The Good Doctor

We're all fairly familiar with what a bad doctor looks like. But what about good doctors? Does kindness equal weight inclusive. Just because they care about and respect their patients, does it mean good doctors don't have anti-fat bias? Explore these questions and more in this week's episode. 

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Transcript

12:32:15 Welcome to episode 10, everyone. This is the fact. Podcast. I am your host, Dr.
12:32:21 Asher Larmie, AKA the fat doctor. I am super excited to be recording this podcast today.
12:32:30 I don't know how much I'm going to talk about my own personal experience. Hamp decided yet.
12:32:34 It's all very much up in the air, which is basically how I do this. Anyway, I never have a plan.
12:32:41 I just wing it in case you haven't noticed. They also don't edit it anymore.
12:32:46 For those of you who are expecting a polyged podcast, You should probably hang out now because or stop her stop not hang up we're not on the phone and press stop because this is not polished at all It's just me winging it and you get to be there for the you know, for the fun of it.
12:33:03 Now, those you watching on YouTube will notice that I am wearing the exact same clothing as clothing as last week and that's because I am recording this podcast directly after recording the last one.
12:33:12 The So you're hearing it a week later that I'm. Only been minutes since the last one.
12:33:18 So I hope you listen to that. Hope you listen to me talking about being unshrinkable.
12:33:22 This week I'm talking about doctors. So let's get into it.
12:33:31 How did this, podcast come about? Basically, I was asked to give some feedback on a podcast that I'm obsessed with.
12:33:40 Oh gosh, now it's really embarrassing, making it awkward. Okay, Jessica Wilson's podcast.
12:33:47 I think it's cool making it awkward. It's definitely got awkward in it.
12:33:51 This will be really embarrassing if I've got the title wrong, but you should definitely listen in and I will absolutely share the link in the show notes.
12:34:00 Jessica had a conversation with Dr. Blair Peters, I believe, who is a gender-affirming surgeon.
12:34:09 Who's quite well known on Instagram. In fact, I follow him on Instagram. So, many of you will.
12:34:16 And it was a very good conversation, very helpful actually. I found the entire conversation very helpful. But a couple of things that he said.
12:34:24 I guess got me thinking and reflecting and that is how we come to this podcast. I want to talk about doctors.
12:34:33 But today I'm not going to talk about the horrible ones because it's very easy to spot the horrible ones or it's fairly easy just got the horrible ones right the ones who are rude abrupt who don't care who ignore you, who make fun of you, who shame you, who who blame you, who make you feel like me make you feel like crap.
12:34:54 Yeah, they're they're we know those it's easy to spot them and I know there's a lot of them I do I appreciate there's a lot of them but there's also a lot of Nice doctors out there.
12:35:03 Nice. I think it's a good word, actually. Nice. And they're a lot, you know.
12:35:09 A lot of you will come and say, oh, I saw Docs Day and they didn't mention my weight or they were quite nice and it was really, really surprising.
12:35:18 It was a different pace. Not what I'm used to. And you say it in a way that's just like, isn't that amazing?
12:35:24 Well, I'm like, yeah, they're sure, I guess. It is because it's not horrible.
12:35:29 And so, you know, it's not abusive. And that's that's a plus point.
12:35:35 But also, mmm, we're stuck in the bar very low, aren't we, when niceness translates into good?
12:35:41 Medical care, it doesn't. And in fact that's what this whole podcast is about.
12:35:45 Being nice doesn't make you a good doctor or a good health care professional. And I hope for the people who are listening today, some of you will be.
12:35:52 Health care professionals of some kind. Or in ally professions or kind of you know you deal you sort of work in the health and wellness industry.
12:35:59 And this applies to you. It's a place to everyone. I'm talking about doctors because I am a doctor and doctors are the worst of the bunch.
12:36:08 I'm well aware of that. But I'm also talking to everybody in the health care profession.
12:36:12 But don't worry if you're not in the health care profession because I think you'll find this just as useful.
12:36:17 Because I think a lot of you won't have necessarily clocked some of this stuff. You're so shocked.
12:36:24 By the fact that your healthcare professional has been nice to you that you miss all the other stuff. First thing I want to say, first statement I want to wait to make.
12:36:33 Kindness does not equal weight inclusive. Just because you're a kind, nice doctor. Doesn't make you way inclusive.
12:36:44 Not at all, in fact. But we are we are so used to meanness. You know, rudeness.
12:36:54 Abuse that we Kind of forget But actually being weight inclusive goes way beyond just not being mean. It's much more than that.
12:37:06 Hearing about people's emotions. Does not mean that you lack that you don't have any implicit anti-fat bias.
12:37:14 Just because you care about fat people, you don't want to upset them. Just because even if you are an activist and you believe in you know equity and justice and all of that amazing stuff.
12:37:27 Doesn't mean you don't have any implicit anti-fat bias. I have a ton of implicit anti-fat bias. We all do.
12:37:33 We were conditioned to have it. The Fat people have internalized anti-fat bias. Then people just have anti-fat bias.
12:37:41 Whether it's internalized or not, we all have it. All right, let's stop.
12:37:42 Thinking just because we're nice and we care about people. That we somehow don't have any.
12:37:52 And this is really important because I think When we When we care about people's emotions and when we care about justice and equity.
12:38:02 But we don't constantly check in with ourselves. We're not constantly reflecting on our own bias.
12:38:08 We have the ability to develop a bit of a savior complex and I Understood this, the black community.
12:38:18 I've learned about this. Specifically from black fat women who have Yes. Who do all the education for free most of the time?
12:38:26 And who really helped me understand this. I don't hate black people. I am not malicious towards black people.
12:38:35 I do not abuse black people. I am not explicitly racist. I don't hold. Any explicit anti blackness.
12:38:42 Maybe it was a long time I might have. I don't think so. I don't think I ever did.
12:38:46 I always knew that was wrong. But I have always had implicit anti-blackness. Again, we all have because we were raised that way.
12:38:56 So, I know it's wrong. And I've been trying really hard. To address that.
12:39:05 But it but once I oh maybe not once I in the beginning I was arrogant enough. To think oh yeah no I don't you know I am not like that I'm not racist Big mistake.
12:39:19 Never say that. And so I developed a white savior complex. I became the white savior.
12:39:26 I wanted to help black people. I wanted to fix their problems. I wanted to be kind and nice and generous and do all the things that I believed were important and those things are important.
12:39:36 Like it's important to be kind to black people of course. But not when you develop that white savior role.
12:39:42 And I'm not going to talk more about this because I'm not an expert. But I think that we all have the ability to do this when it comes to any marginalized or a press identity.
12:39:54 Is to be like, oh, it's wrong to be mean, like I get that, we shouldn't be horrible to you, but instead of addressing my implicit by instead of acknowledging that I am contributing in some way to your oppression.
12:40:07 I'm going to be the one that says, no, it's wrong. And I turn into this kind of savior.
12:40:13 Is not cool. Don't do that. But we all do it, but don't do it.
12:40:18 Try not to do it. How do you try not to do it? You continue to admit. That you, you continue to take responsibility.
12:40:25 Or yourself and you continue to challenge. Your implicit bias. Do we ever get to the end where we can let back go?
12:40:32 I don't have any. I don't know. I don't think so. I've not got there yet anyway.
12:40:36 But it's it's a thing that you continue to do and you get better and better about it.
12:40:39 Because I'm much better at recognising. Oohhhhhhhhhhhhhhhhhhhhh are tiptoeing into a white savior territory right now, rain it in.
12:40:49 I'm getting better at that. I'm not perfect, but I'm getting better at it.
12:40:52 And I and I think that that goes. For, you know, for fat people as well.
12:40:58 You know, especially if you're thin. But even if you're not thin, so Dr Blair pieces who was having this conversation is that benefits from thin privilege but even people who don't benefit from dream privilege you might still be smaller than other people I'm a small fat.
12:41:12 So of course I still have this implicit anti-fat bias and of course I still benefits. From being a small fat.
12:41:18 So it's important to recognise that. Oh, I wasn't, that wasn't even on my list of things I'm gonna talk about today.
12:41:26 Just came out see? Says what happens when you don't learn stuff to spend? Just goes, just comes out.
12:41:32 I want to talk specifically now about healthier consultations. Medical consultations. It is not a successful consultation.
12:41:39 Just because the patient walks out looking or peering happy. Just because they seemed to agree with what you had to say.
12:41:46 Just because They don't show any sort of evidence of being upset. That does not make it a successful consultation.
12:41:53 How many times have I thought, well, that went really well and the patients walked out of there and gone that was shit.
12:41:59 That's part of being a doctor and we recognize this, but it is especially true for fat people because fat people have been taught.
12:42:06 That we don't deserve. Good health care and probably we're not going to get good health care.
12:42:12 And we have to literally Bag for scraps. That's how we've been taught to access healthcare.
12:42:20 And also we have been taught not to show our distress or to show upset. We have been taught to to be quiet, to take up less space.
12:42:32 You know, to shrink. Haha, and you would get in there to shrink, but we're unshrinkable, but we've been taught to shrink and sometimes in the consultation that literally looks like shrinking.
12:42:43 Something you need to look at your patients, your fat patients and look how they try and take up less space in the consultation.
12:42:51 You all have heard of the fight or flight response. All of you listen to this. You all know that in situations where we're faced with a threat.
12:42:59 Often our body gives up to fights or to flee but that is not the extent There's also freeze, many of us are beginning to realize, oh, fight, fight and freeze.
12:43:09 Yes, that's true, but it's more than that. There's also flop.
12:43:13 Blop is when you just give up. Like literally flop to the crowd. And play dead. And a lot of our patients are doing this.
12:43:20 A lot of our patients are flopping in the consultation. They're just like, I have no control here, so I surrender control to you and that feels great as a doctor when a patient's been completely compliant, you're like, woohoo, we're winning.
12:43:32 You're not winning. Patients just flapped. And then there's fawn.
12:43:36 Oh, born. Our patients are often, you know, fat people are inclined to should treat their doctors they've been conditioned to treat their doctors and their health professionals as if they are I'm not going to say royalty, but you know, they're superior.
12:43:53 We are We are considered to be And that sort of top 5% of the population, you know, oh, doctor.
12:44:04 Us know what they're talking about. It's just bullshit. We all know that's not true, but.
12:44:09 So, fawning is a really common response. So, yeah, a successful concentration isn't what you think it is.
12:44:14 As a fat person who has been in a consultation has been super compliant and agreed with everything and smiled and then walked out in there and bawled my eyes out.
12:44:24 I know this is a fact. And I don't need statistics or evidence to prove this to me.
12:44:27 I have your lived experience. You'll know if you're, and you're listening to this, you didn't even have to be fat, you could hold another marginalized identity or maybe you just saw a doctor who just ignored you whatever like you come out feeling like crap So doctors only know.
12:44:43 How will they doing when they actually check in and look for feedback? We don't like to do that.
12:44:49 In the UK as a doctor you have to do it once every 5 years. See there's 2 sources of feedback.
12:44:55 One is from your colleagues and the other is from your patients in the form of a patient satisfaction questionnaire.
12:44:59 You actually hand us questionnaire to your patients say, will you film in? But when we do them We're not supposed to, but we'll often pick and choose who we give them to.
12:45:07 Or like we'll do it online so there'll be certain people who won't have access to you know the stuff online especially older people so they you know we don't get a good representation and even when patients do feel in the forms they'll often be tempted to lie for the same reasons.
12:45:24 Warning, you know? Oh, can't possibly say anything bad about this doctor, so they just say something nice.
12:45:30 Or like with feedback, you know, just pick boxes, whatever. So not not particularly accurate. If you really want to know what Patient thinks about, think about you, you probably have to go on the Facebook groups or you have to you have to start listening to lived experiences what you have to do.
12:45:45 And it's hard, like I don't. I don't want to hear it's not fun.
12:45:50 But when it comes to weight stigma, I think it's massively important. The most important thing we can be doing as healthcare professionals is listening to fat people.
12:45:58 Who talk about their experiences with healthcare professionals. Like that's we learn. That's how we get better at our job.
12:46:08 And remember, I'm talking to the good doctors now. I'm talking to the ones who want to get better at the jobs.
12:46:12 There are some doctors that don't. All right, there's nothing I can say to you, but those who want to get better, those health care professionals who actually care about fat people.
12:46:21 Don't want to be mean to them. Don't want to harm them. How's get professionals who don't actually want to harm their patients.
12:46:28 I know that's not a hundred percent of us, but at least I'd like to think some of us don't want to harm our patients.
12:46:34 So we need to listen. And I want to talk about, I've written a list of things I think weight stigma can look like.
12:46:41 In the doctor's office. Now there are obvious ones. Right? People will always talk about equipment. It's one of the first ones.
12:46:47 And I like talking about equipment because it's what we call a quick win. You can fix that instantaneously.
12:46:53 Like within a week. Make sure you have the right equipment available for fat people. And I mean all fat people, not just small fat people.
12:47:00 Really not hard. Get a blood pressure cuff. Get all the size of a blood pressure cuff and then switch them out like you're supposed to do.
12:47:08 You're not supposed to talk about it. First thing you do is find the right cuff size.
12:47:13 Stick it on the machine. Next thing you do is the rest of the blood pressure. It's not difficult, just do it.
12:47:17 Get the right gowns. Make sure you have chairs that don't have bloody. Sides on them.
12:47:22 It's not challenging really. I mean health care professionals should be doing this as standard because we are absolutely duty-bound to care for all our patients.
12:47:31 You can't not do a proper blood pressure and accurate blood pressure just because you don't have the right size cuff that's not an excuse.
12:47:37 So equipment's a really obvious one and they're like You know, they're really obvious ways that weight stigma manifest itself in the consultation, like I said, abusive behavior, shaming, blaming, blaming symptoms on weight rather than bothering to investigate, failing to examine people, failing to do investigations.
12:47:56 Failing to treat them, coercing them into weight loss, bringing up weight loss for no god damn reason.
12:48:03 Like, so many things that you could do, right? But I think we've talked about this a lot and I've certainly talked about them to death.
12:48:08 I want to talk about ways that weight loss, a weight stigma can present itself in the consultation that you might not be aware of, the way it can sneak in.
12:48:17 So the first thing I put on my list is spending less time with patients. Do you know that there are studies that show that we healthcare professionals spend less time with our fat patients?
12:48:27 Just in general. There's lots of reasons for this. It could be because we believe our patients aren't worthy of our time.
12:48:34 Deep down. This is implicit, not explicit. Remember, I'm talking to the good doctors now.
12:48:39 We think it's a waste of our time. Or, we're uncomfortable. Oh or we don't even know, like we haven't taken the time to examine it, but spending less time with fat patients is discrimination because they're fat.
12:48:57 You will be drawn to your thin and not just your thin but your thin and attractive patients you will be far more likely to do what they need what they want.
12:49:06 And to serve them, to pay attention to them, to believe them, to listen to them, to care about them, then for your fat patients, especially your fat and ugly patients, especially your fat and disabled patients, especially your fat and trans patients, especially your fat and black patients or brown patients or indigenous patients or neurodivergent patients like I don't know what I've missed but you know you are
12:49:28 far. More likely. It treats your thin. White, cisgender, heterosexual, non-disabled, neurotypical for one of a better word.
12:49:41 Hey, patience.
12:49:44 Better. Did I say better already? I can't remember. I got lost in the list and then you're much more like to treat them better than you are everyone else.
12:49:53 It's biased, isn't it? That's just the way it works. So that is how weight stigma.
12:49:58 Shows up in the consultation without you even realising.
12:50:03 Another way is avoiding sensitive subjects.
12:50:10 Oh my gosh, I'm so Oh, they just I know it's gonna upset you so I just won't ask.
12:50:20 That's not good health care. If you need to ask a question, you need to ask a question.
12:50:25 I got really good at taking a sexual history as a as a doctor. Because it's super uncomfortable asking about sex.
12:50:31 I got really good at it. Really early. I knew I had to do it. I knew it was part of my job.
12:50:35 So I needed to talk about erections, masturbation. I needed to talk about, you know, discharge and sexual pleasure, libido.
12:50:44 I need to ask about sexual partners. I needed to just ask these things, just let out ask them, also talking about genitals, using the right terminology.
12:50:51 And it's awkward to have it's awkward. I do not feel comfortable asking you.
12:50:56 How many sexual partners you've had are whether male or female and I need to know that unfortunately and so yeah.
12:51:03 I don't like that part of my job, but I do need to do it. Sometimes it's really important and what I've realised was I was avoiding talking about sex to begin with.
12:51:11 I wasn't avoiding it. Like I did what I needed to but I didn't if it was kind of like, I didn't, if it was kind of like, there, I could talk about this but I could not, I didn't.
12:51:18 And that manifested itself in menopause conversations. It manifested itself in Mental health conversations like sex is important part of that, but I just didn't broach that subject because it was a bit sticky and awkward and then I got really good at it.
12:51:32 I got really good at talking to people and now if you come to see me about menopause or menopausal symptoms, I will ask you about sex and sexuality.
12:51:41 I'll ask you about your libida. And I'm a doctor and most of you, almost all of you, feel comfortable with me asking and will respond to me and will actually tell me and be like, hi, I know it's really crap actually.
12:51:54 I'm like, mmm, not surprising. I will ask about vaginal dryness and invitation, you know, I will ask about Youogenital symptoms.
12:52:01 I have no problem looking at an 18, a 17 year old young lad in the eye and saying how many sexual partners have you had, were they male or female?
12:52:08 And that wasn't something that instantly happened, it's something I learned to do.
12:52:14 I did this the same with suicide and self harm. When we have mental conversations about mental health. It is essential that we enquire about that.
12:52:23 Absolutely essential. Not all of my colleagues do it. I have had mental health conversations with doctors. And I, you know, have been having tremendous suicidal ideation, like really bad, it's been really bad.
12:52:35 And they didn't ask. And maybe it was because I was a doctor. Maybe it was because they knew me.
12:52:41 I was a colleague. That a ask us to do you need to ask because I'm not going to volunteer the information but if you don't ask I may well go ahead and take my life and you would be culpable that you'd be partly responsible.
12:52:51 So I asked everybody. And I ask them straight, I look them straight in the eye and I ask them, it's okay to ask.
12:52:57 Fine. Nobody has ever responded badly to that question. Nobody in my entire 20 year medical career.
12:53:06 But yeah, we avoid sensitive subjects and when it comes to weights, I think that sensitive subject is talking about bodies.
12:53:17 Because we're very good at talking about unsolicited giving you unflisted weight loss advice. But when I want to ask you a question about your fat body, like for example.
12:53:26 One thing that is different or not is different, but you need to be more aware of when you're fat is that when you have fat rolls.
12:53:34 You are more prone to get a condition called into triggered. It is a skin condition.
12:53:39 It is caused by basically yeast. Yeast loves to grow in folds, warm folds, warm moist falls.
12:53:46 Don't like that word moist, but I still use it. And so you're more like to get into Trygo.
12:53:49 And I need to be able to ask you about that. I need, you know, that's part of your hair, skin, your care, sorry, skin health is part of your care.
12:53:57 And I can do that in a way that is respectful and validating and caring. You know, I can talk about your fat roles in a really sort of nurturing and kind way it doesn't have to be shameful.
12:54:11 But I probably do need to ask you. Or I might need to to examine you and I might need you to move your fat or like move position your body in a certain way.
12:54:22 I'm not going to just not examine that area because it's uncomfortable to say, hey, could you lift your stomach for me?
12:54:26 Can you lift your belly fat for me? But I can do that in a way that is kind.
12:54:29 I can do that in a way that sort of because people to relax and sometimes Actually, it's the not asking the causes the tension?
12:54:38 Sometimes when you ask or you sort of talk, you know, talk in a good way. You pop the balloon, the tension disappears.
12:54:46 I remember the one and only scan I had when I was pregnant with my last child. I had one really nice old snog for and she just grabbed she just put my hands on my what you call that like your apron.
12:54:59 Which is like you just lift it up. That's all she said, just lift that up for me.
12:55:03 Just so nice about it. There's no awkwardness and she just carried on. How lovely.
12:55:09 She needed to do it. She just did it in a really good way. So yeah, avoiding sensitive subjects.
12:55:16 Don't do that. Now the next one I put down is the kind weight loss talk. Thanks.
12:55:24 Just because you're being nice about it doesn't make the weight loss talk. Any easier for people.
12:55:30 It doesn't mean that you're being waiting inclusive. It doesn't mean You're not being problematic.
12:55:38 Just because you're nice about saying Have you ever considered losing weight? It doesn't, no better than have you ever considered losing weight.
12:55:45 It still hits the same nerves. It still lands in the same place.
12:55:51 I have taught them if you don't believe what am I going to say here? I do not believe that you should ever, ever talk to a patient about weight loss ever.
12:56:01 Because people are unshrinkable and if you don't believe in listen to the last video or come to the course, I will convince you that there is never a good reason to talk about weight loss ever.
12:56:11 I know, it's going to fetch your bottom line because you get money to talk about weight loss nowadays or sometimes you have to like it's part of your protocol and.
12:56:19 You know, you, you don't want to. You don't want to sort of go outside of the guidelines and the guidelines say it's it must be true.
12:56:30 Guidelines are full of shit. I've looked at the guidelines. I've actually bothered to look at them and nice guidelines.
12:56:35 Fatty liver disease, high cholesterol, diabetes, obese, I've looked at all of the guidelines, I've actually bothered to read the evidence that it is included in the guidelines.
12:56:46 And I can tell you right now, there is no evidence the weight loss is going to benefit people long term.
12:56:49 Just look for yourself if you don't believe me, but anyway, this conversation for another time.
12:56:55 Wait loss talk is always bad don't care how you did it and if you think you did good because your patient has gone away and has attempted weight loss if you think that's a marker of success then you need to start the beginning and maybe listen to all of my podcasts or maybe you need to book in some supervision with me or maybe you need to come to one of my courses because you are on You are, you are
12:57:20 deceiving yourself, my friend. You only, you're only deceiving yourself and you're only harming yourself and your patients.
12:57:25 But I'm just gonna stop there because I think this probably is an entire. Cost. Another way wait Miss Stigma can enter into the conversation is when you're simply uneducated about people's lived experience.
12:57:39 You, you know, It really like, it's one thing that really boils my pace is listening to politicians talk.
12:57:44 You can the UK at the moment like we have the Tory party in power and pretty much everybody in the Conservative Party.
12:57:50 Was raised by very rich parents went to fancy private schools then ended up in fancy universities and hung out with other people who had very rich parents who went.
12:58:00 That's the private schools. And they spent the rest of their lives in this little bubble. There's little bubble.
12:58:06 They have no idea how they rest of us live. They just, you know, they're completely clueless.
12:58:12 And we all, I don't care what walk of life, what career you in or you know, where you are in the world, you know what it's like when the people in power know fuck all about your lived experience.
12:58:24 And it's frustrating because they get to make all the rules and they don't know what it's like.
12:58:28 If you're a doctor and you don't understand the lived experience of fat people, then you're, you are those people.
12:58:35 You're making all the decisions, you hold all the power and you don't have a fucking clue.
12:58:40 And that's a problem. And that's how weight stigma manifests itself in the consultation no matter how kind.
12:58:47 How considerate. How? You know, how involved you are in social justice. If you haven't been listening specifically to fat people talking about their lived experience, then you are not.
12:59:00 One of the good guys. For one of a better word. You're weight stigma is still an issue for you.
12:59:09 Coming to the end. But there's one other thing I really want to point out and it's it's something I really want to point out and it's it's something that like going back to this original podcast I was listening to something that Dr Blair Peters was talking about and he was talking about things from his point of view.
12:59:21 He's a gender affirming surgeon. He sees people who have gone through the process. Of you know accessing gender affirming care.
12:59:31 Which by the way is really hard to do. I'm on a list for gender of human care.
12:59:37 I'll probably be on that list for 4 years before I get seen.
12:59:42 It's not that easy. There will be some parts that lots of parts of the world where it just doesn't exist, even in the States.
12:59:49 Like there are many states where you just can't access it. No such thing as gentrifying care.
12:59:53 And even if you have managed to get into a clinic, do you know how long it takes before your sat in front of a surgeon talking about bottom surgery.
13:00:02 Do you know the length of time? And what we as trans people have to go through to get there.
13:00:11 I don't know that I'm ever gonna be able to access it if I'm honest.
13:00:14 And I've I've had to make my peace with that. Like bottom surgery is not something that I get to do.
13:00:19 I'm not horrible because it's what I want but I can't have it. And it's not just because of my BMI, it's for lots of reasons, but My point is that Hmm.
13:00:30 The point I'm trying to make is that doctors, especially specialists, Only see a very, very small proportion of people.
13:00:36 Right? If you work in ICU, you only see people. You are so ill. That they need your services.
13:00:45 If you're cardiologist, you only see people with heart problems. If you are And even if you're a GP and or a family practitioner or whatever and you see all kinds of things even then.
13:00:56 Even then, you only see sick people, the vast majority of people are not sick and, you know, seeking out your services in that moment.
13:01:03 So we have a very walked idea. Like if we base it on our own personal experience. Our own understanding, then we have this really walked idea of what an entire group of people are going through.
13:01:17 And I think that's really a important important to acknowledge. It reminds me of COVID. You're in COVID.
13:01:22 In the beginning there was a lot of fear mongering to do with weight and everyone was saying, it's much worse if you're fat, which it ended up not being true at all.
13:01:30 Being fat was not. A reason to get worse, you know, to have worse outcomes from COVID.
13:01:40 It wasn't. It was just that we were seeing more fat people in hospital. And we were seeing more fat people in hospital because people, the most vulnerable members of our society are disproportionately fat.
13:01:50 That's just life. And there's lots of reasons for that. But it's not being fat that caused people to have worse.
13:01:58 Outcomes and then there was all these doctors like oh yeah it's got to do with maintaining precious airway pressures.
13:02:06 Short, I mean, if you get into ICU and you are not, and you can't ventilate on your own.
13:02:10 Then I imagine air pressures are really important, but the vast majority of people who caught COVID did not end up in ICU.
13:02:16 But the vast majority of people who were fat and caught COVID were terrified that they were going to die because ICU consultants.
13:02:24 Do you say I see your IT? I don't know where in the world you are but Intensive care, consultants.
13:02:31 We're saying, oh yeah, they're all fat. And they're very difficult to ventilate.
13:02:35 They're more like to die. That's a very small proportion of people and I think it's really important to remember that.
13:02:41 Wherever you are, whatever you're seeing, you're seeing a small selection of people and a few a specialist The people who are coming to see you have gone through many, many like, you know, have gone.
13:02:53 Through many, many hurdles and, you know, a funnel, as it were, to get to you.
13:02:59 The vast majority of people will never end up in front of you.
13:03:01 But yet we use our own person experience on our own. Understanding and our own I don't know.
13:03:10 Yeah. Our own beliefs, which we have come, now we've come to those beliefs based on, you know, a lot of things based on our education based on our, our experience, our hard work.
13:03:24 Some of us have been doing this for decades, like, you know. It's not a bad thing to have these things, but we forget to put it into a wider concept into a broader context of the entire population.
13:03:35 And that's really important. Again, listen to lived experience. Listen to people just talking about what their lives are like.
13:03:49 Book studies and papers and here review journals. Sure, nothing better than a good mister analysis sometimes, but but they're not giving you the whole picture It's just statistics, statistics by the way that are easily manipulated.
13:04:09 Just because there isn't any research into something doesn't mean it's a bad thing. It just means we haven't done research.
13:04:15 You know, if. Think about the broader context, think about the bigger picture. I think I've said everything I want to say because I'm now repeating myself.
13:04:24 I have no idea what the next, episode is going to be because I haven't planned it yet.
13:04:29 I'm sure we could. I think it will be good anyway. Remember that you can ask me a question.
13:04:36 And I will try and answer it on my podcast. People are not taking advantage of this. Folks, I am saying to you, I'll basically do a Consultation for you for free if you email me.
13:04:49 Contact@dot.dot.dotdot ukthread it very easy Just say, hey, this is the problem I've been having.
13:04:56 Could you give me some ideas? Could you include it in your podcast? And obviously I won't share any personal details.
13:05:01 I'd never do that. I can do an I could dedicate something to you anonymously.
13:05:07 Hmm. I think you got another week. To, join unshrinkable. Why haven't you yet?
13:05:16 I don't know, maybe you have, but unshrinkable is gonna be amazing. I know this because it kind of came to me in a vision.
13:05:22 And so I believe in it. And, We are unshrinkable, as I said many times last time.
13:05:31 There's also loads of other things you can do if you want to access. Me? Because if you listen to this podcast, I'm assuming you Kind of like me.
13:05:40 So if you want to listen to more of my stuff, obviously there's this podcast. There's lots of free resources on my website.
13:05:44 As well. I have books. Hopefully more coming out. There are courses that you can watch.
13:05:52 There are reruns of masterclasses that I've done. Or, and here's a novel idea.
13:06:01 Some of you might need to book a consultation with me. Yeah, I don't know who you are.
13:06:06 I don't know like who this is meant for, but I think someone you need to pick a consultation with me.
13:06:10 You when I do consultations with people I have realized how best to manage them. I've tried lots of different options.
13:06:17 The best consultation a person can have with me is to begin with, you get an hour. Where we chat.
13:06:24 And it's the anti doctor consultation. Like everything, everything that you're used to, I will do the opposite.
13:06:32 You have as much time as you need. You don't have to The eloquent, you don't have to bring any notes, you haven't, don't need to have done any research, I will always validate you.
13:06:42 I will always encourage you. I'll always listen to you and I will never bring up weight or weight loss.
13:06:48 Unless you, I mean, unless you do obviously. So you get a consultation with me and that's great.
13:06:53 But did you know that we only take away, I think it's something like 20 to 30% of what we don't we only retain that much and that's enough in a shorter consultation if it's been an hour you probably forget a lot of stuff so what do you get well you get like a summary I'll spend time writing up a summary and I will write up everything we talked about.
13:07:13 And I will kind of put it into like I know sometimes like everything's all jumbled I'll put it into some sense of order I will include links resources things that you might need or will help you or talk about what the plan is.
13:07:27 What you know what you're going to do what your you know, how you're going to act next.
13:07:33 If you need help with writing a letter of complaint, I've got a, what's it called?
13:07:40 Okay. Oh, template. There you go. I got template for you.
13:07:45 Things like that. So that's a consultation with me. That's a one-off. A lot of people will be like that's nice but I need a follow-up and so you can you can book consultation with a follow-up you can book consultation and a series of 5 follow-ups if you think actually I've got a lot to talk about.
13:07:59 I got a lot to get off my chest. It's going to take me more than one follow-up.
13:08:02 So you can book any of these things with me. It is not a substitute for medical consultation with your physician.
13:08:09 Okay? I can't be your physician. It's not, I'm not, I'm not a practicing position anymore for starters. So that's not what I'm offering.
13:08:17 I am offering the opportunity to talk to a doctor with 20 years of lived experience who is now Parts, Advocate, Poch.
13:08:26 Art Councillor, I don't have any qualifications that make me any of those things, but yeah, I've been a GP for 20 years.
13:08:33 And I will absolutely help. Talk about like symptoms, diagnoses, you know, I'm not here to treat you, but I am here to listen to you and I am here to offer you my experience and my opinions.
13:08:45 But they're not a substitute for an actual medical consultation. I won't do prescriptions.
13:08:49 I won't do investigations. I obviously can't examine you because it's virtual. So There are, it's not a doctors consultation, consultation with the fat doctor, but Yeah, maybe that's what some of you need.
13:09:02 So head over to my website.co.co.uk backslash consultations. How easy.
13:09:09 I just did a blood sugar, managing blood sugar master class a couple of weeks ago. You can watch the replay.
13:09:14 On my website and there'll be another one coming soon and I don't know what it is yet but they tend to be I tend to advertise them at the very end of the month and they tend to be on the first Monday of the next month so they'll be in.
13:09:26 April. Cause it's March now, isn't it? Because yes, because I'm recording this in February, but it is actually March now.
13:09:35 Alright, ask me done. See you next time.