Can I Have Another Snack? podcast

27: "I'm so Sorry That Anybody Has Made you Feel That Your Body is Flawed and Needs Fixing" with Dr. Molly Moffat

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Today on the podcast I’m joined by Dr. Molly Moffat - A GP who practices medicine from a weight inclusive, neurodiversity affirming lens, celebrating both diversity of bodies and of minds.

In this episode, we are talking about how Molly moved away from recommending diets and weight loss to her patients, towards an anti-diet, weight-inclusive approach, focused on treating individuals with care and compassion. We get into what exactly medical anti-fat bias is and why it's so harmful, and she has some really lovely suggestions for how to talk to patients who come in with the idea that they have to lose weight for medical reasons.

Find out more about Molly’s work here.

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Here’s the transcript in full:

INTRO:

Molly: Fat folk don't go and see their doctor when they need to. And you know, I don't need to explain why that is a concern. That is a concern. It means that diagnoses are missed, diagnoses are made late, and it absolutely contributes to stress, mental health, physical health and health inequity in an already marginalised group of people.

Laura: Hey, and welcome to the Can I Have Another Snack? podcast, where we talk all about appetite, bodies and identity, especially through the lens of parenting. I'm Laura Thomas, I'm an anti diet registered nutritionist, and I also write the Can I Have Another Snack? newsletter. Today I'm talking to Dr. Molly Moffat

Molly is a GP with a special interest in learning disability and autism. She practices medicine from a weight inclusive, neurodiversity affirming lens, celebrating both diversity of bodies and of minds. She's neurodivergent herself and has three children. 

In this episode, Molly and I are talking about how she moved away from recommending diets and weight loss to her patients towards an anti diet, weight inclusive approach, focused on treating individuals with care and compassion. We get into what exactly medical anti-fat bias is and why it's so harmful, and she has some really lovely suggestions for how to talk to patients who come in with the idea that they have to lose weight for medical reasons. I really loved talking to Molly and I think you're going to enjoy this episode.

But before we get to today's conversation, I want to tell you real quick about the benefits of becoming a paid subscriber to the Can I Have Another Snack? newsletter and community. Now, I know we're not used to having to pay for content on the internet. and why would you pay for something where 85% of the content is free anyway?

Well, because without paying supporters, this work just wouldn't be possible. None of the newsletter, not the podcast. As well as supporting me in the time it takes to research, interview contributors, and write articles, your support goes towards paying guests for their time and their labour, as well as a podcast and a newsletter editor, so it's a whole team effort.

You also help me keep the space ad and sponsor free, so I don't have to sell out to advertisers or exploit my kid for freebies. Plus, keeping the community closed to paying subscribers only means that we keep the trolls and the fatphobes out. I recently asked the CIHAS community why they support the newsletter, and this is what one reader had to say:

“I'm a mum of one fairly adventurous, self proclaimed vegetarian and one theoretical omnivore. The latter survives almost exclusively on added sugar and butter, but mostly sugar. I consumed all the picky eating advice, some of it really well meaning and pretty mellow, but by seven years in, I was more frustrated, confused, and full of self doubt than ever.

Enter CIHAS. The no nonsense, cut through the bullshit, science backed content is exceptional. The content about sugar is especially helpful to me, and the anti diet lens is an antidote to my extremely anti fat/diet culture conditioning. And as an American, the British references are just an added bonus. To say your work is actively changing my life is not an understatement. Thank you.”

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All right, team, here's my conversation with Dr. Molly Moffatt

MAIN EPISODE:

Hey Molly, can you start by telling us a little bit about you and the work that you do? 

Molly: Sure, yes. So I'm a GP, although I actually only do one day of general practice at the moment. I have a special interest in learning disability and autism. I've been working in that field for a few years, and I've recently started working in paediatrics, doing some neurodevelopmental assessments, and I also do some teaching for medical students. 

The reason I'm here is because I do my very best to practice in a weight inclusive manner, so I'm not worried about fat bodies, but I'm really worried about the way fat bodies are treated, particularly when they're trying to seek healthcare.

Laura: Yeah, that's what you're here to talk about today, but I feel like we could probably have a whole other conversation about neurodivergence and feeding differences and all of that stuff, but I will try and rein myself in because, yeah, like you said, I really wanted to talk to you about how fat bodies are perceived and how they're treated in medical settings.

So I'm wondering if you could kind of take us on a bit of a journey with you. Can you set the scene for us? You're a medic, straight out of training, going into your GP specialisation. At that point, what do you believe to be true about the relationship between weight and health?

Molly: Okay. So I mean, all of my medical school teaching, all of my junior doctor training, and my GP training was absolutely based in this weight normative approach.

So the idea that weight was a marker of health, and that we should be pursuing weight management for our fat patients. And there was never any discussion around where that came from. So, you know, it was just stated as a fact that ‘ob*sity’ came with all of these comorbidities and put people at increased risk of X, Y, and Z.

And, like I say, I never remember – and I'm really confident it didn't happen – any discussion around where the evidence behind those statements came from, and the fact that actually...it was really complex and that maybe there were some other factors at play that cause that association between body size and certain diseases.

And I also never remember any conversation about weight stigma and the impact that that can have on people's health.

Laura: Okay. Well, there's so much that I could kind of, like, tease out of what you just said there, but I think the sort of headline for me is just how this information was presented to you as complete certainty. I think if I'm kind of reading between the lines, or what I've even learned in my own training,...

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