Making it Awkward Podcast

I’m blessed to be on a lot of podcasts. I enjoy them because the topics I’m interested in cannot be adequately conveyed in short social media videos. I prefer the deeper dives. 

When I was invited to the “Making it Awkward” podcast, I knew that there was an agenda to challenge me. I was eager to engage in a discussion about our paper: Dismantling the myth of “all foods fit” in eating disorder treatment.

The paper struck a chord with some folks because we used “o-words” three times and asserted that: “there are definitely times when weight loss occurs as a result of improved eating behaviors and normalized eating in the course of eating disorder treatment.” 

As a scholar, I have undergone many rounds of peer review. I am highly attuned to the broad range of perspectives and theoretical perspectives in the fields of nutrition and mental health. I love civilized scholarly discourse, and I also appreciate those of us with lived experience to offer. 

Our paper suggested that people with eating disorders should be exposed to a wider range of treatment options and should not be forced down a single nutritional path. We made the argument that some people with eating disorders also have addiction-related issues that make the regular consumption of ultra-processed foods more difficult and can even lead to other mental and physical health issues. Some–not all. My best estimate is about a third. 

The paper followed up on our previous work, which aimed to disentangle eating disorders from addictions and consider how treatment strategies could be nuanced based on proper clinical assessment. I stand by this so firmly–not only because more and more research supports it but also because I’ve been practicing clinically for 12 years now. 

This was one of the best podcasts I’ve ever recorded. I was able to introduce the host to some new concepts. Her orientation is the social determinants of health, and I was able to describe how the commercial determinants of health play such an important (yet often hidden) role in shaping the nutrition landscape.

I summarized some of the latest data on ultra-processed foods and mental health. I broke down how addictions can compromise the mind and become the thief of joy. I left the podcast feeling invigorated! 

Here is where the story gets good…

There was a “counter-podcast” with a psychology doctoral student who had a rich lived experience with an eating disorder and strong points of view about addiction. She had several predictable talking points from the “food addiction doesn’t exist” camp. She argued that the science of dopamine and salience was missing the mark and any signs of addiction come from dietary restriction. 

She continued to focus on matters of weight stigma and sizeism even though my episode did not discuss these issues. Her talking points were about our paper but not my podcast episode. I gathered that she was confusing and conflating “food addiction” with weight loss and dieting because they do have a murky history together. She stated that the concept of “addiction” was not helpful to her personal recovery story. 

She wasn’t viewing “addiction” as a mental/behavioral issue but rather kept coming back to the point that the addiction framework represents anti-fat bias. At least, that was her experience. I am all for lived experience, but not when lived experience is used to invalidate other people’s lived experiences. 

I have engaged in these conversations for years now. The “anti-addiction” folks think addiction is stigmatizing when some research suggests the opposite. The classic “all foods fit” perspective completely ignores the neurodiversity that can exist when it comes to eating behavior. I was talking about brain diversity, and she was talking about size diversity. 

The “counter-podcaster” argued that all people with all forms of eating disorders should get the same nutritional treatment. She interpreted our article as saying that “all foods fit” is wrong when we clearly stated that it is a helpful philosophy, but there are some people who deserve more personalized care based on their psychiatric and psychological profiles. 

She had a very common and predictable “my way is the only way, and all other ways are harmful” narrative. She even went as far as calling me a “thin white male” to suggest that I must be a proponent of sizeism, racism, and sexism. Her thinking was very binary, and I can only chalk it up as a trauma response. I didn’t take it personally. 

Being a straight white male and working in the eating disorder field has been challenging for me. I am a minority and often get judged for my appearance and my courage. It’s almost as if the “counter-podcaster” didn’t listen to what I said but was committed to presenting a case against me (or perhaps people who look like me). I do believe she has the right to do so–I recognize my privilege and am open to being challenged and engaging in productive conversation. 

Here is where the story gets even better…

The protocol on the “Making it Awkward” podcast was to give me an opportunity to respond to her response episode, which would be featured in a third episode that summarized any conflict and resolution. I spent an hour crafting my responses about the need for nuance to address the phenotypic diversity of eating disorders from a mental health perspective.

I argued that subtyping and recognizing heterogeneity based on mental health profiles usually represents an advancement in care. I made the point that we were identifying areas for improvement in the assessment of those with eating disorders and that she was arguing for a regressive approach that lumped everyone into a single group.

The podcaster decided not to mention my responses and instead went on to discredit me and call me “anti-fat” and “orthorexic” to create a storyline that I was a harmful proponent of diet culture. The podcaster asserted that there was nothing wrong with ultra-processed foods, and her main support for this claim was that she enjoyed eating them. 

I enjoy eating some ultra-processed foods, too, but I will never support or defend the financial agenda of greedy multinational corporations that prioritize private profits over public health and continue to deceive the public to support their bottom line. The thought crossed my mind that maybe the podcaster had some financial support from the food industry–I’m not saying she does, but this is not uncommon in my field. 

I was disappointed but not surprised. Registered dietitian nutritionists have been attacking me for years, mostly in subtle ways–but this was a coordinated attack. The part that bothered me the most was when the podcaster called me “more of the same.” That couldn’t be further from the truth–it just felt so wrong. 

The take-home message 

There are many different social justice issues related to nutrition. A major one is anti-fat bias and weight stigma, and I have been on the front line addressing these issues clinically for years.

Meanwhile, there are other important issues plaguing our field. My view is that nutrition is a major unspoken tool of oppression for socially disadvantaged groups, including those with substance use disorders and those living in institutional settings such as correctional facilities. I am advocating for better nutrition to improve the mental health of those who have compromised life choices and chances, including many people who have eating disorders. 

Multiple perspectives can exist simultaneously. They do not need to compete, even if there are seemingly competing value systems. When people shut their minds off to opposing perspectives, we end up in “politics” and can lose touch with each other and with our health. I believe that is what the mega-corporations want: for us to fight amongst ourselves rather than join forces to address the real systemic inequities that plague our world. 

In a follow-up email exchange with the podcaster, I told her that it was a missed opportunity to promote peace-making in our fractured field. I also told her that she was actually the one who was “more of the same.” My feedback appeared to be well-received, and we ended on a positive note. I also sent her this newsletter to “fact-check” it and she had no objections. I remain hopeful for additional peace-making, because that’s who I am.

Who am I?

I will continue to fight for open-mindedness and shades of gray in the nutrition field and beyond. I will continue to advocate for my institutionalized people. I am brave enough to take a stand and trust that my internal compass will not lead me astray. I am willing to take some darts and arrows along the way. 

Feel free to stand with me (or near me). All are welcome here, including those with views that differ from mine. Diversity is what makes the world an exciting place, and there are many forms of diversity in addition to size, race, and gender.  

I welcome all scholarly discourse and debate–not just because that is what scientists are supposed to do, but because I’ve done my own internal work to feel safe in my sense of self and will continue to seek ongoing growth and expansion.