episode101

AN ANTI DIET APPROACH TO HEALTHCARE WITH DR. MAGGIE LANDES –


Dr. Maggie Landes is on the podcast today. She is a board certified physician, a public health nutritionist, and an anti diet wellness expert. Now I’m guessing most of you don’t want to sit down and read scientific studies, do statistical analysis in your free time. I know I spent years doing that with my degree, and I have spent a lot of time in the last year reading study after study to be able to become a certified, intuitive eating counselor. But I know you don’t probably want to do.

Thankfully Maggie has done all the work for us. Now don’t get worried, we’re not going to be on here talking about scientific studies. We’re not going to be analyzing data, nothing like that, thankfully, but what you will hear about that, might blow your mind in this interview.

You’re also going to learn what led Maggie to practice in this anti diet space as a board certified doctor. And what she discovered when she spent the time digging into the research and statistics on weight loss. I want you to listen in for her fundamental belief around the human body, you’re going to love it. Then she is going to be dropping one truth bomb after another. Have you ever thought, why do I keep on dieting? Why do I go back even though I know it doesn’t work? Maggie’s got something for you.

Connect with Maggie:

Maggie’s website

https://www.maggielandesmd.com

Social media

https://www.clubhouse.com/@maggielandesmd

https://www.facebook.com/maggielandesmd

https://www.instagram.com/maggielandesmd/

“The Eatfluencer Podcast” with Maggie Landes MD

The Diet Disruptors & Maggie Landes MD Facebook group (for women only)

https://www.maggielandesmd.com/the-diet-disruptors

FULL TRANSCRIPT

Jennifer: Hey ladies, welcome to episode 101 of the health, life and more for women podcast. I’m your host, Jennifer D’Amato and I have such a treat for you today. My dear friend, Dr. Maggie Landes is on the podcast today. She is a board certified physician, a public health nutritionist, and an anti diet wellness expert. Now I’m guessing most of you don’t want to sit down and read scientific studies, do statistical analysis in your free time. I know I spent years doing that with my degree, and I have spent a lot of time in the last year reading study after study to be able to become a certified, intuitive eating counselor. But I know you don’t probably want to do. Thankfully Maggie has done all the work for us. Now don’t get worried, we’re not going to be on here talking about scientific studies. We’re not going to be analyzing data, nothing like that, thankfully, but what you will hear about that, might blow your mind in this interview.

You’re also going to learn what led Maggie to practice in this anti diet space as a board certified doctor. And what she discovered when she spent the time digging into the research and statistics on weight loss. I want you to listen in for her fundamental belief around the human body, you’re going to love it. Then she is going to be dropping one truth bomb after another. Have you ever thought, why do I keep on dieting? Why do I go back even though I know it doesn’t work? Maggie’s got something for you. You don’t want to miss. Before we dive in, I just want to say, I know I have a doctor here on the podcast, but just a friendly reminder that all content shared on this podcast is for informational purposes only and should not be considered to be a diagnosis or treatment plan. Without further ado let’s dive into this interview with Dr. Maggie. 

Welcome to the health life and more for women podcast. My name is Jennifer D’Amato a certified intuitive eating counselor, coach mom of four, lover of all things pink, and I want you to live your best health and your best life. I believe the way we can all do that is by finally walking away from diet culture by relearning what you’re body needs. Reconnecting with your body’s biological signals and redefining what health is on your terms. This show will shed some light on sneaky ways diet culture has infiltrated your thoughts, your family, and your wellbeing. My heart is that no matter the episode, you walk away feeling informed, inspired, and encouraged. Let’s go.

Well, thanks Maggie for joining us on the podcast. I’m so glad that you are here and excited to dive into what we’re talking about today. 

Maggie: Yes. Well thank you Jen, for inviting me. I’m happy to be here. 

Jennifer: Now listen, we have a really cool opportunity to sit down with a board certified physician, but I really want to know a little bit more about you .Share with the ladies listening, and then what got you into this space of anti diet and wellness and all of this.

Maggie: Well, this anti diet space people, that’s the first question they ask is have you always been like this? No, not spoiler alert, but no, there a, if you’ve met anybody, who’s always been like this. They’re probably not telling you the truth, but I, so I’m a physician, I’m a board certified. I’m actually a pediatrician and I’ve been practicing for almost 20 years at this point.

I also have a graduate degree in public health nutrition. But let me tell you what, but this diet culture disrupting you know, mission that I’m on happened after I had a personal kind of life health event, it was the turning point for the entire narrative on health in my brain. 

Jennifer: Yeah. Maggie, would you tell us a little bit about that? Cause I do think it’s really poignant to what led you here. 

Maggie: Right. So, I mean, the bottom line is traditional medical education is diet culture, focused, weight centric. It has been that way for decades, probably centuries. And it still is even now. So I’m, I was part of that, just like everybody else who’s been sort of schooled in that way.

Well, I was diagnosed with cancer right after my 40th birthday, which is now almost five years ago. And in that, and I’m, I’m recovered by the way, and I’m in remission and I’m doing fine. That’s not the point of the story that thank goodness. But the point of the story is I was forced to sort of take a professional pause if you will.

I was out of work for about six months getting chemotherapy and everything. And in that place. I decided to do a kind of independent study. If you want to say like that, I wanted to learn what was the perfect, “perfect human diet”, because I was certain that it was out there and I was certain that I was capable of finding it. And now, thanks to having this break. I had time to like really dig in deep. Okay. So reading articles going to, you know, meetings, it’s not, not talking like looking at Instagram and stuff, but reading books and all, you know, really informing myself. Cause I was going to find the answer. Isn’t that weird? That’s so diluted.

Jennifer: But actually I think it’s more common than not, but please continue. 

Maggie: So, you know, and to preface that by saying I was, you know, a product of diet culture. Besides my professional training, I grew up in the eighties and nineties. I mean, you know, low fat, everything, this you’ve got the SlimFast and the deal a meal and the thigh master the whole bit. So I realized that not only was there not a perfect human diet that eluded me up until this point, I also realized that there was very little scientific evidence to support all this weight centric, healthcare that we collectively have been delivering to patients. And. I did what any good person does is I think, well, it’s probably me. Like I, at this point it was 15, you know, 17 years ago since I went to school, I probably am like, sort of outdated. Right. So I’m going to, and we talked about this before I’m an Enneagram three. This is what you do. 

Jennifer: She and everyone on the podcast already knows that I am too. I love it. 

Maggie: Okay. So there we have. So, this is what Enneagram threes do to answer questions in their lives. They go to graduate school because that just seems like the next logical step in our training. More knowledge do it. Yes. Do it big. Do it big. So, so I went back to graduate. You can’t go to medical school twice. I mean, that really would have been the best controlled experiment is to go back to medical school again, 20 years later. But nobody does that, that wasn’t even beyond Enneagram three. So I said, I’m going to go get a graduate degree in neutral. And certainly they must be teaching these, you know, future dieticians of America, something different than what I learned in medical school. And I can just prove to myself that I was sort of like behind and to get myself up to speed.

And then we all move along with our profession. Well, lo and behold, punchline is no, they’re still teaching this antiquated weight centered diet culture influence way of approaching nutrition and health. In now we’re talking the 21st century, well into the 21st century. So that’s when I thought this is not right.This is not right. And with the amount of disordered eating and eating disorders and weight cycling and mental health issues and all these things that are really come out of our obsession with health and nutrition in our bodies. Like, it’s never going to change. If the quote professionals, I shouldn’t say quote, they are professionals. I mean, doctors and PAs and nurse practitioners and dieticians are professionals. You know, if we aren’t teaching, what is evidence-based, there is no hope for anybody else. I mean, the bottom line is the lay public is not going to be spending their time, looking up articles on pub med and doing like you know, a statistical analysis of the results.

Like I don’t expect that out of any kind of average person. That’s not there, what they’re trained to do. That’s not what they want to do. But I do hold health professionals accountable for delivering evidence-based information to otherwise, you know, if you don’t do that, it’s like a bad game of telephone. It really is. Like if the original person doesn’t even get it right from the beginning, there is zero chance that the person at the end is going to receive accurate information. And that’s what I feel like we’re sort of doing. That was a very long answer to your question. 

Jennifer: No, it was really good though Maggie. Cause I think what struck you, which was, you know, I’m going to find the perfect answer, right? The perfect diet. That is what every single person thinks, you know, in, I think that same thought of, well, I’m going to find the answer. No one else has found it. So what happens is though, I’d say for the average person, I’m going to raise my hand as an average person back when I was in that space of, well, then I’ll just try this diet. I’ll go. This one didn’t work for me. So what must not have been that I must need this one. And I just keep in that same diet loop, right? Cause I’m not well at the time, again, it wasn’t reading studies and publications and all of that,.

Maggie: And you’re not expected to, you know, that’s the whole point is that we’re not expected to. It’s just we think that it’s out there in the next one is going to be quoting. Like it, and then it’s like, well, that didn’t really work, but then this next new shiny thing, well, there’s just a tidbit of something that seems convincing enough. And that’s the, you know, one of the problems, there’s so many problems, but one of the problems is that all this diet culture stuff, it does start a lot of those programs and plans and apps and all this sort of stuff starts with a teeny tiny morsel of truth. You know, it’s not like it was just fantasized out of thin air. It really does start with something. But the second that, that is taken out of context and applied to all people and blown so far out of proportion that we don’t even know which end is up. Then it is meaningless and in some cases harmful, in my opinion, you know, but it starts with just enough. We’re not dumb. I mean, most people are. Totally dumb. There are some, oh, 

Jennifer: We won’t name them by name. 

Maggie: But if you’re listening to this podcast, you are not one of them. You are smart, so we can sense complete garbage usually. So in order for diet culture to work, there has to be like a little teeny morsel of not garbage so that we get hooked on it so that we believe in it so that we. Commit to it. 

Jennifer: Yeah. So I think Maggie, a great example of this, I think is what Keto has done. You and I grew up in that same time where fat was like from the devil, it was evil, no fat, no fat. And so Keto brings in this place of, wait a minute, I can have fat, which of course you can have fat, you can have proteins and carbohydrates and all these things and what it did,it had that sliver. I mean, then I’m grabbing here, but this sliver of like truth of, yes, you should have all of these macronutrients, you should have fat, but then what it does. Is, it goes completely bonkers and cuts out a whole other food group, which of course it cuts out your carbohydrates, which again, your body needs. So I love that take on it. Where I have fats, I eat avocado and I have oil and other things than ice cream and all of those things do. And yet I enjoy all of the foods available to me and where Quito comes in and then they take it all the way to the other side is, but now you cut out something out 

Maggie: Right , well, let’s, let’s take one step back here because my fundamental belief is that the human body works. I mean, it, it works. 

Jennifer: That’s amazing. I love it. 

Maggie: Okay. I mean, and the default condition is it works because it has to truthfully, and whether you look at that with, you know, divine creation or just good engineering or whatever, like it has to work, or we would not exist as a species. So let’s, we can all agree that it, in most cases, the default is working. So in the way that the body works has not changed in probably thousands of years, maybe longer than that. So, so to think that just, as you said, you know, in the eighties and nineties where, you know, fat was awful. And so we just ate all carbohydrates and then 20 years later now we can’t eat carbohydrates and we eat all fat. Like the fact that these things are changing in this sort of cyclical way within 10 or 20 years of time. Is just evidence that that’s not based in human physiology because human physiology in 1984 is exactly the same as it is in 2021. But yet the recommendations from the quote experts are completely polarized opposites. And so that by the controversy is the evidence that it’s not good evidence. 

Jennifer: That’s so good. I feel like if I could, if it would make a lot of noise, I’d do like a mic drop 

Maggie: Yeah, it’s the fact that we are all so confused that in and of itself is the evidence that there’s not one way to do this, because if there was one way, trust me, we would have figured it out. Somebody would have figured it out. We would have all done it. It would be like over and there wouldn’t be. Like a conversation anymore. There would be no debate. There would be no competition because the winner would win. Right? Yeah. 

Jennifer: I always say if diets worked, it would work. It would, what would be done by now?

Maggie: If it worked we would be done by now. 

Jennifer: Yeah, yeah, yeah. I mean, and again, factually Maggie, we can know that, but I think that’s where that comma comes in and the, but we don’t take action that reflects that thought. I’m curious your perspective on that. So, you know, we can all know that and maybe there’s women listening, like they’re nodding their head. Like I know that I’ve done 16, 25, 30, whatever it is, diet, I’ve dieted it for X amount of years. And I know factually it doesn’t work, but I keep going. 

Maggie: Right. Well, and I think some of that is fear that, what else am I supposed to do? Like, is there another way to do something? Like, it’s very scary to like, even though we don’t like diets, basically, I mean, we can not, I mean, nobody likes diets. Even the people doing them. Don’t like the people who manufactured them don’t even like them. That’s why they don’t call them a diet. So it goes to show… 

Jennifer: I love it. I love one truth bomb after another, keep going. 

Maggie: Exactly. So, but there is something about predictability. There is something about structure. There is something about being told what to do by a, you know, expert or an authority that we do like. We do like that infrastructure of dieting to some degree. And so when you say I’m going to just stop dieting. Like that is like, it’s kind of like a F like a disorienting, I guess, is a good word. Then what do, what do I do? How do I, cause that’s what my, you know, my clients are like, okay, I get it. Like, it doesn’t take much convincing to tell them diets suck. They already came to me because diets suck that doesn’t take a lot of, you know convincing. But then they’re like and what do I cook for dinner tonight? Like what do I order at the restaurant? What I’m pushing my grocery cart through the store. And I literally don’t know what to put in the cart because every decision I’ve made around food for 20, 30, 40 years has revolved around a diet culture idea telling me what to do. And now if that little voice is not telling me what is telling me? So I think they’re kind of lost. I think that’s, and I can tell you, I felt like that too. I was like, there’s gotta be. There’s gotta be something to make this a comfortable transition because just pulling out the diet security blanket and saying no more diets, you know, now eat, you know, Godspeed with you. It doesn’t like it doesn’t I work like that.

Jennifer: And it invokes the pendulum swing. You know, I share a lot about that pendulum swing because once you let go of the diet, you very likely swing all the way to the other side. And you actually maybe have done that for years because of eventually what’s happening. You’ve been drawn back in right to the next diet.

Maggie: Well, that’s what we do on like a micro-scale between like, you know, Friday night and Monday morning. I mean, that’s, you know, when our dieting life, it was like just a smaller version of that. It’s like restrict, restrict, restrict, restrict. And then usually for me, when I was dieting, it went off the rails Thursday night, happy hour after work, you know, and that’s, and then it’s sort of like, then Friday was kind of like a whatever. And then the weekend was like a whole big, you know, whatever, because Monday I am going to do this is the last Monday I’m doing this. I’m going to be so serious. I’m I’m going to, you know, you’re going to be this different person until the following Thursday. So it’s just like the little pendulum swinging back and forth week to week.

And now. If you look at the big picture, it’s like, we’re going to take diet culture totally away. And you’re dieting infrastructure. It is like a giant pendulum. Yeah. And it is it’s scary. I mean, it is scary, but see, this is where the intuitive eating, and I know you, you know, use intuitive eating framework to help people make this transition. And I think that is one of the major utilities of it is to fill that space where they need something sort of structured to think about. So it’s not just this like free fall of what, like this nebulous, no man’s land, like that’s in my mind where intuitive eating, like kind of can bridge that gap. 

Jennifer: Yeah. No, I think that’s such a great thing. I always say, you know, when we’re replacing thoughts if you don’t want to leave an empty space there, so let’s fill it with another thought, the one you want to be thinking, and that’s a great way to even look at how intuitive eating for the beginning part can fill that space because you and I both know it is not this rigid rule following practice, but I love this idea that it comes in, kind of gives you some structure, some framework, because I do think it’s personalized and should be, but it gives you that starting point, Maggie, you brought something up that, you know, I really want to dive into here because there’s these external forces, you know, that kind of tell us what to do, right. That thing that guides us. Oh, you follow a diet. And some of that’s coming when we go to those yearly doctor’s appointments or quite frankly, any, and we’re left leaving with, so they told me I need to lose weight. Now, what, why what’s going on? And going to the doctor’s becomes this tainted experience based on my weight. I love if you could speak to that, because I think a lot of women want to feel more empowered and not feel defeated even before they go to a doctor’s appointment when they maybe they’re there in a larger body, or they’re not, or maybe especially after this last year and a half, their body has shifted and changed. So there’s some fear about going to a doctor’s appointment and having that feedback given to them. How would you suggest to approach these kinds of appointments?

Maggie: Right. Well, and that is, that is a big issue because our healthcare system, and I can speak from this country, you know, and most westernized countries I think are sort of in line with this. We have a weight centric, view of health. We do. There are reasons we do. Some of it has to do with the inadequate kind of education incomplete education of the doctors and providers. Some of it is the fact that we have such a overwhelming diet culture, a social diet culture here that, you know, let’s just be honest doctors are just people. So I mean, as much as I’ve studied and gone to school and all this sort of stuff, I still go to the same grocery store. Look at the same internet as all my patients. I mean, we’re still subject to our personal you know, sort of social biases and our healthcare system is like really certain aspects of it are totally broken. I mean, when you have 10 or 12, if you’re lucky, 15 minutes with a patient once a year, maybe twice a year, I mean, you and I have already been talking twice that long and we haven’t even scratched the surface. So to assume that a doctor even if they are as objective as possible, and they’re informed as possible can unpack this kind of stuff in a clinical encounter is, is almost unreasonable to expect, you know?

And so. Because there’s also a million other things, you know, we’re supposed to be screening for all this other stuff too. So it’s, and I’m not throwing out excuses for the doctor. There is no excuse for stigmatizing and weight, shaming patients, period. It, there is no excuse for that. 

Jennifer: Thank you. 

Maggie: But I can see how it happens. I can see how it happens because we’ve just got to keep moving. And from what we know, it comes, I want to say that. In most cases, it does not come from a malicious place. Like doctors are not, they don’t come to work in the morning and say, I wonder if I could make the fat people in my practice so mad that they never come back. Like nobody’s saying that right. But most doctors are fairly ignorant of the science of weight regulation, and health at every size. And. Things that we know this sort of evolved science that we know. And so we unfortunately bring that into the exam room and on top of the kind of power dynamic that exists between a doctor and a patient and the way we have it set up. So let me just say. And you go to a doctor’s appointment. It is a weight centric experience from the word go. I mean, there’s doctor’s offices that don’t even have appropriate seating in the waiting room for people in large bodies. And then you go from the waiting room to you get weighed in the hallway, usually before, at least in my doctor, before you even get to the exam room, it’s like you get dragged through the hallway. Here’s the scale. The first thing that gets entered is your weight. And it comes up as a diagnosis code. If you’re in the obese category, all of this work, then you go and put on a gown that doesn’t fit. And then you go in the exam room where they can’t find a blood pressure cuff that fits your arm. And I’ll be like, it is a negative experience from the beginning before the doctor has honestly even come in the room.

And then that is just like the icing on the cake when the doctor comes in. And particularly if you’re in a large body, Your weight is the problem. And weight loss is the solution. And that is almost universal advice. Whether your problem is back pain or migraines or acne or anxiety, or blah, blah, blah, blah, blah, fill in the blank. It doesn’t even matter. The experience of going to a doctor in a large body is frequently the epicenter is, you know, and that’s just, it’s wrong. It’s it’s wrong. And I will be the first to admit I am guilty of practicing in that way for up until I had cancer and learned better truthfully. Okay, there’s two problems.

The first problem is the individual patient is not getting the care they deserve. Okay. I mean, that’s, they’re not getting, if you, if the only problem is your weight. And the only answer is weight loss that is not complete clinical information. There is not a single disease where it only exclusively occurs in large. Not one of them. Yep. And let me tell you what the doctors in the exam rooms with these skinny patients are not like shaking their heads, like all confused with what I don’t can’t believe that you have diabetes. I mean, you’re thin I have no idea. I don’t know what to do. I have no tools at my disposal. They’re not saying, okay, there’s an answer for those people too. And you deserve that same answer because the answer should be independent of your size. Yeah. The bigger scale, this is the public health part of me speaking problem is when we make people’s experience in the healthcare system so traumatizing and such a demoralizing experience, they don’t come back at all to any doctor, not just that doctor, they don’t go to any doctor. That’s when bad goes to worse in a hot minute, because getting no healthcare is clearly bad for outcomes, no matter what. I mean, that’s just, that’s, there’s, that’s not arguable at all. People who never see a doctor do less favorably than people who see some doctor somewhat intermittently, and then it perpetuates the cycle because then people that have been stigmatized and sit in their cars, crying after the appointment and never, ever, ever go back.

What makes them come back is a major problem. Like, I mean, they, don’t not going to go back until there’s like something big 10 years later maybe I don’t know, 15, 20 years who knows when they go back, but by the time you have a big problem, it’s a big problem. And then we collectively, we take all this data and we publish a study that says, well, look at this, all the fat people have breast cancer or whatever you want to say, fill in the blank. And we don’t account for the fact that we made the fat people feel so miserable about their healthcare experience none of them did any of the proper preventative care or the stress of being traumatized and the sort of psychological damage of even going to a doctor. And then we publish this paper that says, you know, fat causes breast cancer, and then we bring them all back and start beating them over the head and say, look, I told you, you shouldn’t be fat. You know what I mean? It’s just…

Jennifer: Yeah. So insightful, I mean that you’re bringing in such a great perspective of things that I know, I didn’t think of the entirety of the experience. You know, I, I definitely start my visit on the scale, which I actually don’t weigh myself. I do weight refusal at every appointment I go to. However, what I hear you saying is this, the totality of these appointments is even something I didn’t consider as having such an impact on individuals. 

Maggie: Well, and here’s the very interesting part. The other side of the coin, and we’re talking a lot about people in large bodies being marginalized and they hands down absolutely have it worst. I mean, they do because they have whatever’s going on there. They have the social stigma of navigating a straight sized environment in a large body. I mean, they are discriminated against in our culture period. However, let me put this out there. The people in the slender bodies, aren’t exactly getting the best health care either because when you show up in your doctor’s office at a quote, normal body, And nobody bothers to ask how you relate to food. What’s your eating, what are your eating behaviors? What are your exercise habits? Do you have an eating disorder? Are you addicted to substances? Are you having depression? Are you, I mean, like when we don’t even ask, when we see your BMI as being quote wonderful. And we pat you on the back and say, congratulations and essentially praise stuff right in front of our faces. We’re missing all those people too. We’re missing an opportunity for health promotion also. So let me be honest, that weight stigma affects people in all sizes of bodies. It’s not exclusively people in large bodies. You’re getting the short end of the stick. If your doctor’s not asking the right questions, irrespective of your size.

Jennifer: That’s so good. You know, Maggie, I wonder what would have been different for me had my doctor at the time that I had in the height of my orthorexia had asked me. 

Maggie: Did they ever ask, did they ever screen you for an eating disorder? Anything? 

Jennifer: No, it was your weight’s going down. Well done. Good job. Keep it up. Keep doing what you’re doing.

Maggie: Yeah. And without even knowing what the doing is, I mean, that’s the scary part is that’s. How are you going to tell somebody to keep up doing what they’re doing when you haven’t even asked what that is. 

Jennifer: Yeah. Yeah. So it becomes this blanket, whatever you’re doing is working because the working means your body is being manipulated to be smaller. And again, you start believing that there is this connection, right? There’s an equal sign that goes from smaller body is healthy, smaller body you don’t have these health issues that if you’re in a larger body, you’re going to have you start believing that to be true. 

Maggie: Sure. And you’re going to absolutely believe it to be true. If you go to doctor’s appointment after doctor’s appointment, after dietician’s appointment and every single person in a white coat has told you congratulations. Yeah. Yeah. 

Jennifer: Do you remember sometime in the last couple of years, and I don’t like to name, drop off in, but I’m going to throw this one out there because it actually is something that shook my world. Bob Harper, he was part of the biggest loser. And I could do a whole episode on my issues with the biggest loser. I’m sure we, we could probably talk just for an episode about that, but he had a heart attack and I almost fell on the floor going, I don’t understand. Wait a minute. That doesn’t make sense to me. And again, I know there’s, you know, some history, all of that stuff, but we’re talking about, let’s say the poster child for fitness and health, and he had a heart attack and I went I don’t understand. 

Maggie: Yeah. So my opinion and see I’ve had, and he was, of course he’s sort of a public figure. But I hear this from time to time from just people in my life that I know they’re like, well, my uncle Joe just dropped dead of a stroke and he’s only 55. And I I’m so surprised. I mean, he’s a runner and he’s thin and blah, blah, blah, blah, blah. He always eat salad for lunch, whatever they say about uncle Joe. In my opinion, If we were having the correct conversations in the office and screening for the actual health metrics, there would be far fewer surprises.

Now, I’m not saying random things. Don’t sometimes happen. Random things do sometimes happen. Okay I got cancer and I don’t think my cancer was caused by anything specific that I did or was in my environment. But most of the time, I think the uncle Joe that drops dead, who is a runner and eat salads, like there’s probably something going on there somebody didn’t figure out like there’s, there’s something underlying, like we’re using the body size as, and the sort of appearance of health, like, you know, Bob Harper sort of like the, the visual, you know, like you said, poster child of fitness. We’re using this as an excuse to not actually figure out or investigate what is going, what is actually going on.

And I don’t, you know, of course I’m not his doctor. I can’t say anything intelligently about that, but it’s just a distraction. The weight is always a distraction. It is, it is almost never. I see. They teach us in medicine never say never because you know, nothing is 100%, nothing is 0%. I’m pretty much a believer in that. So I won’t say never, but I will say almost never, the weight is not the problem. I get doctors all the time. Not all the time, but I do get some sort of doctors that send me emails and trolley messages like, I can’t believe you’re saying that it’s an obesity crisis and your, your license should be revoked and all this crazy stuff. I’m like, okay, thanks. Doing great. You know, so I, Instagram has a, have a good day. 

Jennifer: Have a great day. Yes. 

Maggie: Okay. What I would like to ask these people. I, I, first of all, I just blocked them. I don’t have time for that, but if I were to engage them in a conversation, here’s my questions. Okay. For, for just a minute, I will take your side of this conversation. What if being smaller, had some health advantage? Okay. I just, for clarity, I do not believe that, but let’s just for a moment, play devil’s advocate and say yes, if patients were smaller, they would be healthier. Okay. So for 50 years you have been telling your patients lose weight. How’s that working out for you? Like, because guess what? Even if the goal is to lose weight, which as a side note is not, it doesn’t work to tell people to lose weight. Like you can’t just do weight, wait is a noun. It’s not a verb. 

Jennifer: Come on that’s good. 

Maggie: Yeah. So losing the air quotes, I think those are getting tired of the year. I know the podcast, people can’t see it, but we’re doing some hardcore air quoting major, major, major quoting that it doesn’t even work in their own perspective. Like the belief system is that patients need to be smaller to be healthier. Well guess what, what you’re doing is not even making your patients smaller and it is absolutely not making them healthier because we know smaller isn’t healthier, but that aside it’s not working. So like let’s open our minds to like, maybe there’s another way to approach this. Like, if what we’re doing, isn’t working, that’s the whole idea of scientific progress. It’s find something else. That’s the punchline. 

Jennifer: Maggie, I don’t know. You’re thinking really rationally here.

Maggie: It seems a little too simple. And it sounds, I mean, it really does sound comical to even say out loud because it sounds so ridiculous, but we get caught up in when you’re practicing medicine you are in the weeds. I mean the amount of pressures. And like I said, I’m not making excuses for doctors, but practicing medicine is a hairy deal. And there is so much to know and so much to contend with and the system and this and that, and that like, you don’t really have time to stop and second guess and be cynical about everything you’ve ever been taught.

Like at some point you are just taking information and applying it to the best of your abilities and just moving on and moving on and moving on. And that’s what I was doing. And honestly, that’s when I had this cancer break in my life story, I had the luxury of time to deliberately question what I had been told and that’s where I got the answer. But see the most people don’t either have the time, have the interest, have the bandwidth to do that. And you can’t question everything. I mean, if you’re going to sit there and medical school and every time you’re taught something, say, wait a minute, I got to research that on my own. Like you’ll never get through. I mean, you’ll, you just, there’s too much volume of information, but important stuff like this, where it’s not working where it’s very clearly the way we’re doing things, not working. To me, that’s like a low-hanging fruit to sort of like address, you know, there’s something not right about this. And even if you can’t put your finger on exactly what that is, it deserves a little investigation.

Jennifer: Yeah. That’s so good. Let’s grab something tangible here for the listeners, because most likely they’re not all doctors listening to this who might have already turned it off by now. If they were, and just enraged and going to find you on Instagram and send you messages. I know that, you know, the listeners are going to go to these appointments and we’re hoping that’s what they’re doing. That they’re going to feel in power to even go back. If they have stopped going that if there’s one or two things you could gift them with. here in approaching that appointment in a new way, from an empowered point of view, that they actually do believe that there is it’s beyond the weight, that their weight cannot be that guiding factor. What advice or tips or strategy would you give them? 

Hey ladies, I know this episode’s a little bit longer than my normal podcast episodes, but this interview already is absolute fire and Maggie is about to share with us some amazing tips and strategies in the second half you don’t want to miss it. I mean, really this is the stuff you can put into practice right now. Whether you have a doctor’s appointment coming up or, you know, it’s in the future, or maybe this is the stuff you’ve been talking to, your coworkers, your family, your friends about, and you’re like, I don’t know what advice to give them. The second half of this podcast is going to be the answer. All right. I want to head back in so we can listen to these tips and strategies that Maggie has for us. 

Maggie: Right. So, first of all, You can decline to be weighed. You mentioned that you declined weights at your visit. Absolutely. You can decline to be weighed and it’s a urban legend that it’s required for all visits. It’s an urban legend that you can’t get an antibiotic prescription if you don’t have a weight, if you’re an adult, like there’s, that’s all bogus. Okay. I don’t know who started that, but that is not, that is not true. The number of health conditions that require a today weight is very small and are very specialized. I mean, yes. If you’re on dialysis and your doctor wants to weigh you. Yeah. I’m sorry. You do need to be weighed. You know, if you’re getting chemotherapy, you actually do need to be weighed and you’re going to have to just deal with it. But that is not 99.9% of the reason people are in doctor’s offices to get chemotherapy and dialysis.

You don’t have to be weighed. And there are ways to say that. And here’s what, here’s some like real tactical talking points because people hear that and they say, okay, I get it. But like, what do I actually do when the ma is like dragging me down the hallway and is like, take your shoes off and get on the scale is you can say something as simple as I’m going to opt out of the scale today. Or I prefer not to be weighed today. I’m not sure that it’s relevant for my visit today, or here’s a good one that is even less confrontational is I’m going to go ahead and pass for now I’d like to talk to my doctor first about what the relevance is of my weight for today’s visit. And then, and so it just sort of like kicks the ball down the street a little bit, and the truth of it, once you’re in the room, talking to the doctor, having your visit, they’re not going to drag you back out in the hallway to get your weight, unless you’re leaving. 

Jennifer: I’ve never had a doctor even you know, approach, it’s always been the pre-appointment

Maggie: it’s the like preview. It’s not the person and the person in the hallway. And here’s the thing that will make you hopefully feel reassured and trying some of these talking points is the person who’s actually doing the weighing, which is usually an MA or an LVN or something. They actually don’t. Like let me, they don’t care about anything except for getting you into the exam room, getting the next person out of the waiting room and getting their lunch break on time. They don’t care. So, so I think the, the, the preconceived ideas, there’s going to be like this big fight about, no, you have to adheres the reasons why you have to. And you’re saying I won’t do it and they’ll say, do it. And it’s 99 out of a hundred times they’ll be like, okay. Like, it’s like, it’s going to be such a non-issue. You’re not even going to believe that it’s not an issue. So I encourage you to try that. The middle ground, if you’re really not comfortable with that is of course doing a blind weight where you stand on the scale backwards so that they get their weight, if they feel so compulsed to have it, even though I still think you should refuse, but then you don’t have to see it and have it like the thing.

Jennifer: I mean, maggie, that’s where I started. I don’t think it’s a bad starting point, you know, if that’s what you feel most comfortable with and just explaining to them, and I don’t want to know. Right. What the information is. I don’t want to hear the weight or anything related to it, if you still feel empowered to do so.

Maggie: Right. Exactly. And then here’s the thing is a lot of patients are reticent to speak up with the doctor. Like they kind of let the doctor drive the conversation. All right. And if you’re in a large body in particular, we know how that’s going to go. We have plenty of observational evidence that that is going to focus the conversation on your weight. But if you lead the conversation and not in an aggressive disrespectful way, but if you sort of lead the dance about what you intend to get out of this visit, why you are there, your specific reason of having that appointment. Actually not only will that divert the doctors that, you know, focus on this weight thing, but it actually helps the doctor a lot. We, we want to get to the root of the problem, whatever your problem is, whatever is the reason you showed up, believe it or not, we actually want to serve you in that way. We want to get the answer. We want you to be healthy and get the treatment you need or the diagnosis you need. We want you to be a quote, satisfied customer. We want you to come back. We want you to stay in the healthcare system. We like that is the general feeling. We have trouble when, you know, especially if it’s a person you have, you’re a new patient and there’s no established relationship. We don’t know, up from down, like what is important to this person?

I mean, do I, do I real, do they have a really complicated social situation I need to get into? Is that not a big deal? Do they have eating issues? Do they have a complicated medical history? Everything seems sort of equal when you don’t know anything, but when the patient takes that lead to bring up like, Hey today, I know I haven’t met you before. I really am here for knee pain and this is how it’s affecting me at work. And this is my goals of what I’d like to be able to do. This is what I’ve tried in the past. Can we talk, you know, I mean, and you sort of redirect that. You may have a higher probability of getting what you want out of the appointment.

Jennifer: I like that you can actually even do that well ahead of time. You can come in to that appointment and maybe that will help you, you know, that confidence where you’re prepared, maybe you have your notes section on your phone or your old school, and you write it down on a paper and you bring it in to show like I’m prepared also for this. And, and this is what I want. And I don’t know, like, I like that idea. Thinking ahead of time, what is it you want? Because you are the one having this appointment, this is your body. This is your health.

Maggie: Right and, and I’m not suggesting that the patients are responsible for ending weight stigma in medical medical care. I want to make sure that’s not what I’m saying. But when all other things are equal and there’s just like this big blank space, your diet culture influenced doctor in a weight centered environment is going to focus on weight. I mean, that’s like the default when there’s no other guidance, but if you have specific concerns, specific questions and we love informed patients who have good questions who want to know more. Who are participants. I mean, we want you to be a participant. Like this old school deal you know, in a doctor, walks in the room and the patient is silent and the doctor touches you and tells you what to do. And you say, yes, sir. And you walk out of the room, like that’s old school. Like, no, that’s not our current practice model. So we want to be partners in this and you are allowed to take the lead. And that might be a helpful thing to do if you’re afraid that. You know, this whole thing is going to get derailed by the scale and, and this sort of stuff. 

Jennifer: Those are really great points to both things. And I love that you gave some specific language and some things you can really just very tactically do again, whether it’s before or you just have it in your head, you know, whether it’s written down or not to show up with that. I just, I I’ve been on both sides where I let doctors lead after lead, you know, and leaving there not feeling empowered. Feeling again I need to lose weight and I’m not in a larger body yet I’ve always had that experience up until I drew a very clear line in the sand. Now I’ll tell you Maggie, I do still get some funny looks. I do still get a little, you’re not, I said you can just put patient refusal there, whatever you need to put in your system. However, I leave so much more empowered. I leave there feeling like I am in the one in the driver’s seat. And that’s the ending goal I want to experience now at the end of the doctor’s visit. 

Maggie: Yeah. I mean, healthcare is such a privilege and it is this precious little interaction that we have. So you’re there to get care. You’re there to get healthcare. Okay. You’re not there to. Impress the doctor. You’re not there to become friends with a doctor you’re not there to pacify the doctor, you know, really, truly you deserve to get what you want out of that visit. Yeah, the information you want out of that visit. I’m not saying you go in there and demand antibiotics. So that’s like the, that will drive me insane. But no, but you get to, like, you deserve complete and total information for your current concern. And if you go in with that in mind, and that gives you something to focus on, instead of thinking like, oh, this is going to be awful. Last time they wanted to weigh me. And then he told me I’d lose weight and I didn’t lose any weight since I was here last time. And what’s he going to say? And blah, blah, blah. Like we do sort of, it’s sort of self-defeating to, to presume how bad it’s going to be before it’s happened. If that makes sense. You know, and know that the stuff I’m telling you is not the mainstream conversation.

So I, you are going to get weird looks. You are going to get questioned. You are going to get now. I don’t think it should be aggressive and confrontational. I mean, and you have the right to know, like, if they say, well, you know, I really do need to weigh you because I’m going to give you antibiotics for your sinus infection. Oh, you do. So could you use my weight from the last visit? You know, what, if I weigh X number of pounds, just make something up who cares, you know, like, and it doesn’t matter. See, that’s the thing is that people don’t realize it doesn’t matter. And when you catch the doctor trying to like you know, they, they kind of leverage this white coat authority, but like an antibiotic prescription, an outpatient oral antibiotic prescription for an adult, guess what? It’s the same, it’s the same. Whether you weigh 85 pounds, 285 pounds, 485 pounds. I’m telling you the truth. It’s the same antibiotics. So don’t even for a minute, think that like when you have strep throat and they’re like, oh, I can’t give you your penicillin until you’re weighed. No, no, no, no. I want to talk to the pharmacist. I don’t, you know, like that doesn’t make it, you know, and I, I don’t, I’m not trying to make it an antagonistic thing, but it’s just, there’s a lot of misbeliefs that weight is super important for all these reasons that it’s really not. 

Jennifer: I do think, I think overall Maggie, what I hear too is we can do better. Like we can do better in the healthcare system. We can do better. In, in the field that we’re talking about here in the medical profession can do better. 

Maggie: Oh yeah, we can do better. But at, at minimum, Please don’t do worse. Like let’s just like, I would love for all the doctors to like get on board with health at every size and learn about this and learn about intuitive eating and stop weighing their patients. And that’s great. That’s very cutting edge and innovative, and I hope it catches on like wildfire until then. I’m actually sort of okay with the doctors at least not weight shaming their patients and making this whole experience worse. Like if you’re not going to make it better pretty, please don’t make it worse.

Jennifer: Pretty please. If we could just ask for one thing, don’t make it worse. And again, I think, you know, just to reiterate your point, Maggie, we want you coming back for those appointments. We want you getting the care that you need. We want, you know, what you need being addressed. So don’t, you know, if maybe you haven’t found the right doctor and you know, we do live in this culture where you oftentimes have a choice. I know not everyone has that choice in their healthcare and who they can see, but if you have an opportunity and you can find someone else, because maybe that person doesn’t suit you, that medical professional, that business, if you have an opportunity look for somewhere else, and maybe you might feel more empowered to ask some new questions as you’re seeking different care.

Maggie: Sure. Of course. And there’s, I mean, cause doctors are just people like doctors, you know, like. Like likes every haircut they get. Like, I had to go to a very specific lady who cuts my hair because like, I can’t say she’s like the best haircut lady on the surface of the earth, but I like how she does it, you know? And so I choose to go there and, and it is a privilege to be able to pick your health care. But, you know, even if you don’t have the opportunity to be super selective you can do. You know, sort of a conversation ahead of time. People forget to do that too. As you can communicate with an office, particularly if you’re a new patient, you know, you can communicate before your visit either by phone, by email and just, you know, talk to either the provider, talk to the lead nurse, talk to the office manager and be like, Hey, here’s the deal, I’ve had such an experience in the past with other doctors I’m coming here as a new patient. You know, I want to make sure that I’m able to be seen in sort of a weight inclusive way and, and set up that ahead of time. That’s, that’s fine. That’s fair to do your, you can do that, that doesn’t, you know, and they’re not gonna charge you extra money for sending them an email or something. I mean, Just know that you are invited to be part of it. And in this particular situation, you know, I’m not putting the responsibility on your shoulders, but it will help facilitate a good interaction if you take a leadership role in that. 

Jennifer: Yeah. Yeah. Maggie, I could probably sit here and talk to you for another hour. There’s so many things I want to cover, so I might just have to have you back on, because your perspective is really valuable. And I love how you would just like headfirst dove into this, the research and the information. And you’re bringing that to the world. And I’m unbelievably grateful, which really leads me into one last point is, you know, what we take in the information, the things we see, the things we hear really do have an effect on us. And if I wasn’t in this space and Maggie wasn’t in this space, you know, as well, we probably wouldn’t have met, you know, very unlikely, but we’ve chosen who, and what you know is influencing is it we’re hearing the messages. Social media has a huge impact. You know, we’re on it all the time. We’re just realistic is probably how you found this podcast is, you know, on Instagram you found it maybe cause you know, Maggie, you know, What you take in is important. And I want you to really take a look at that feed. And if you’re not following Maggie, I’m not really sure what you’re doing with your life, because not only does she bring such valuable information, her Instagram reels are something else. This woman brings it with humor to invite you into a real conversation about what, you know, what she’s addressing. So Maggie, would you just share how they can connect with you where they can connect with you and a little bit more about just your practice? 

Maggie: Well, absolutely. Thank you for saying all that, Jen. What you surround yourself with what any of us surround ourselves with that becomes our perception of reality. I mean, that’s just, that’s how it is in any way. I’m not just talking about diet culture, I’m talking about just that’s how your life is, right. And that influences your belief system and everything. And so I think that’s great advice to sort of curate your experience, but I’m easy to find. I am Maggie Landes MD everywhere. That is my website. MaggieLandesmd.com. I’m Maggie Landes MD on Instagram. Facebook, I have a free private Facebook group for women. And so if that sounds like something that’s of interest to you, I’m happy to invite any of your listeners into that community where we’re, you know, having these conversations and bringing up issues that we are all struggling with. And I, I do primarily group coaching. And all that information is, is on my website. Plus I have a podcast too. I’m I clearly like to talk. 

Jennifer: These Enneagram threes and all they’re talking 

Maggie: Awww, Enneagram three. I love the Enneagram. The EATfluencer podcast. That’s the name of my podcast. 

Jennifer: So I’ll make sure I link. 

Maggie: Yeah. I’m not sure when this episode is airing, but my podcast birthday’s in October. So we’re, you know, full year of podcasting under my belt. 

Jennifer: I absolutely enjoy your podcast. I’m going to link everything below so that anyone who’s interested can connect with you. 

Maggie: Sounds perfect. Well, thank you for having me 

Jennifer: After that episode, you might be wondering what’s next? Well, don’t worry. I’ve got you. You can do a couple of things right now. If you go into the show notes, wherever you’re listening to this podcast, I have links to my Instagram, my website, and you can get on my newsletter. I connect with you each and every week, so we can hang out on the podcast and in your inbox. If you just listened to this episode and you are ready to walk away from diet culture, but you’re not sure what the next steps are. Book a free consult with me. You can do that by heading into the show notes or going to www.healthcoach4life.com. I have a limited availability for one-on-one coaching, and if it’s for you, grab your spot now.

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