internal medicine physicians, anesthesiologists, um, and you spend like a month or two with these people, and basically learn how to be that kind of doctor and learn what the important things are for those kinds of doctors.

Um, on those clinical rotations, I saw lots and lots and lots of fatphobia. Um, I saw lots of wisecracks about people's weight, um, at times when they were, you know, rather vulnerable, like as they were going under or just under anesthesia. So we're pretty sure they couldn't hear us, but can't be 100% sure.

And then I, you know, you watch residents and the main doctors, um, go from room to room and you see the interactions that they have with different patients. And you could see the difference in the way that patients were treated if they were in a thin body versus if they were in a fat body. Um, and honestly that, that, that really stuck in my craw, um, to the point where I started, like, volunteering to, to see, um, the patients on our list on our census, um, who we knew were in fat bodies, um, namely, so that someone in their care was going to treat them with kindness because I was not convinced that it was gonna happen otherwise.

Um, and like, uh, and yeah, it, it was, it was, it was kind of a hard time in my life. I'm not gonna lie. Um, but it's really hard to stand up even if you feel like these patients may not be getting the best care. Um, it's really hard to stand up because of the power dynamic, because the residents and the, the, all the other doctors, they're the people who determine your grades and your grades are really what gets you into different residency programs, into the specialty of your choice, into getting a job later.

So, and it's, it's decently subjective. So, um, it's really, you kind of do what you can and be as subversive about fighting the system as you can. But, um, there's there, I did not feel like I had a ton of power in that situation. 

CP: Um, it really sounds like you're like trying to work from within, until you could get to a point where you didn't have to impress people for grades or anything, right. Like you would be in more of the position of power.

KO: Exactly.

CP: Which I think is probably where we're going. Sorry to interrupt. I'm sure we're getting there! (All laugh)

KO: Yeah. Well, that's, that's where I try to be at this point. So, you know, um, from these experiences, as it, as I got more and more quote-unquote power in the situation, I would, I am able to, um, really treat patients regardless of their size with respect and make sure that the people around me do the same thing. Um, and so, you know, I do occasionally have learners with me these days, I'll have, um, medical students or nurse practitioner students, and talking to them about ways to not be sizeist or fatphobic in your language, you know, changing the way that you, you address something with someone or, “Hey, did you really need to talk to them about that particular thing today?” That sort of thing. So, you know, specifically for me, what being, you know, what being a body positive doctor means for me in practice is, um, working with patients, um, on what their definition of health is, um, and really focusing on healthy behaviors instead of weight loss. Um, so, and doing this with all patients.

So it doesn't matter if you are, um, yeah, kind of what body you're in. Um, we talk about what the recommendations are as far as exercise and, um, and food intake are, um, because just as a fat does not necessarily equal unhealthy, thin certainly does not necessarily equal healthy either. A lot of people can do a lot of things to improve their overall cardiovascular health and longevity. Um, that does not, does not mean weight loss.

Um, the other thing that I try and do is to keep that what we call a differential diagnosis or having the, kind of the list of potential things, if someone comes in to me for a complaint, there—I always kind of have a list of things that it could be and things that I have to either rule out or rule in with testing.

Um, a lot of times, unfortunately, when someone in a fat body comes in, um, that is assumed to be the cause of their problem. Um, and that is not always a fair assumption. And unfortunately, a lot of patients, um, that I have, that I have seen who have started to see me have bad experiences where a diagnosis was missed or was, um, took a long time to actually be diagnosed, um, because it was just assumed that the weight was the cause of that problem.

Um, so trying to make sure that I all, I always keep a—that list as broad as I can, thinking exactly what could it be? You know, why is, why are these things on the list? Why, you know, why is this not on the list? But making sure that you try and keep that, that list broad also, the more things that you think about, if you—if you don't think about it, you won't diagnose it. So it, it also helps keep me like, always learning, which is a good thing, because I always need to be learning in my job because there's a lot of stuff to know about the human body. It's really cool.

Um, and then, um, you know, my—a big rule for me is really to not discuss weight loss, um, unless a patient brings it up as something they want to talk about, um, or as a treatment option when it is appropriate, but as in, as a possibility as a, one of the options available, um, in a list of different things that I can work on with a patient.

Um, and then if I do think if we do have the weight loss conversation, if someone wants to have that conversation, um, I don't just say, hey, you need to lose weight. Um, you want to give, give people a direction, give people a concrete ideas about how to go about it, because it's not really intuitive. It's not a simple calorie deficit situation for everybody.

Um, so going through that and going through how to do it safely, um, Is really important. And I think a lot of people just kind of gloss over like, “Oh, well you can figure out how to lose weight on your own.” That's not appropriate. 

SB: Yeah. Yeah. I think what really spoke to me in what you just shared is just how much you keep on top of the knowledge that's out there. Not only because of the field is, it's required, but it sounds like you kind of have this innate interest in learning more. And I wonder where this all started for you. Like what drew you into the medical field in the first place? 

KO: If it hasn't been obvious yet I am a geek. I am a nerd (All laugh) and I have always loved science. Um, I've always been science has always been my favorite subject. Um, I've always been most interested in human anatomy and physiology, and I figured this out pretty early. Um, namely, uh, because I come from a family where my mother is a professor, she taught psychology, but one of the classes that she, um, taught was, uh, human sexuality.

And so, often, um, she was a single mom, so I would have to come with her to the university, which was near my elementary school in the morning before classes cause I had to get close to the school. And so sometimes I’d just sit in on the class, um, and at times she would, you know, I would, I would earn some allowance by helping her grade her exams with like fill-in-the-blank anatomy diagrams, ‘cause those were relatively easy to do.

Um, yeah. And I was also just, you know, just recognizing my own privilege. I was privileged to live in a family that really highly valued higher education and had the means to allow me to get there. Um, my mom was a, is a psychology professor, I guess she did retire a couple of years ago, so was a psych professor. 

Um, one of my uncles is a physics professor and department chair at another university. Um, another as a professional trombone player in big cities, symphony orchestras, higher education was really expected in my family. Um, so it was not kind of, it was not a question of what advanced degree—or which—if you were going to get an advanced degree, it was a question of which one? Um, I am the first one in my family, however, to have, uh, to, to go the medical doctor route though.

SB: I, I love that. Especially considering just an elementary student grading my exam paper, that, that visual is perfect. 

KO: Only the easy stuff I promise! Only what I could do a T for!

SB: I love it. 

CP: So Katherine, we, our audience love a HAES-informed medical practitioner. Um, and I guess we want to know what you would suggest for our audience members. If they're looking to find a practitioner like what they should be looking for. Um, you know, like when you're looking at people's bios online, what kind of like, are there any words or phrases we should look for or avoid? And then also once we find somebody, if it's someone new, how might we prepare for that meeting, that initial meeting with a new physician?

KO: Yeah, that's, those are great questions. And honestly, I wish it were easier to do, but it's, it can take a little bit of a nuance to find the right provider, um, for you. Um, there is a HAES registry that may be helpful, might help you kind of move in the right direction. Um, but is an incomplete registry, not everyone who is, um, HAES-informed or kind of has the same, um, practices, um, is on that registry.

For example, I just found out about that registry while I was preparing for this interview, I am not on it yet. Um, and then like, you know, I, for me, as, as myself, as a fat person searching for a primary care provider, um, yeah. I don't, I don't have a lot of personal experience to empower part on that, because at this point, like I'm just really bossy. I just need someone who's going to put through the, order I tell them that I need, um, for, for my own health. And fortunately that's, that's not too hard to find.

Um, as far as, um, the, you know, people finding a fat-friendly provider, um, word of mouth is, is often helpful. I would say, especially on social media, um, there are often, um, like, groups on Facebook, um, or, you know, certain hashtags, um, the groups like the Facebook groups that I have found, like I have seen a lot of recommendation, like posts, doctor recommendation posts would be like in, um, there are often city fat groups, like a Twin Cities, fat group, or, um, like, uh, a mom's group for a certain neighborhood or just certain neighborhood groups.

Um, I'm on neighborhood groups and mom's group in my community, um, namely to keep my ear to the ground for things that might affect my pediatric patients, but I often see posts about doctor recommendations. And so that can be a good way to get, um, some good recommendations for people who have gone through and met a couple of providers in your area.

Um, when it's time to meet your new physician, um, I do find it really helpful with as the, as the provider now, um, for patients to mention pretty early, um, in that first meeting that they're looking for a provider who's fat friendly. Um, really this can be as simple as saying something like “I've heard, I've really, I've had some negative experiences at the doctor's office because of my weight or discussion of weight, um, before, and I'm looking for a provider who is willing to see me as a whole person,.” Um, or, you know, disclosing pretty early if you have, um, uh, disordered eating past, um, that contributes to, um, to this explaining that pretty early.

Um, if your provider's good, you should be able to tell that pretty quick. Uh, you should also be able to tell pretty quick if your provider is gonna be a dick about it, and then you can end the, and the visit early. Um, if seeing your weight is a trigger for you, um, mentioned that to the medical assistant that's rooming you, um, or just say that you don't want to be weighed. Um, both of those are very reasonable.

I will say one thing that I learned when I was on the like fully fledged doctor side is that there are rooming standards for the medical assistant and there are quality measures for the doctors that require us to have weights in the system. Um, and we can get dinged if we don't have that. So I'm not saying that we need to, but I'm saying that there's more to it than just wanting to judge your weight. There's actually like some kinda sinister monetary stuff that's potentially going on there as well. 

CP: So from that I understand that like, you'll always probably be asked to be weighed, but like as a patient you can say that you don't want to be, is that true?

KO: Yes, 100%. You are the boss and in the medical, um, in any medical encounter. Ultimately we cannot do anything to you that you do not want to be done to you. Now, there may be certain things that we would really want to know what your weight is.

Um, if there's a weight-based dosing of a certain anesthetic, that sort of thing, sometimes your weight is a important vital sign to us. Sometimes it is really important for us to know, but that does not mean that you need to know it. We have, we definitely have patients who will be weighed backwards or where I will Sharpie out their weight on their after visit summary so that they don't know it so that they don't see it.

Um, we can work with that. Um, but yeah, the, as far as do you need to be weighed at the doctor's office? No, you always have the right to refuse that.

CP: Got it. 

KO: One more thing I wanted to say about kind of preparing to meet your new physician. Um, if you are in a fat body and you struggle significantly with mobility, um, you might actually want to do a little research onto the clinic site itself.

Um, namely because, uh, older clinics or clinics that were really kind of built before usually about 2000 do not always have accessible rooms and doors as far as width is concerned and not are not always equipped with, um, toilets that can hold a fat body, that sort of thing. Um, I have, unfortunately at my current place of practice had to refuse treatment to a patient at my clinic. Um, they had a wheelchair larger than the width of the exam room doors and did not have a support person with them to help them navigate those. Um, and we don't have lifts or anything in our, um, in our, our clinic that would, um, allow our, our staff to, to help this patient with their mobility in a safe manner.

Um, so, so, uh, usually facilities that are built or dated after 2010 are gonna have the wider doorframes, armless chairs lifts, um, to help those with significant mobility issues, but that is something to think about if you are, um, if that situation applies to you. 

CP: Thanks for mentioning that part about the facilities. That's something I hadn't really—I guess I just thought like, by default, like, oh, it's the healthcare, you know, providing establishment, they must be, uh, you know, up to snuff in terms of ADA and like thoughtfulness about, uh, accessibility. But unfortunately I guess that's not the case, huh? 

KO: Not always. I think there, a lot of places are, are trying to get better and are making adjustments if they weren't built to code in the first place. Um, but it—there are still enough that it is that it is not the case, that it is worth a little bit of forethought if that is gonna be a concern for you. 

CP:  Got it. I also just wanted to call back to what you had said about different, like social media groups and things like that. Um, and we—so for folks who are in Minnesota, um, there is this Twin Cities Fat Community Facebook page that I'm sure we've mentioned on the pod before, but that is a place like, I always direct people there if they're looking for doctor recommendations, because there are just so many good threads saying, “Hey, stay away from these people,” or, “Hey, these folks are really good.” um, and I don't, I think, I hope that you're comfortable with me sharing this Katherine, but like Katherine, you're my doctor. And I found you through someone's post in Twin Cities Fat Community.

KO: Yeah.

CP: So it's good.

KO: And I was so happy about that, honestly, like when you established care with me, I was like, I kind of like giddy because I shop at Cake a lot. And so I was like, “Oh my gosh, oh my gosh, oh my gosh, it's like a celebrity!”

CP: I was very happy to meet you in person because I had like, I didn't realize I knew you, but I knew I recognized you. And I think the first time I came in, you were wearing a dress, you got a Cake. And I was like, wow, this is great. (CP + KO laugh)

KO: Yeah!

SB: I mean, I love this is because when, when I remember when Cat shared, hey, like we should talk to my doctor. She's fabulous. I'm like, all right, let's talk about it because we have so many questions that come up that you are addressing, which is like one, how do you advocate for yourself in this process?

It's really difficult. It's challenging, there's lots of great community supports, but I'm wondering—and you did touch on this a little bit—but should someone experience fatphobia while receiving medical treatment, what are some options or ways that you would suggest them to navigate that. 

KO: Yeah. Um, and that is again another great question. Um, I wish that standing up to a provider who's providing like glaring fatphobia, um, would work. You know, it'd be like, “You're being ridiculous. What are you doing?” Um, but after seeing multiple different ways of patients dealing with fatphobia over the years, um, that does like just standing up to someone in the, in the moment when it's really rather awful, um, tends to make providers feel righteously indignant. Not all of us are good people, unfortunately, I wish we were.

But, um, if you are experiencing that, um, remember you are the boss in the medical in office visit. So you have the right to end the appointment at any point. Um, what I would say is end the appointment, um, while you are still fuming about it, attempt to write down the full name of the person who was doing it, ‘cause it's not always the provider who's going to do it either, sometimes it's medical assistants, sometimes it's the front desk staff. Um, whoever you, you know, whoever was the person who did that, um, write down the name or the, uh, description of that person and the specific words or phrases used, um, so that, you know, the next day after you've had a chance to kinda cool down a little bit, you can file a complaint with a lot of specific feedback, um, for the organization. 

CP: How do you file the complaint? If you do want to file a complaint with an organization, like where do you go? Is there like a space on their website or how do you figure out where to share that information?

KO: Um, a good way to do it would be to call the, the office and say, “I would like to file a complaint.” Um, and a lot of times that means that you will end up talking to the clinic manager or they will send you to, if it's a large organization, they'll send you to their human resources or risk department to take down the details, um, and such.

Usually there's, I wouldn't say, I don't know, at least in the systems that I've worked in, um, it, of there being like a “Questions? Contact us!” button on their, um, on their website. But if there's a specific concern, I think that calling and asking to speak with someone to file a complaint is the best way to go about it. They'll probably get your complaint to the place it really is going to make the most impact.

Um, so that's like if it's like glaring fatphobia, um, but you know, if it's less glaring, um, or if the fatphobia is coming from someone you wouldn't expect like a provider who you've known for a while, um, or someone who claims they are, um, health at every size educated or informed, sometimes a gentle nudge can help.

So, you know, if someone has kind of focused in, on, um, weight as the, you know, weight loss as the panacea of your, um, particular issue, things like “What else?” could be a question, like “What else would be causing my symptoms besides my weight?” That is, um, maybe going to bring a little PTSD onto your, your provider is to think of, “Oh my god, my, my doctor or my attending is, is asking me to broaden my differential diagnosis, broaden my list.” Um, and so that brings them back to that place of fear. And, and then they, they can kind of think, “Oh yeah, I suppose there are a couple of other things it could be.” Um, or, you know, something like, “Are there other treatments besides weight loss that we could consider, or we should consider?” Um, or, you know, if it isn't something related to that, if it's just making you uncomfortable, say that. “That phrasing makes me uncomfortable.” 

Um, often this is enough to just get the provider to take a step back, um, or unfortunately push them forward into glaring fatphobia and then see above. Um, but I do want to point out that no provider is perfect. We all make mistakes, myself included. Um, unfortunately recently I found out that a conversation I had with a patient, um, caused a tailspin into disordered eating, and that is the last thing that I want to do, um, to, for, you know, with, with a patient. Um, but unfortunately things happen. And so if we're, if we're doing something that's making you uncomfortable, please let us know a lot of us want to we'll want to fix that or apologize for it right away. 

CP: Whew, good stuff to keep in mind if we experience those things and, and hard to know, like I appreciate you saying too, like that no provider is perfect, um, because we are all human after all, right? We're all gonna, um, we're all gonna make mistakes, but it's good to hear in the moment if we can, you know, work to do better.

Uh, okay. Final question. The pandemic has been a struggle for all of us. Um, but of course it's like dramatically impacted healthcare providers like yourself. So we want to know how have you found joy or like what's brought you joy throughout all of this?

KO: I may not be the best example of this. (All laugh) To be perfectly honest. Like, I mean, at first the work environment got crazy. Like my clinic shut down for a couple months. Um, I, I mentioned earlier that I deliver babies. Um, they limited who was on labor and delivery for a long period of time, and so I was not able to be up delivering babies for a while, and then I was there for 24-hours at, you know, 24-hour stretches at a time, multiple times a week for a little bit there. So I mean, and lots of meetings regarding COVID lots of, bajillions of emails regarding COVID. It was really hard to escape for a while.

Um, in the early pandemic, when we were all under lockdown, I did, you know, I did a lot of the whole like basic bitch stuff. Like I baked a lot, I learned to garden, um, and that—I refinished a piece of furniture too, um, that didn't last for super long. Um, and then, uh, then I did like kind of your basic computer word games and watching MSNBC constantly in the background when I was at home, that was not super sustainable either.

Um, uh, honestly, what has kind of kept me sane and grounded throughout this process is, um, I, strangely in, during a pandemic, uh, found love. 

CP: (swoons) Yes!

SB: Um, that's amazing. 

KO: So, um, uh, someone I have been talking to kind of just as a pen pal, um, on and off since my fourth year of medical school—so almost a decade now—um, we were able to, to spend, you know, reap and spend a little more time talking to one another and then seeing one another and, and yeah. Um, so that has been a really, really, that's been my saving grace through this pandemic. 

CP: That’s so lovely to hear! Oh, I'm so happy for you. 

KO: (Laughs) Thanks. 

CP: Yes, wonderful!

Well, Katherine, thanks for telling your story as—

CP + SB: —A matter of fat!

[THEME MUSIC FADES IN AND FADES OUT]

SB: That was such a wonderful conversation with your doctor, Cat! 

CP: Yeah, I'm so happy she could join us. 

SB: I just, she shared so much. Can we just chat? Can we debrief a little bit about that interview? 

CP: I feel like there's so much—yes. So much was discussed. I have a lot that I would love to debrief with you. 

SB: Lots of thoughts. Lots of feelings per usual for us. Yeah. Okay. So when she was talking about her medical school adventures, it was very horrifying to me, the casualness of fatphobia in the rotations. And just like, how lucky for those patients that someone like Katherine could volunteer to provide that type of care, uim, cause it sounds like that was few and far between at least in her and her experience. And then just acknowledging how hard it is to stand up to the power dynamics in that situation too. 

CP: Right.

SB: Um, yeah. And then I was like, okay, if this is what it's like, as you're in school, what about the people who, you know, maybe want to get to that point, but can't? I guess, um, I'm just thinking more of those who are most marginalized by healthcare probably don't want to sign up to be a healthcare provider in the future, either. And then even if they do get into the educational system, you know, their identities being beaten down time and time again is not going to, I don't know, allow them to be the type of provider that they want to be necessarily. It was just—

CP: —Yeah. I mean, I hear that. So many of those things stood out to me too. It was, I mean, I'm glad she shared the kind of thing she witnessed when she was in medical school, on rounds, but also like kind of confirms our worst fears, you know? Like people hear these doctors talking about us, um, and how beautiful for her to say like, “Oh no, I really went out of my way to be able to provide care for fat folks that I was worried they wouldn't get in the same way otherwise.” But knowing that that's not the case with everyone, right? And then to your point of like, um, I think an extension maybe of what your, you shared about medical school, I just, like, I expect a lot of everyone. I want all these, I want to snap my fingers and be like, doctors get with the dang program, like where, where are you? What's going on?

But to realize that, like everyone who went to medical school, especially folks who went to school, you know, when Katherine did or before—and even probably still now, um, though, I think things maybe are getting just a little bit better.—it's like, I can, I can want, or I, we, as a culture, are we as fat folks or we, you know, people who are marginalized can push back at these systems, but know that like, for doctors to stand up against that is like just in almost total opposition to what they've been taught in some instances or what they've been like, what's been role modeled to them. And that’s just—

SB: Or what we hear, right? Like the whole thing that kept coming up in my mind is like, “Where does ‘do no harm’ kind of fit into this?”

CP: Truly. 

SB: What's the definitions that we're working with? Cause I think black connotation might be a little bit different from somebody else's connotation here. 

CP: Yeah, totally. And I mean, I like this really struck me and so much that I interrupted Katherine earlier about this idea of like working from within. I think it's, you know, you really have to deal with a lot of bullshit in order to be in those positions of power in spaces where you can work to make, you know, larger-scale change.

I think, you know, on an individual level, folks can make change with every interaction, but to be at a place where you can kind of be, um, helping to push back more fully on some of these systemic pieces here, it's like, you need to be in positions of power to do that. And therefore kind of need to like, keep your head down for years to get through the system, to be at that kind of place. It's just like, it's great to hear about. And also just like really disheartening in some ways, you know?

SB: I mean, it confirms a lot of what me as a non-practitioner expected, but then knowing that someone like Katherine exists and like has their own rules about not discussing weight loss, unless a patient brings it up, or if it's one of many options available in a treatment, that gives me hope too. And, you know, hearing a medical practitioner talk about like, not focusing on a calorie deficit, uh, or straightforward weight loss as something that can happen just because that is not what I experienced in my, um, many, many doctor's appointments over the years. So if she's one of many other doctors out there, like there's some—

CP: —There’s hope!—

SB: (Laughs) There's some great doctoring happening. 

CP: Something that really struck me that I want to, well, I guess. Many parts of her interview were really helpful for folks, um, folks who are fat, um, going to the doctor, kind of knowing like you're in charge of your care, here are things you can do. 

But something that really struck me was being able to her recommendation for folks to say right away, like the kind of care we're looking for. So like in that first meeting, to be able to say like, “I'm looking for a fat-positive approach,” or “I'm looking for a HAES approach,” or like her example, I have had some negative interactions previously because of my weight. And I'm really looking for care that doesn't focus on that, like being able to say that right away.

Um, and so now, like whenever I give recommendations, because like now that I'm comfortable with Katherine, I will recommend her to other people I will say and make sure sometimes I'll say, tell her. Tell her, I sent you, but more fully, I'll say, let her know that you are looking for a fat positive approach and let her know that you're looking for health at every size approach when you meet with her, so she knows that's like what we're up to here. You know?

SB: I just, uh, we talked a little bit about this before we got into the interview, but like your own advocacy or your own autonomy in this and her emphasizing that? I'm living for it.

CP: Yes, yes, yes.

SB: Like, you're the boss of that appointment. That's like a good mantra to keep in your mind. As you're setting yourself up to go to a doctor's appointment, I personally will be in my mind saying, “I'm the captain now.!” over and over—

CP: —You are!—

SB: —I’m the captain of this, and I think there is something to be said, like the systems, power dynamics do feel off more often than not. And so what a, what a hell of an idea to just like continuously cycle through your mind? Like I'm the boss. 

CP: Yes.

SB: If you're going to react poorly to me, like asking for care in an individualized way, well then, this is not a good fit and I love that so much. 

CP: Me too. Me too. 

SB: Also though something that like really blew my mind and it shouldn't, it's like my own, uh, ignorance of the situation was just about accessibility at medical buildings.

CP: Oh that struck me too.

SB: Oh my goodness. And like, not being able to get a wheelchair and not having, um, devices or, um, like seating or options that are available for everyone. I don't, I don't know, like 2010 isn't that long ago, but like here we are. And I guess if someone listening is a building influencer, like let's please—

CP: —Inclusive design, please!”—

SB: —Please, universal design. Like let's make it cost effective, let's make it chic. let's give it a moment that never ends. That's all I'm asking. 

CP: That's all we want. (Both laugh)

Okay. One thing unrelated to, um, to doctor patient situations, but just so loved how Katherine responded to the question about joy and just like, love that she has found love in the pandemic. I cannot, I don't know. I could go—I just, that is just so lovely and beautiful. 

SB: Mhmm, yeah! And to imbue this into a conversation. I mean, this is constantly what we do. So we talk about difficult things, challenging things, but to be able to recognize just like how lovely these beautiful things can come out of difficult scenarios. And I mean, like, I basically just said nothing, but it sounds like a Hallmark card, good kind of nothing, but what isn't Hallmark card good is the whole process for submitting the complaint.

I'm really glad you actually asked how to submit a complaint, because I wouldn't have known, I mean, other than my experience of just being able to do a survey and getting that response, um, but you know, if a clinic is worth its salt—is that a saying? I don't know—if it's worth it and it is doing what it should be doing, I imagine that they would actually want any complaints or unsatisfied experiences told and shared directly to them as opposed to out into the like inner webs, the world wide web or that, because that could be really damaging for the clinic for the doctors, but at least this way they can try and do right by you and also maybe get some training support to those providers. I'm not sure how that works though. 

CP: Yeah. I mean, I guess I think that kind of with anything, like not to say healthcare is customer service, but there is like a bit of an element of that. And it's like, if you can go directly to whoever has wronged you and explain what's going on and ask for, you know, them to make it right, or to help you in the ways you need help that you did not receive, um, I think often that can help, like help them be better and help us get the care we need. But also, recognizing like sometimes things are so egregious or awful that that might just not be what's, what folks are able to do. And I, you know, I think that that has to be respected as well. 

SB: And I mean, to that point, not that Katherine really brought that up, but I think she did a great job of reminding us that, um, providers are people, they are complex, they have their good days, they have their bad days.

She was so vulnerable in sharing that kind of negative outcome of care that she never anticipated. And so that's also something I'll be mindful of going into my next appointment of just like, this is another person, not just a doctor, they hold a lot of different identities. Um, you know, how can I try and communicate with them on that level as well? So, yeah. And you know, honestly, those are all my thoughts and feelings, I think!

CP: Mine too. Okay. But we have one more thought actually from Katherine who sends a little information in.

SB: Yeah, it's perfect because it aligns beautifully with our dirt and discourse.

CP: This is Dr. Oyster’s COVID Minute, um, which I will read aloud, pretend it's her voice. And also note that she shared this with us at the beginning of April. 

She says, “I would like to encourage all of you to get vaccinated against COVID-19. This virus is scary and has taken too many of us already, and all the vaccines, no matter the kind are almost 100% effective at keeping you out of the hospital and alive.

Even if you've had COVID before you should still get a vaccine, because we're not sure how long natural immunity can last. Getting a vaccine can unfortunately be easier said than done these days. Most states have hospital systems giving out vaccines and pharmacies are vaccination sites as well. In the state of Minnesota, those of us in fat bodies have an advantage in that obesity is listed as a high-risk condition that allows you to get the vaccine sooner. Now that all adults are eligible to get the vaccine, this is still important because it gives you the opportunity to potentially go through your clinic system, to get your vaccine, instead of refreshing your vaccine connector a billion times a day.

If you have a primary care provider and have been seen recently, which is in the last 12 to 18 months, it may be worth reaching out to them to see if you are able to get a shot through them. Your provider may have absolutely no say in your ability to get the shot, but they or their team can check and see if you're able to and/or make sure your chart accurately reflects the important high risk conditions that determine your place in the line.

In Minnesota, if you have a medical condition that puts you at higher risk, we'd like your clinic or clinic system to help you with your vaccine. If you have an occupation or a life circumstance that puts you at higher risk, try going through the state. If it's been a hot minute since you've been to your medical provider, also go through the state.

Also the best vaccine is the one you can get in your arm first. Don't hold out for a particular brand of vaccine. Lastly, should you develop COVID, reach out to your provider immediately upon diagnosis. There are medication infusions that are phenomenally effective at keeping the level of infection mild and keeping you out of the hospital. Different clinics systems have different ways of determining how people get connected to these meds, but it's worth asking about.”

Thank you, Katherine. This is really helpful information. And like you mentioned, Saraya, leads us perfectly into— 

CP + SB: —The Dirt and Discourse.

CP: It's time for The Dirt and Discourse. This is where we dive into the excitement and/or discomfort around relevant pop and cultural happenings. 

SB: Yes. In today's dirt and discourse, we've got a lot of excitement and a lot of discomfort because we're talking about COVID vaccines and the BMI or body mass index.

CP: The vaccine rollout has been a little wild, you know, moving more quickly than anticipated for us in the U.S. which has been great. And also has just like brought up a lot of issues, of course, 

SB: Of course. And just, just like a, some context for y'all, we’re both vaccinated, at least partially.

CP: Ayyy!

SB: Yeah. I, at the time of recording release, am one jab in, and Cat scored that one-and-done J&J baby. 

CP: Yeah. You know, something that's been on everyone's minds or at least everyone who's fat is the BMI being considered an underlying condition for vaccine access. So we just had to talk about it. 

SB: And then there's like so many points at which to talk about this. I think a lot of them are just surprising for me. Like I remember when I saw the little infographic rollout was saying like, “Which Minnesotans get the vaccine?” I was like, huh? I am in two of these under like underlying condition spaces because my BMI is just like that much higher, because I think they listed it twice in the early, early options.

And I was like, wow, this is the first time that my weight has actually helped me in like a healthcare related scenario. It was just kind of astounding to me. 

CP: Yeah. It's like, I think, I don't know. Maybe it took like many of us off guard or startled us. Like it was surprising to see it like that. I don't know about you, but like, um, there was this thing that we filled out to get on a waitlist for vaccines, and you had to identify your underlying conditions. And I had to Google the BMI so I could figure out mine, because that's not something—I think the BMI is bunk.

SB: We’ve rejected it so soundly that I don't even know where we fall on it. I love that. (Both laugh)

CP: Truly! I was like, I guess I'll Google it because to your point, there were two categories. They kind of broke off, like they called it like “obese” and “severely obese.” Right? I guess I would prefer severe to morbid, but like still again, just like the whole system is a mess, so I'm not, I can't get with this, but for these purposes we did, you know?

SB: Yeah. And if you're wondering why we are just like, like soundly rejecting the BMI, I mean, have whole Minisodes about it, but it is just like a very arbitrary basis to assess, you know, your, your weight and your like, wellness. It doesn't actually correlate.

And so that's why it's so weird for this to end up being such a big indicator for people to get access to this life-saving vaccine. And so, um, yeah, I guess. So I was just in the house. Like I am all day, every day, come, come through. Actually don't come through. It's still a pandemic. Bbut I was listening to the radio and I was listening to NPR and Lulu Garcia-Navarro was, uh, interviewing this doctor out of Harvard who is actually like a head of obesity research.

And I was just like, oh brother, strap in. What's this going to be about? How is this going to go? I look forward to being stigmatized through my own radio in my own home, my own, really excited for this. Um, um, I think the only reason that I brought it up to you Cat is because I wasn't as horrified as I expected to be It was kind of nice and also still not great?

But, um, essentially this doctor broke it down to say that like the BMI by itself is an arbitrary cutoff, but it ends up being a decent population wide measure. And I still don't know if I agree with that, but she's also talking a lot about how COVID-19 has a lot of like inflammatory impacts to our bodies. And so, you know, people who have obesity may also have all these other different, um, conditions that when coupled with the inflammatory aspects of COVID-19 could be really, really harmful for them.

So like, what's the best way to do kind of a dragnet approach to helping that? Well, it ends up being the BMI and I was like, okay, I appreciate the nuance of this, this is not what I anticipated. And also it was just like kind of curious to have this person talk about how obesity is a disease. You know, like people have obesity, people are not obese.

You know, for fat folks, obesity has been such like a medical slander or slur. Um, over time that it was unique to hear someone, um, kind of extricating a person being obese versus having obesity. Uh, but it's still like, I don't know, you brought a lot of light to this for me and just like parsing out why it was really gratifying to hear this, and also still disappointing. 

CP: Yeah. So I also listened to this piece, um, after you pointed it out and I—you're right. Like, it wasn't as awful as it could have been, which I guess like, are we giving cookies for that? Because it's pretty awful, which again, we've discussed as many a time. Like, not as surprised for MPRs programming. Um, you know, as much as we are NPR fan girls and like really enjoy public radio, we know that NPR, you know, with Noom being one of their main underwriters for years, uh, if their heads are not in the same place that ours are in terms of fat stuff, you know.

But yeah. Um, yeah, it was really interesting to listen to this piece and hear the doctor taught you that language that you just did, which is like having obesity rather than like being obese or obese people. And there was even a moment in the interview. She was like, um, “Actually Lulu, let me stop you there.” And like, like kind of reframed the way that Lulu Garcia-Navarro was like saying something. And I was like, oh bold, okay. Um, but I think that it long story short, it just felt like a lot of talk and not a lot of actual, um, caring or in concern for fat people.

Not so much like the information about inflammation and you know, how fat folks can potentially be harmed more from COVID, like those kinds of things. I'm not here to debate that. Um, but I think that the conversation felt a lot, like people talking about fat folks without any fat people's voices being shared.

Like it was like this doctor saying, well, here’s how we should talk about you. Here's how we should say this. But at the end of the day, you're still calling obesity a disease. You're still pathologizing me merely because of the size of my body. Not even like taking other, other, things into consideration.

Like I'm not saying that all fat people, myself included, are like disease-free beings. There's like, stuff wrong with me, but yeah, is it because I'm fat? Or perhaps are, am I fat because of things are quote, unquote wrong with me or is it something totally different? I just, I can not get behind the idea of, um, telling someone, anyone that they have a disease just because they're in a larger body. Like that just doesn't feel okay for me. And also scientifically, like, doesn't make a whole lot of sense.

I also think if you're fighting this disease, like what is the cure then? Weight loss. Like, do you have a sustainable way that more than a small percentage of people can do that? You know?

SB: Yeah. And it's also like, you're having this bigger conversation about obesity and then not even talking about that, right? ‘Cause like you only have so much, so much time with the interview, and as delightful as this nuance is for a fat person hearing it, like, what does that mean for the rest of the audience who are hearing it?

Now they have language to be able to say like people first, but like people first is fraught to yeah. Um, like if you talk to like a lot of folks in disability, justice community, or, you know, even me, I would rather be called a fat person than I would be called a person with obesity. Like that's just not it.

CP: A person who happens to be fat. Okay. Yeah. I don't know. And I also like, of course, when on a little bit of a dive and read some other things about this doctor and I am just not a fan, but to go, kind of go back to where we started, this piece was not as awful as maybe we anticipated, um, in a sea of lots of information about BMI and vaccine and COVID stuff that's been shared, you know?

SB: Yeah. And yeah, I don't know. My one last thing about NPR is that the title for this, if you want to check it out, was “Obesity Specialist Says BMI is a Good Measure for Vaccine Priority Group.” It's like, no, no, no. That's not even truly what was said, but like sure. Way to clickbait, I guess, I don’t know.

CP: I guess, I guess we'll go with it.

SB: It just, it just goes to show that like anti-fat stigma is so strong, even in these like, you know, quote, quote-unquote “progressive” or more liberal media outlets.

CP: Um, yeah, so I, one thing I do know for sure is that, and, and I think really speaks to the content of this episode is that like—oh my gosh, the way I said episode was just so Minnesota, we'll double down on that. This episode— (Both laugh)

SB: —Doncha know, the content of this here episode.

CP: Once thing we know for sure is that fat folks are not given are often not given the, the care that we deserve in the hospital. And I just like something so important to me that has really informed tons of my decisions over the last year is that I just want to keep as many fat people out of the hospital as possible.

And so if that means us getting access to this vaccine early, I'm here for it. I hate how we got here, I think the BMI is just so severely flawed, but like, you know what, in terms of this vaccine, I will take it. 

SB: Absolutely.

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SB: It's that time again, we've come to the end of another episode, but it was chock-full of timely and useful information. It's what you might say, just what the doctor ordered.

CP: (Laughs) Oh gosh, Saraya, wow. And also I really loved that.

SB: Of course you loved it! You love me. If you enjoyed even just a little bit of this episode, you may want to visit our website www.matteroffatpod.com.

Why wouldn't you? Uh, the next Podluck is coming up on may six and you can register there. Uh, just so you know, there are topics we'll cover in the Podluck episode that relate to some of what we've discussed in this episode. I mean, you can also find show notes, transcripts info about Matter of Fat access to older episodes and so much more, 

CP: Yes! More like—

[Music: Matter of Fat]

CP + SB: Cash! 

CP: For years, several of you have asked about ways to show Matter of Fat some monetary love. And so here we are, we made a Venmo and you can send us some Fat Cash. 

SB: It's truly astonishing that we can say years, but it's truly true at this point, we're on season four! But, um, find us on Venmo @matteroffatpod. And of course we have all the details about this on our website, and we want to give some love to those who show us love. Those lovely, lovely people are Anna, Lofey, Amanda and Harry. We so appreciate you sharing some Fat Cash with us and just know in Fat Cash is one of the many ways you can show Matter of Fat some love.

CP: Yes, one of many ways, because you know the drill folks: please subscribe, rate, and review the podcast wherever you catch Matter of Fat. Special, thanks to @DebAnne18, @KelRish and @AnnieKate03 for your Apple Podcast reviews. And of course we absolutely love your tags and shout outs on social media. Keep them coming. 

SB: Keep ‘em coming! I want to list off people's names constantly, throughout all of this season, so please let us know that you're listening. And until next time when we're back with another episode of—

CP + SB: —Matter of Fat!

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