The Body Collective - Weight and Health: It’s Complicated

Episode Date: October 3, 2024

In episode 2, we’re asking: What does it mean to be healthy? We’ll talk about how to find a doctor who treats you with respect, and we chat about GLP-1s from the perspective of a doctor and a patient. Dr. Melanie Jay will share her experience as director of the NYU Langone Comprehensive Program on Obesity. And writer and editor Samhita Mukhopadhyay is here to discuss her firsthand experience going on and off GLP-1s. Plus, we’ll talk about whether or not we should ditch BMI altogether.  The Body Collective series is sponsored by WeightWatchers. The content in this podcast should not be taken as medical advice. Please consult your healthcare professional for any medical questions. You can follow our hosts  Katie Sturino @katiesturino on Instagram   Hunter McGrady @huntermcgrady on Instagram   Ashley Longshore @ashleylongshoreworld on Instagram Tracy Moore @thetracymoore on Instagram Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.  Joining Lemonada Premium is a great way to support our show and get bonus content. Subscribe today at bit.ly/lemonadapremium.  Click this link for a list of current sponsors and discount codes for this show and all Lemonada shows: lemonadamedia.com/sponsors To follow along with a transcript, go to lemonadamedia.com/show/ shortly after the air date. You can share your story at https://www.speakpipe.com/bodycollective See omnystudio.com/listener for privacy information.

Lemonada. and transform it into a source of power. And I'm doing it with some of my greatest girlfriends. You're going to love them. Who am I? I'm Katie Storino. I'm the founder of Mega Babe Beauty. I'm a body acceptance advocate, and I am the co-host of this podcast. Hi, I'm Hunter McGrady. I'm a mom of two, a plus-size model, body image advocate, and we are going to dive in. And my name is Ashley Longshore. I'm an artist, an entrepreneur, an author, and an overall wild woman that loves chicken strips and ranch. Let's do this. My name is Tracy Moore. I've been a broadcaster in Toronto, Canada for over 20 years. And man,

has my body changed over my time on television. Let's face it, everyone. We are in a whole new era for the body with medications on the rise. People seem to be talking about weight more than ever, but how do we do so in a way that feels healthy, empowering, and informed? In this series, we're chatting with friends and experts to help us navigate the hard conversations. They are hard. So we can listen to our bodies, advocate for ourselves, and feel comfortable in our own skin. The most important thing. So no matter what your journey with weight is, and I know we've all been there, please trust this is a judgment-free zone. And today we are talking about advocating for yourself at the doctor's

office. We have two special guests to help us. Dr. Melanie Jay, who's the director of NYU's comprehensive program on obesity and writer and editor Samita Mukhopadhyay is here to discuss her firsthand experience with GLP-1s and weight loss drugs. Seriously, let's just get into this. Well, I am very excited to talk to you guys today about our topic, which is the doctor. Oh, yeah, the doctor. I know it. Like for me, I don't know about you, but even when I feel healthy, most visits I've had when I go to the doctor always end up in, I don't know, me in tears because I'm like, I came in to talk to you about a hangnail and I left with like a diet plan. Yeah. I had a little thing on my eye like three weeks ago and I went to an urgent care and Michael came with me.

And I walk in and this bitch tries to put me on a scale. I'm like, honey. I'm like, first of all, I'm going to decline the scale. And by the way, I just... For your eye. Yeah, girl, you don't need to weigh me to know what kind of eye cream to put on my eye. You don't. But then it's like, okay, but why am I feeling that way? What am I avoiding? Why is this upsetting me? I'm a confident woman. Ashley, I'm going to guess, so you're not alone in this, and I am going to guess it's because you've had so many experiences where your weight has been unnecessarily tied into a diagnosis.

I hear all the time stories of people who don't want to go to the doctor because they do not want to have that same fight, and there's so much shame in it. And I am trying to destigmatize that. You guys are all trying to dest that same fight. And there's so much shame in it. And I am trying to destigmatize that you guys are all trying to destigmatize that. One way to do it I've seen is actually to decline getting weighed. Have you guys found any tips or tricks to actually get attention or respect in the doctor's office? Yeah, date your doctors. Date them. Go around and do different doctors, right? I literally almost interview them. So after I was pregnant with my son, we had moved about a year and a half earlier and I hadn't found a GP yet.

I went to three different doctors and I told them this. I was pretty freaking fiery after I first had my son. I had just dealt with a ton of grief and then being a first time mom. And I was just like a little bit mad at the world, a little bit kind of cuckoo just in the world. So I was like, I'm going to go and find a GP who's real and honest, but like is also just doesn't shame me, bullshit me. So I basically went and interviewed three doctors and I told them my whole spiel. Listen, I do not want to hear about my weight first thing. If you truly think if I'm coming in for a problem with my finger, do not mention my weight. I was so bold and brazen. The doctor that I ended up with was like, I've never had somebody do this before, but I appreciate it. And she's the one who I ended up with and I recommend her to everybody. And now she's booked out until literally next April. But, you know, it just goes to show like people are literally like wanting that. They want support, right?

You feel safe. You feel safe. That's what a doctor should be. You feel safe for the person. You're hurt. You go there, right? So I think advocate for yourself right off the bat before you even sign the papers, before you even get into a relationship with them. Figure out how they are by dating them almost.

We asked our social media followers how they felt about all this, and they had a lot to say. Roll the tape. So I went to my GP for my annual physical and we did all of the things, the blood workup, and we even did an EKG. Let's just make sure that the body's in a good place. And it is, and it was, everything was great. And the only thing that he was able to talk to me about was my weight. And he came to me this way, quote, we have to get you to lose weight, end quote. And for 20 minutes, he just proceeded to basically, yeah, shame me. And it was devastating. I have loved this doctor for so many years, and now it makes me not want to go back. I am going to go back. I'm going to have a conversation with him now that I feel like I've loved this doctor for so many years and now it makes me not want to go back. I am going to go back. I'm going to have a conversation with him now that I feel like I've sort of collected myself.

And I'm going to let him know that it really hurt my feelings and that I just feel like there's a better way to have the conversation. But for the first time in my life, a grown woman, I absolutely felt shamed by my doctor. And that just doesn't feel okay. It makes me sad that the onus is on us to go in there and steal ourselves and gather all of our confidence in order to have this conversation with an authoritative figure that should know better. That's what's sad to me. I see my parents going through that

as octogenarians, like the kind of healthcare my father has been getting. I see the nurses using certain language with him because he's a big guy and they have to move him from like the stretcher to the chair. And they're like, oh, you're a big guy. Or they're like, don't worry if you want to skip a meal, you know, like all of that kind of stuff. And I call them on it. I think healthcare professionals need to understand that we are putting so much like importance on their role. And so there's a deference. And when they abuse that and make us feel really small and like we can't advocate for ourselves, people might lose their lives.

This woman is saying she doesn't want to go to the doctors anymore. Yeah. That's bad. Yeah. I also think kind of what we've talked about before is a complete lack of attachment to the emotional psyche part of who we are and then the way that we look and the whole like, you know, science of our bodies that they're looking at. I mean, it's like, you know, if you've gained some weight, is there ever a conversation about like, how are you feeling? Are you doing, do you feel healthy? How's your energy level? How's your energy level? How's your energy level?

Someone fucking asked me that. Yeah. I think it's so interesting also what you both of you have said this thing about feeling powerless in the room. I went in for a feeling of what felt like heart palpitations to me. And I, me, recently, with all the things we do here on the internet

and how confident and everything we are online, I sat in a room with a male doctor and had him say, well, your breasts are quite large. And make that movement with his hands. And he's like, so it could just be muscular. Didn't even want to run any tests. Just was like, you got big tits like yeah that yeah that is literally infuriating and i took i took that i took that i was like oh okay bye because we know we've we've grown up to believe don't question doctors they know what they're doing and it's like no question if question. No one should ever walk into any room and be the smartest person in the room. Question people, ask questions, and continue to do so. Just because they have a degree doesn't mean they're the end-all be-all, right? That is absolutely insane that instead of being like, you know what, let's run EKG. Let's like see what's going on there just to make sure. We are so skewed.

We are so far from understanding what good health actually means. I wanna know if I'm healthy. I feel very healthy. What does that even mean? I can squat 200 pounds. I can deadlift 215. I can walk up the stairs.

Okay, I'm a little breathless, but still, like I to know what is health? What is it about? Like my stress levels are good. I sleep well. So I cannot wait to get into that in this conversation. So when we come back, we are sitting down, Dr. Melanie Jay. Hello. Hi, thanks for having me.

Yes, Dr. Jay is an associate professor and the director of NYU's Comprehensive Program on Obesity. Welcome to The Body Collective, Dr. Jay. Thank you. It's great to be here. I want to know how, this is, okay, I know what this is. This is a question I get asked all the time. It's a problem I've had myself. How do people find a doctor who will actually treat them with dignity? Yeah.

I mean, when you go to the doctor's office, you know what dignity looks like, you know, who is going to listen to you, who sounds like they have expertise, who's been recommended by other people. So I know this question comes from a history of people in larger bodies experiencing shame and judgment when they go to the doctor. And ideally, all doctors would be trained, all health professionals would be trained to recognize their own biases, because healthcare providers have the same biases that the rest of society has. And ideally, we would have systems set up that make people feel comfortable where the scale is not in a open place. But that doesn't always happen. Does it happen at all? And, but, but that doesn't always happen, but they are.

Does it happen at all? Oh yeah, sure. There are a lot of people and it's getting better. You know, I do a lot of work trying to train doctors to provide more compassionate care. Most people, that's what they intend to do. You know, it's just that people don't recognize the biases that exist. And so we do a lot of training about that. But yes, it exists, but it doesn't exist everywhere. And so people have to kind of advocate for

themselves as well and be able to ask the questions that they need to get the healthcare that they want. I want to talk about GLP-1s. What are the benefits? What are the risks? The medications are not miracle drugs, and they're not taken to make someone skinny. They're taken if they can improve your health. And what's exciting for me as an obesity medicine specialist and primary care doctor as well is that they can really have been shown to improve health and improve obesity-related disease. So they have been shown that in people with cardiovascular disease, it decreases risk of heart attack and stroke and all-cause mortality over

four years. In people with kidney disease, it decreases risk of kidney disease, heart failure, sleep apnea, you know, prevents diabetes. It keeps being shown to help with a lot of different medical conditions that are associated with obesity. So they are really exciting drugs, but they are not the desperation that people have. And I totally understand it because we live in the society that values thinness. And also people are sick of being sick if they have excess weight that's making them sick. So I can totally understand it. But it needs to be under good medical supervision for these medications. Hunter, are we going to talk about BMIs? Yeah, I want to talk about it. I want to talk about it too. I thought you were going to

say bowel movements. No, because Ashley, you sent me an interesting article yesterday. And yes, it was in the New York Times. And actually, I have it pulled up right here on my phone because I wanted to bring it up. But it said the headline time to say goodbye to the B body mass index is a measure of your weight in kilograms over your height meters squared. It approximates in most people a level of adiposity or how much fat one has in our body and especially visceral fat around the abdomen is the fact that can cause inflammation and health problems and disrupt kind of the access between our brain and our gut that regulates fullness and, and appetite and metabolism. And so these things are, you know, it is a decent measure. And the benefit of body mass index,

by the way, is that it's not as invasive, because, you know, you're talking about the trauma of getting on a scale. For body roundness index, you know, you're talking about the trauma of getting on a scale. For body roundness index, you would have people actually measuring your waist circumference. I want to go back to the indicators because we talked about BMI. We talked about, you know, measuring the middle. What is a better indicator or what indicator would you suggest that we should be using if we don't love BMI and you don't really love the, you know, the measuring the middle? Metabolic health?

Yes. So exactly. So, I mean, I don't, I use BMI, I use waist circumference, just to say those are all important, but we also use all the tools that are disposal. History really counts. Like what's been someone's experience? What are someone's family history? What diseases do you currently have? Do you have high blood pressure? Are you,

do you have prediabetes? Yes. Metabolically, do you get your blood tests done? And we look at their lipids and we look at their glucose and we look at, you know, all those kinds of things as well. And, um, and we screen for sleep apnea and, and, and see if they're having sleep problems related to weight. So there's, it has to be comprehensive care. And then it's a conversation. Because first of all, not everybody can afford the medications or have their insurance pay for it. And we have other options for everybody, whether they have obesity or not, lifestyle is incredibly important and having enough sleep, managing stress, eating well, physical activity. But I think that's universal. And it's not just for people in larger bodies.

It's like universal precautions. But it's always the basis of weight management, because even on the medications, we have to make sure people are getting one. I think the other on the medication is to make sure people are getting enough protein, that theyP-1s, one thing that I find really comforting about this is that we've taken away this onus of, you know, the shame of feeling that people that have larger bodies just have terrible willpower and terrible discipline. And so if GLPs, would you put them as part of that narrative that if you have obesity, it may be something that you are genetically predisposed to. It may not be because you're sitting on your couch every day piling back fast food. Absolutely. I mean, willpower and motivation are not part of the process actually. So obesity, like any other chronic disease, is an interaction between our genes

and our environments, including our food environments. And of course, personal decisions and choices do play a role, but they're affected by our environments and what's available to us. And also, once someone has obesity, like we said, the adipose tissue signals to the brain and the gut and kind of affects how people feel hungry or are satiated. And so all of that plays a role. So it's not the person's fault. And I think the GLP-1s just kind of magnify that because it shows that people who've been struggling their whole life have lost hundreds and pounds in their lifetimes and gained it back, had so much willpower to do that. It takes so much willpower to treat obesity, whether you are using lifestyle alone or lifestyle and plus medications, but it's not a driving force in terms of the pathways for developing obesity and how

we can support people, if that makes sense. I would say that we've been hearing a lot that like BMI is actually bullshit and that it's dated. And you did say it's an important metric of health. And so I'm saying that out loud because that was interesting to hear because you were like, yeah, no, it is important. But the internet keeps being like, it's not. Yeah. Well, I mean, it's problematic, right? It's problematic to say like, you need to be this BMI.

People will look at the BMI and think, oh, I, look at the way they label it. Like BMI being, and maybe that we could say this, it's the fact that BMI is labeled as normal weight, overweight, and obese, right? Yes, morbidly obese. Yeah. And then, well, we use class three, severe obesity. So class one, two, and three, I do not use that M word because I feel like that's really- That's nice.

Not great. Yeah, that's kind of you. Yeah. Yeah. But people think that because of that, our goal is to be normal BMI. Well, it's not actually like in the overweight range, people actually sometimes have lower risk of disease depending on where they keep their fat than when they're at low BMI. So it's really the higher BMI. And, and that's mostly who we see in

healthcare these days. A lot of it is BMI is 35 and 40. Like then, then that's usually a higher risk. And that's usually where the conversation has to go. So, so what if you're really quickly, what if you're our 35, right? Yeah. But your blood test is great. Your cholesterol is great. Your blood pressure is great. Yeah. Everything is checking out. Yeah, right. Everything is good. What do you tell that patient? Well, I ask them what their goals are, right? I mean, there's no urgency at that point because they are healthy, right?

But it's same thing for any other disease. If you have high blood pressure, for instance, a little bit high blood pressure, but it's not causing headaches, it's not causing anything at this moment in time, it's still at risk in the future of causing problems, like you're still at higher risk in the future of having weight related diseases in the future, you know, so you might not all your numbers might look good now, but you're still probably have increased risk of cancer. I have a family history of breast cancer, right? So I don't have breast cancer right now, I'm completely healthy. But that family history makes it that I need to, you know, do things and screening tests and other things to keep myself

healthy. And so when someone has a BMI of 35, and everything is great, there's no urgency, we talk about what they prefer to do. But, you know, doing things to optimize health, eating well, doing physical activity, not gaining more weight, right? Like that, a lot of it is just like keeping the weight neutral. And then in terms of treatment, then we can talk, we can talk about what, you know, is shared decision-making of what they want to do as a result. There's no then urgency. I think that part of the problem is that we have to accept a bit of nuance in this situation. So BMI, as much as the internet is now telling us to throw it away, it is still an indicator, and it might just prove to be absolutely nothing of concern in a whole bucket of indicators. And I think part of the issue, and I know I have this issue, when I'm trying to be on top of my health, I'm trying not to make it an all or nothing weight thing.

And I think that's where the mental health issue comes in. So can you give us a little bit of guidance? If there's someone there that wants to lose weight, but they do not want their mental health to go off the, like just off the chart, how can they gently do that? How can they take care of themselves instead of just looking at a number? Any advice? I think in true for anything that like empowerment and self-worth comes from within, it's harder if you have a stigmatized condition to not internalize the stigma. And also talking about expectations, like losing weight is not going to solve all your problems,

right? It's going to, it's, it's, it's for health reasons that, you know, I talked to my patients about the even and it's hard to do in a time we have about positive self talk, you know, yes, weight, you don't blame yourself, like the like, maybe the treatment that we're giving you is not working for you, right? That, or maybe it's really bad timing, there's a lot of stress in your life, you're not taking care. You're not able to eat as well. But you end getting help if you're having emotional eating, for instance. If you eat as a way to deal with emotions, then that needs to be addressed, right? Because we need to have other ways of dealing with emotions if you're going to do weight, uh, weight management. Um, the self-loathing

never gets you anywhere. Yeah. That, that, and we've, we've talked about this so much throughout all this, that, that, that inner monologue has got to be the reasons why you love yourself, not the reason, reasons why you don't. And I think that's just such a good jumping off point to love who you are, to love your body and to get you on the way to whatever that, I hate using this word, journey genetically, biochemically, and then based on their unique, what we call social determinants of health, which are what environment, social environments do they live in? What is their home life like? What are their communities like? And so those things are very important too. Dr. J, thank you so much again. Yeah, thank you. So good. Lovely. Yeah. Hey, listeners. At Weight Watchers, we're all about building a community to support you through any stage of your life journey.

That's why we created the Body Collective. Here's a clip from a real Weight Watchers member speaking about their experience, sharing how vital that power of community is when it comes to health. Take a listen. I work full-time and have young kids. With work and everything else, I found it hard to prioritize my health. Connecting with the community at Weight Watchers has given me the support I needed to really care for myself. Seeing other people in the same stage of life and working on similar goals has been invaluable. They understand the challenges of balancing all my commitments and finding ways to take care of myself as well. I would not have stuck with this program without the community around me.

Hi there, it's Julia Louis-Dreyfus. This fall, my podcast, Wiser Than Me, is back for Season 3 with even more wisdom straight from some legendary old ladies. These chickadees have a lot to teach us. Every word is a lesson in living unapologetically and focusing on the stuff that really matters. From Lemonada Media, Wiser Than Me, season three, out now. Find it wherever you get your podcasts. Subscribe to Lemonada Premium in the Apple Podcasts app and listen to every episode of Season 3 ad-free. And we're back. Okay, we need to talk about GLP-1s.

This drug has really shifted the way we talk about willpower, weight loss, and healthcare in general. I think this is such an interesting and nuanced conversation, and I'm glad that we have my girl, Samhita Mukhopadhyay, the best-selling author of The Myth of Making It, and a regular columnist at New York Magazine's The Cut, where she actually documented her own journey with these new meds. Hey, Samhita. Hi. She's a badass. She's here. Samhita, welcome to The Collective. It's so good to be here.

So, Samhita, let's go right into this. How did you come to the decision to get on the shot? So, it was a really long, like like I took a really long time deciding. And, you know, similarly, 2010 to 2020 was a great time. And especially for someone who my body changed profoundly in that time. And I was working in fashion. And it was a moment when brands actually wanted to dress plus bodies. And I had met all these amazing influencers. And so when my doctor, when my blood work came in that I was pre-diabetic and my cholesterol had gone up, and I was having stress and weight-related health issues,

she suggested Manjaro, which is a terzapeptide, which is similar to a GLP-1. And now it's also on the market. It's known as Zepbound, but in the same class of drugs that kind of works the same way. It's a shot that you take weekly and it helps with your food urges and cravings. And I first was like, wow, I'm a failure. Like I cannot believe that I let myself get to a place where they are prescribing a weight loss drug. Like how could I have let this fully transparently? It was not a body positive moment. I was riddled with shame and guilt that I had kind of- Because you're human. Yeah. That I had, quote, let myself go. And I had done quite a bit of research to find a doctor who

was not a fat shamer. I actually looked for someone who understood obesity science that wasn't going to be like, you need to diet and exercise. But what I faced instead was a completely new narrative, which I think has surrounded these drugs, which is weight gain is not your fault. And certain brains are wired differently. And this is a hormonal intervention. This is not fen-fen. This is not a crash diet. This is a different type of medical intervention. This is not a, you know, this is not fen-fen. This is not a crash diet. This is a different type of medical intervention. And so I, you know, went about it like a reporter.

I took six months. I talked to different people. I think the thing that I, why I ultimately decided to do it is things were feeling out of control. I was really scared. My father had just died of diabetes-related complications. And the anxiety of that happening to me was like so front of mind. And so I decided to take the leap and go on the medication. I'm also going to say, so you have this career at Teen Vogue. And in the fashion industry, there's like four plus size editors, would you say? Four? I would say less than that.

I think four is generous. And I think it's so interesting also to come from that perspective of truly being like in that time, being one of the only women who is plus size in that industry. Yeah. And, you know, I will say my background wasn't in fashion, right? Like I'm a feminist writer. I've been writing about politics for like 20 years. And, you know, Teen Vogue at the time was covering politics. And so I had gone there to help with their political coverage, but I've always been I realized how much I personally didn't identify with so much of it. Because again, most of my weight I gained later in my life. And so I had never, even though I would fight to the death for fat inclusivity, I realized that I'd never fully seen myself in it. And so when I got the Teen Vogue job, all of a sudden I'm getting all these interview requests like, this is a historic moment. What does it mean to be a fat woman in fashion? And I was like, wait, I'm fat. And it was like this moment where I like hadn't reflected on it in that way. And I write about this in my book where it's like, you know, I'm going into Vogue. And literally,

before I'm going on the Anna interview, I'm thinking like, do I need to go on a crash diet? Like, I mean, the rumors about this woman are crazy, right? And so then to get in there and be celebrated for it, but have this kind of fraught relationship with it. And I will say that was such a big entry for me because it was people like you, Katie, and Hunter, people that I would see at Fashion Week that would be like, girl, you look so good. And I'd be like, oh my God, there's social justice spaces, but it was really like the plus girlies in fashion that were the most radical about this and the most kind of inclusive and really gave me a language. I think prior to that and like, you know, to then be like asked all these, you know, kind of invasive questions and be like, oh, wow, this is actually a big deal. Like there are so few of us that it's worth putting in the article about, you know, I mean, it was historic because I was the first South Asian woman.

Like there was all these other things. And, but it was like, I was fat and that was a big deal for, cause that's how few fat editors there are. Is there this, so like, of course there's the shame of being someone who is overweight, but then do you feel the shame being on the shot? Like we really can't win in this world, right? Like, that's what I'm really coming to terms with is it's like, you just can't win. Do you feel that shame now being on the shot and being like, well, okay? Yeah. So, you know, for what it's worth, I've now been off the shot for about nine months. Oh, interesting.

Can I ask you, you mentioned that you have to stay on it your whole life to maintain. I didn't know that. What was the choice to get off of it? So it was less a choice and more, thank you, America's terrible healthcare industry. So yeah. Well, Hunter, to your point, I think, yes, I had a tremendous amount of, when I came forward with that cut piece, like I knew people were going to be talking behind my back. Like I knew, like it meant so much to me that like those of you that did post it, because I just knew that people would be like, oh, they got her too. And really like what I was trying to do is make an intervention around the shame that so many of us in larger bodies feel when we make any decision about our body. Right. And now it's like, okay, we can't stick to thinness, but now we have to stick to some invisible line of like, I have to embrace my

fatness. Even if it's at, you know, at cost of my health, I have to still be like, yes, queen, like, I'm so proud of this. And it's like, there has to be an in-between space. The reality is most women are actually somewhere in between, right? Like they're somewhere in between the like coming off of the shame and cycle of dieting and the embracing the self, you know? And that was part of why I wanted to come forward with my story because I think there is so much shame around fat people getting any kind of medical help and advocating for ourselves and actually getting the care that we need. And ultimately my decision to take it was seeing it as an act of care for myself that like from the information that I had in the moment, that was an act of care for myself. But, you know, as the conversation evolved and the kind of panic, and I think Katie, you put it so right at the top of the segment,

like no one can fucking stop talking about it. You know, it's like the fact that we became fixated on it as a miracle drug for weight loss really removed what the actual power of the drug is, which is a profound intervention for people that struggle with diabetes or are on the path to diabetes. And that is not the same thing as trying to be a size four from a size eight. Right. Those are two. And we have fixated so much on the latter conversation and understandably that we've actually missed this much broader issue around accessibility and how this could profoundly. I mean, both of my parents struggle with diabetes. My father died of diabetes related complications.

And I always say this. If he had had access to a drug like this, if it wasn't so cost prohibitive, if it was made and not just marketed to people as a miracle weight loss drug, so many more people could actually have it. And that's where I sat. I was in the intersection of those two things. So I get on the drug, my health outcomes start to get better. My numbers go down, my sugar goes down. I'm feeling better in my body. I was having some like mobility issues and I'm starting to feel better. I'm starting to be more in touch with my body through it. And then it turns out that it had been on some kind of coupon and the company revoked the coupon as these pharmaceutical companies do. And all of a sudden they wanted $800 a month for me to get the shots. incredible, very vulnerable, unbelievable article. Why would anybody be mad at you about that? You're making a personal decision. I'm a plus-size girl over here rocking these titties and all of this. Why would I ever be upset with you? Why would I feel abandoned as a plus-size person just because you made a decision about your own body? What the hell is going on? everyone we've got in the community, because there's some strength and power in numbers. And it's so complex that what I loved in your article was that, Samita, you talked about having

to figure out how to make health changes without hating your body. And I think that's where I see the tension in this whole conversation, because I have no problem with my body, but I also believe everyone has a right to good health. So how do we get people on that road to good health without having them slamming their body as this, the enemy? Samita, how have you been feeling being on a GLP-1 and really seeing your numbers go down. And I'm sure a lot of that had probably brought up a lot of, oh, like worth thoughts and feelings and then now being off of it. And especially as someone, you know, I'm so sorry for your loss with your dad. But of course, I'm sure that, you know, I don't want to put words in your mouth, but that might be in the

back of your mind, right? God, if my dad had had this, this is a life-saving drug, right? Yeah, that's a really good question. I have felt the full gamut of emotion, as you can imagine. I think at first I was just really angry. I was angry that I was basically told that this was a short-term intervention only to learn that for, so for GLP-1 or trisopeptide, like a manjaro, to be effective, essentially what it's doing is it's making an intervention

to the way that your brain communicates with your body, right? So your hunger cues are shifted because you, it tells you. Hilariously, this is my second Ozempic interview today. You're really, you're educated on the topic. Yeah, yeah. And so, and actually, I'm not a doctor. So, you know, probably, you know,

this is the very high level, my understanding of how it works, basically. And so when that no longer, when you're no longer taking it, when you're not on it, those hunger cues come back, right? And one of the things I really experienced was this, while I was getting more in touch with my body, I was more disassociated from my actual hunger cues. And so since it is an appetite suppressant, however you want to frame it medically, that's fine. At the end of the day, it is an appetite suppressant and it works as an appetite suppressant. It makes you want to eat less. And so once that is gone, all those hunger urges come back. And so I spent the first couple of weeks, first of all,

there's a lot of side effects. I had a lot of side effects. So my stomach was in really crazy shape. I had some digestive issues for like three months after I came off the medication and I had digestive issues the entire time I was using it. And so I kind of felt like I was angry. I felt like the system had let me down for sure. And I also felt like I had an opportunity to reconnect with my body after having put it through this experience and to really get in touch with a much more authentic sense of my own health and to really work on not judging myself as I started to put the weight back on, which I have. So I've gained back about, I lost almost 50 pounds and I've gained back almost 20 to 30.

So I, you know, and everyone was like- What a mind fuck. Like, absolutely, right? So all of these clothes that were big on me are like small, you know, like that whole journey has been really hard. And I actually, I wrote a follow-up piece about my decision to go off of it, or decision to go off of it, and then kind of what's come from that. And that's where I feel like, that's where I feel like the conversation needs to go. Because the reality is this isn't actually a sustainable intervention if what we're trying to solve for is fatness.

Because at the end of the day, if we still live in a culture that prioritizes thinness over everything else, then these are not effective interventions. Because what I need more than anything is social support, right? I need community support to remind me that it's okay to live in this body and that when I have a health issue come up, that it's okay. And I'm not going to blame myself because I gained a little bit of weight. Yeah. Samira, I would say so much of what you said is a bomb to a lot of the noise that I hear in my head. And it's not even that you've got the solution, but I wish more people were saying, what I need is not necessarily to fit in the little genes. What I need is a community that understands that I'm good now. And I think a lot of us understand that we're good now,

but it's not affirmed. We don't get that back. And I feel like that's- But we have to feel that within ourselves though too. I know I feel it, but the influences that I'm getting, it is so hard to hold that back. And it's so hard to keep telling myself that I'm good without that reflected anywhere else. Absolutely, it starts with us, but wouldn't it be great if everyone was on board? So I think that that was great reflections. Well, that is why this podcast is so important and conversations like this are so important so that people still feel like they have a place to belong. Yeah. Yeah. I know it. Yeah.

Thank you. Thank you, Samhita. Thank you so much for having this complicated and sometimes very difficult conversation with us today. And thank you to my fellow collective members, Hunter, Ashley, and Tracy, and our guest, Samhita Mukhopadhyay. We hope you learned a few things today and you can keep on learning with us this season too. We want you to feel empowered at the doctor's office, right? And we want you to know that health and happiness are an important ingredient in each of your individual journeys. You're a

part of the Body Collective Club, so please keep listening. Give us feedback. We'll see you soon. Bye-bye. There's more of The Body Collective with Lemonada Premium. Subscribers get exclusive access to bonus content like outtakes that didn't make it into the show, subscribe now in Apple Podcasts. The Body Collective is a production of Lemonada Media and Weight Watchers. Your hosts are Hunter McGrady, Ashley Longshore, Tracy Moore, and me, Katie Storino.

The Body Collective series is sponsored by Weight Watchers. The content in this podcast should not be taken as medical advice. Please consult your healthcare professional for any medical questions. This series is produced in sound design by Mariah Gossett. Additional sound design and engineering from Ivan Kuraev. Music by APM and our senior supervising producer is Kristen Lepore. Our VP of narrative content and production is Jackie Danziger. Executive

producers include Stephanie Whittles-Wax and Jessica Cordova-Kramer. Series consulting and production support from Anna Pascal, Kelsey Merkel, Lauren Zeinfeld, and Vivian Walsh. Help others find our show by leaving us a rating and writing us a really, really great review. Follow The Body Collective wherever you get your podcasts or listen ad-free on Amazon Music with your Prime membership. Thanks so much for listening. See you next week. Bye-bye.

Hi, everyone. Gloria Rivera here, and we are back for another season of No One Is Coming to Save Us, a podcast about America's child care crisis. This season, we're delving deep into five critical issues facing our country through the lens of child care, poverty, mental health, housing, climate change, and the public school system. By exploring these connections, we aim to highlight that child care is not an isolated issue, but one that influences all

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Let me tell you, things can get weird, and I love every second of it. Weird is my comfort zone. The newest season of the Sarah Silverman Podcast is out now, wherever you get your podcasts.