The Fat Doctor Podcast

Stop Blaming the Patient! (Why Healthcare Needs More Compassion And Less Judgment)

• Dr Asher Larmie • Season 5 • Episode 10

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 In this episode, I tackle the simple but revolutionary idea that if we can't control our health (and we can't), then we shouldn't be blamed for it! When healthcare professionals blame patients, patients stop trusting us and start avoiding care. That's dangerous! This week I offer some straight-talking advice for both doctors (ask better questions!) and patients (call out the blame when you feel it!). Let's take the shame out of healthcare and remember that illness isn't a personal failure and when all else fails, chose compassion over judgment, folks. Every time. 

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The aritcle quotes in this episode is " Veenendaal, M V E et al. “Transgenerational effects of prenatal exposure to the 1944-45 Dutch famine.” BJOG : an international journal of obstetrics and gynaecology vol. 120,5 (2013): 548-53."

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Hello and welcome to the Fat Doctor Podcast. This is Episode 10. I'm your host, Dr. Asher Larmie. And today I am going to be talking about moving beyond blame, beyond personal responsibility.
We talked last month about how health was not something that we could control. And this month I want to talk about why, if we can't control it, we can't hold people responsible for it, and therefore we cannot blame them for it. Seems simple, and yet such a struggle for so many healthcare professionals. So I do hope you'll be paying attention whether you are a healthcare professional yourself. I've actually got a question that I'll be answering later from a healthcare professional. So that's exciting.
But also this is going to be just as valid and important if you are a fat person, or you know a fat person who is not getting the kind of care they deserve because they are being blamed instead of cared for.
So we talked about last week, and it was episode 6. We talked about the fact that health is not something that we can control. It's just not. And I'm not going over that again because it just isn't. And so we're just going to have to accept that as fact. And so what happens is this lack of control that we have gets weaponized through blame.
And if we cannot be held responsible for our health when it lies beyond our control, and therefore we have to decide why and how we're allowing this the language of blame to continue within the healthcare system, and what we're going to do about it. So I mean, like, it's really really simple. Most of us, when we develop a condition, especially a condition that is associated with weight, we blame ourselves.
And we blame ourselves because we are being blamed by other people because we're being told that health is something that we can control. And therefore, if we didn't control it, we did something wrong, and we should be blamed for it.
And it kind of shows up with thoughts like "God! If only I had done this, then I wouldn't have got sick. If only I hadn't done that I wouldn't have got sick. This wouldn't have happened if I'd had better self-control, if I hadn't eaten so much, if I had gotten my ass off the couch more often," or blah blah blah, and there are certain things that we blame ourselves for more than others. And of course that has a lot to do with society, and what society has taught us over the years, but being fat is definitely something we blame ourselves for. And therefore it's something that we blame our health conditions on as well. And, as I said, doctors are really good at doing this. In fact, they like to warn us in advance, don't they? If you do this, you're going to get this. If you don't do this, you're going to get that. If you don't lose weight you're going to get this. If you lose weight, you're not going to get diabetes. If you don't lose weight, you're going to get diabetes, and then if you get diabetes, well, of course you're going to blame yourself.
And I would know, because that happened to me.
And you know, in Episode 6, we talked about the weather. You can't control your health any more than you can control the weather. Those things are interchangeable. You can't control your health any more than you can control the weather. You can check the weather forecast. You can come prepared with an umbrella and a hat, and whatever. But at the end of the day, you cannot stop it from raining, and you can't stop yourself from getting sick either.
And I think one of the things we have to understand about illness is that there's never one cause right? That is way too simplistic a definition. I mean, I guess a virus causing viral meningitis. Yes, pretty binary. You get a virus, it attacks the brain, you get viral meningitis. But even then, I think, if you explore that a little bit more, there are other things going on, because not everyone who comes into contact with that virus is going to get viral meningitis. So it is more complex than we like to think.
And certainly when it comes to chronic illnesses, there are always going to be more than just one cause for that illness. And also, I should point out, it's not like we'll ever be able to determine what the cause is. You know, it's not like we can look at it and be like this caused this, but we can have a good guess, and sometimes it's more obvious than others. But oftentimes we just don't know. And I know that often patients will come to me and say, why this happened to me? I don't get it. Why did it happen to me? Because we're still under the illusion that if we do certain things and we don't do certain things, then we won't get sick. But of course it doesn't work that way, and it's really hard to say, "Well, it's just kind of bad luck, like shit happens." I mean, that's not what you want to hear from your doctor, but it is kind of true.
And we know a little bit more than just "shit happens." We know that there are genetic predispositions. We know that environmental exposures, especially at a younger age, but actually at any age can impact things. We know that not just genetics, but epigenetics and transgenerational epigenetics, and actually got a little case study to present later that I really found really interesting or a study, I should say.
But yeah, you know, there's all sorts of things going on. We know that the hormones, our stress levels, our mental health. We know that a history of trauma, all of these things will impact whether or not we develop a condition or a symptom or disease, and then also part of it is timing and chance.
My great grandmother survived a genocide, smoked every day of her life, didn't speak a word of English, but lived in England since, you know, for about 20 or 30 years, was fat, grew up in the turn of the century in Lebanon, and so she had a lot of factors, reasons why she should have been unhealthy and unwell. That woman lived to be like, she was almost 90, and she was in good health, and she didn't get any - like she had a problem with her heart. She didn't have a problem with her lungs, you know. She would smoke every single day and drink whiskey, and she was fine, because sometimes it's just good luck, or it could be genetics. But if you think about my wonderful great grandmother, and I took her - I was named after her. My second name is her name was Gare, and Karadik lived a long, a very long, and relatively healthy life, in spite of the fact that she had lots of things sort of again fighting against her health.
And so folks, timing and chance right. Some people are lucky, some people, you know, that's just kind of how it is, and I know we don't like to think of it so random. We like to think about health as something concrete that we can control. But it's not.
I think I've told you now that I have a condition called Frozen Shoulder. And it's just one of those really shitty, bad luck type of things that people get. And I've met other people who are, "Oh, I had a frozen shoulder. It was horrible," and one of the worst things about having frozen shoulder is, it's very difficult to pull up your pants, which is a problem, because every time I go to the toilet I can't pull up my pants because it can't do this motion.
Yes, that's a real big deal for me, actually. And it hurts, and it means I can't lie on one side, and it means I can't do certain movements and certain exercises I used to do, and I can't do anymore. And like, if my dog jumps up on me and tries to cuddle me and catches me the wrong way. It like, the pain is excruciating, and I've had it since November, and I'm not complaining, although it sounds like I am complaining, and maybe I am complaining a little bit. But one of the things I wanted to know when I got it was why the fuck did that happen? What did I do wrong? How could I have prevented this from happening? And of course I knew a little bit about frozen shoulder, and I knew that one of the most common - well, nobody knows what happens. It's one of those conditions. It's idiopathic. We don't know why it happens, but we do know it's more common in females between 40 and 60 who are diabetic.
So of course I was like, "Oh, you see, if I hadn't been diabetic, this wouldn't have happened," and of course it's all my fault. I'm diabetic, and so I blamed myself.
I blame myself, and every time I get that horrible pain I'm like, "Oh, it's my fault," and every time I have to ask my sweet beloved, if you will help me pull my pants up. I meant up, not off, hey? It's not that kind of podcast. I meant up folks.
That was such a Freudian slip. But anyway, when I have to ask him to cut up my food, or help me reach something, or pick something up or turn off a light switch, or any of the other millions of things that I have to ask them to do now, because I can't do them. I feel deeply ashamed and responsible. I feel like it's my fault. It's my fault. If only I hadn't been diabetic, and if only I had taken better care of myself, I wouldn't have been diabetic in the first place, which, of course, is not true. But you know it happens, and when we blame our patients, I'm speaking to healthcare professionals now, especially when we blame our patients, we cause a lot of damage.
A lot of damage. There is a cost. It's a hidden cost. It's not one that we can necessarily calculate, not like we can calculate how much fat people are costing the NHS. No, we can do that very easily. We just do some maths and get some numbers and work them out. Fat people cost us this much money, but the cost of healthcare blame that's pretty difficult to work out, and yet think about all the ways that blaming our patients for their condition is costing us as a society.
Number one, the emotional impact. And also you're going to be like, "Oh, who gives a fuck about emotions?" Well, to be honest, we should. It's pretty much written into our contracts that we should care about our patients' emotions. I'm not saying it should be the only thing we care about, but it's definitely one of the things we should care about. We should not be responsible for shame or guilt or diminished self-worth in our patients. That is not something that we should be proud of. So there is the emotional impact. But also it goes beyond that. There's the behavioral consequences, right? Because when we blame our patients, they don't trust us anymore. They don't want to come and see us. They're ashamed. They don't want to. "Oh, I don't want to bother my doctor. They're just going to say it's my fault." So they don't come and see us, and that delays treatment, and that actually puts people's lives at risk.
There was no place for blame within the consulting room.
And then, of course, there are the social effects, the isolation - like if you blame yourself for your condition, not only is it going to impact you as a human being on an emotional level, but you begin to withdraw into yourself. You begin to conceal your symptoms right? You don't tell anyone what's going on, because it's your fault. Like if you don't blame yourself, if you just think "Oh, this shit thing happened to me." Then you tell everybody about the shit thing that's happened to you. But if you think it's your fault, you don't want to tell anyone. You're going to keep it a secret, and therein lies danger, right? When it's hidden undercover, and we're keeping it a secret from other people. Because if we're not, if we're concealing our symptoms and we're not seeking healthcare, then, again, lives are at risk.
And it even goes beyond that, because think about it. When you blame somebody for their condition, what's going to happen? You're going to initiate the stress response, the acute stress response. And sometimes the chronic stress response, if it's something that they're going to be thinking about for the next few weeks and months, which it probably is. As a doctor or a healthcare provider, and you turn around, you're like "It's your fault that you're sick. It's your fault that you've got this condition." Even if you didn't say it outright like that, you made them feel that way.
You've just - congratulations. You've just switched on the adrenal cortex. You've just got people - you've got the adrenal glands, I should say. You have now created an environment in which people are going to have long term chronic stress, which will impact all sorts of things like healing and immunity, and also increases long term risk of heart problems and cancer and all sorts of things. Like, why would you want your patients to be stressed about their illness? They're already going to be stressed about their illness because they've got an illness. But when you have the blame and the shame and the guilt, it's going to make things even worse. And so you're actually in doing so sort of preventing them from healing, preventing, you know, you're increasing their risk of developing an infection. You're causing harm.
That didn't come out as well as I hoped it would. I feel like today, I'm not really on form. But I'm going to keep going, push through because, you know, I need to get to the end of this podcast and so do you. But I hope you realize, if you're a healthcare provider, that when you are blaming your patient or making them feel as if they are to blame whether you do it in the moment, or whether you had done it previously, or maybe you didn't do it personally, but your colleagues did it, and you didn't do anything to challenge it, then a person believes they are to blame for their health condition. They will have the emotional impact that will in turn impact their behavior. It will cause healthcare avoidance. It will cause delayed treatment. It will cause chronic stress which will in turn impact healing and will in turn impact immunity and will in turn impact long term health outcomes. It will cause chronic inflammation, which is something that we're trying to avoid. It will cause social isolation. Most importantly, it will cause concealment of symptoms, and that is the very opposite of what we, as healthcare providers are trying to achieve.
So what happens if we turn things around? We just said, instead of blaming my patients, I'm just gonna think about the way that we collectively, someone blame myself collectively. I'm going to think about how the healthcare system collectively could be failing my patients. So instead of saying, it's your fault, it's your responsibility. I've been able to help possible that it might partly be our fault or our responsibility collectively, us, we altogether.
What would happen if I asked myself, as a healthcare provider, am I delivering the care and support that my patient needs rather than blaming my patient for being there in the first place? It's a little shift, right? It's a little reframe, but it's quite a big one.
Yeah, I think about my training. And I remember I learned this from a really early age, and I can't quite pinpoint what it was. But there was this fucking arrogance, especially of the senior doctors who just walked around like they were God, and they knew everything, and their patients were kind of a nuisance, and there wasn't any - I mean there was occasionally, but there wasn't that much compassion, or care, or consideration. It was much more like, "If only you were doing that done this, you would have made my life a lot easier." That was the attitude that sort of rubbed off on me in a way, and I think impacts a lot of us, and the more stressed we are, and the more overwhelmed we are, and we are overwhelmed. There's no doubt about it, but the more overwhelmed we are, the more kind of defensive we get, and the more we're like, "It's your fault. It's your - I blame you," and we sort of take it out almost on our patients. But what if we were just to flip it around, a little reframe? And every time we made a diagnosis or a patient came in, we just thought like, is there any way that I might be letting you down? Is there any way that I'm failing you, or just even just asking, am I delivering the care that you deserve?
Just a little question there, and you know, rather than kind of like, "If only this patient would lose weight! If only this patient would go on that diet! If only this patient would take care of themselves!" I asked the question, "Oh, I wonder if I'm spending enough time with this patient, or have I done a good job of taking a history? Have I examined this patient today, or I wonder if there are some tests that I could be giving this patient? Or I wonder what this patient actually needs from me? Maybe I should, maybe I should figure it out. Like, how can I know if I'm delivering the care that they need if I don't know what they need in the first place? Maybe I'll just take a couple of minutes to figure that out." It's possible. It's also what we're supposed to be doing, but it doesn't happen very often, and it's something that I do in my practice now.
Questions I ask are like, "What do you want to get out of this consultation?" right at the beginning, like, "What are you hoping to get out of this consultation today? What do you feel like you need? What do you think is going on? What do you think is causing your symptoms?"
I don't like to say in a kind of like, "Well, I don't know. So what do you think?" I'm not asking them to doctor themselves. But "Do you have any idea? Do you have any inkling as to what could be causing this? What do you feel that you need right now? What are you worried about? What are you concerned about?" When you start asking questions like that, oh, gosh! The answers come fast and furious, and then life becomes a lot easier, in my opinion.
Talked many times about the social determinants for health, and how there is a real kind of inequity when it comes to healthcare inequity. There are real disparities, and part of it is economic. So there are socioeconomic privileges that shield us from blame. And I, you know I personally experience this on a regular basis that I don't - I'm not made to feel as ashamed of my medical conditions as someone else in my place who didn't have the doctor in front of their name, and I just notice often when people find out that I'm a doctor. So when people see me in the street, you know, they treat me a certain way, when they find out I'm a doctor, they treat me in a very different way, and let's not pretend for one second socioeconomic privilege is a real thing, and it absolutely impacts healthcare.
But I also think that there's more to it. Who gets blamed versus who gets treated with empathy and compassion and sympathy depends a lot on what they look like. Yeah, and maybe a few other things, but a lot on what they look like. It's a lot about body hierarchies again, isn't it? You look a certain way, you're going to get more sympathy, more empathy, more care from your doctor, and if you look another way, then you're more likely to be blamed. And that's not okay, is it? That's not okay, that that's, in fact, impacting healthcare.
There's very little evidence that our individual choices have much of an impact on whether we develop a condition or how we manage that condition, or if we develop any complications from that condition. Like, of course, there is some degree of personal choice that will impact outcomes slightly. But it's very small amount compared to what we think it is. Like in our minds, we think it's 98% under your control, where it's probably more like 5% under your control. And so rather than berating people for like not managing the 5%, maybe we should be focusing on the 98% is what I'm trying to say, or the 95%. Like, why not focus on where we could be doing better?
If you're a person, not a health professional per se, but maybe you're a fat person, and you're experiencing discrimination and stigma in healthcare. And you're thinking, all right. So what do I do when my doctor blames me for something? The first thing I think is really important is recognize that you feel like you're being blamed and don't second-guess yourself. If you feel like your healthcare provider is blaming you, then chances are they are, and it might not - it might be through non-verbal communication. Because don't forget that that's about 70% of all communication. If I'm right in saying that, so it could just be the way they're looking at you or making you feel non-verbally. It could be something that they've said, and you probably aren't able to process that in the moment, because you know, our brains are not functioning at full capacity when we're in a consultation with a healthcare provider for lots of reasons, predominantly, because it's a very stressful situation. So you may not necessarily be able to pinpoint the exact thing. The doctor is not necessarily being very, very explicit in their blame, but if you feel like you're being blamed, or if there's certain words that are coming up, and you're like, they're blaming me. So it's really important to recognize that, and then how you choose to act on it kind of depends on who you are. You could just call it out and say, "You're actually making me feel like this is my fault. Did you? Did you intend to do that like? Were you trying to make me feel guilty?" Or you can just call it out, or you can find a way to redirect the conversation.
"This part, this is not particularly helpful talking about whether or not it's my fault. Can we talk about what we're going to do? Or okay, I hear what you're saying. But can we focus on the treatment options? Or where do we go from now?" Or something like that. So redirecting conversations, really helpful and or calling the behavior out. And sometimes we can't do that in the here and now, and sometimes we have to do it afterwards, you know, in the form of a complaint, or in a second consultation, or through whatever online facilities that you have. Having an advocate really helps, because sometimes you can't say it, but the advocate can. So the advocate can step in and say, "Oh, hang on a second. It feels like a lot of blame going on here. I don't think that's very helpful," you know, and perhaps even having a few phrases beforehand that you've discussed that they might use should the conversation turn into a blamey, shamey conversation that can help.
And of course, finding a provider who is not going to blame you is always very helpful. Unfortunately, there aren't that many of them, and there are a lot of you and many of you. "Can you help me find one? I won't blame you."
I'm a healthcare provider, but I appreciate that that's not necessarily the solution for some people.
I do have a script that you can download from the website. It's completely free, and it helps navigate some of these conversations that can be really, really tricky. And there's even a section that sort of talks about a phrase that you can say that's just something like "In the past, doctors have made me feel like I'm to blame, and that has impacted my ability to communicate, or it's caused me to avoid healthcare professionals," and in calling that out right at the beginning with this script it makes it much harder for a doctor to then spend 10 minutes blaming you for your symptom. I mean, some of them will be that oblivious that they won't care. But a lot of them will be like, "Oh, all right, I better not do that," you know, paying attention all of a sudden.
Things like "I'm looking for solutions that work with my circumstances. I don't want an explanation of why I'm ill. I'm looking for solutions, not explanations." And again, with the script, there's a bit about, "This is why I'm here," like actually telling the doctor quite explicitly, "This is what I'm looking for, and of course this is what I'm not looking for," so that can be really helpful as well.
So in conclusion, folks, can we stop blaming people for their symptoms? Can we remember that illness is not a personal failure. It's not something that you can control, and it just is what it is. And I know that that's not often the answer we're looking for. Often we're trying to find the reason. It's not satisfactory to not know to know that there isn't much of a reason. A lot of it is just chance and happenstance. But it's definitely not a failure.
And we're gonna be talking next week. We're gonna have a guest patient. We're not really. You know me. I like to make them up, but I'm going to be talking about it in a more kind of practical way. But just right now I want to remind us to be compassionate towards ourselves and towards one another. A friend of mine was talking to me the other day about fierce self-compassion, self-compassion doesn't have to be sweet and gentle. Self-compassion can be fierce as well. Self-compassion can be a mama bear protecting her cubs. So don't forget that. But yeah, self-compassion, please, especially in these troubled times.
Now I'm going to move on to the next section, which is everything you've been told about weight loss is a lie. I want to talk to you about transgender epigenetics. I just found this really fascinating. So this study is transgenerational effects of prenatal exposure to the 1944 to 45 Dutch famine. And when was it published, or doesn't say 2013.
So I remember we talk about how starvation often in the long term, leads to weight gain. We know this right? We've talked about why it happens, and if you don't know this, then, really, you want my unshrinkable course. It is an awesome course. It is only 25 pounds. It is well worth it. There's a lot of value for money in this course, and you will basically learn all the science behind why weight loss is unsustainable. And one thing you'll learn is that starvation leads to weight gain. And we've known about this for a really long time, as far back, probably before, but definitely, since the Minnesota semi-starvation study, which actually showed what happened when people starved and what happened when they stopped being starved. So we know that starvation leads to weight gain. And if you don't you need unshrinkable.
And so, what was fascinating about this study was it looked at whether the effects of starvation during pregnancy can be passed down to grandchildren, to grandchild, not to children, to grandchildren. If it's to children they could just be that they were conceived at a time of famine, and that could have impacted them. But, grandchildren, one has nothing to do with the other right. This is now a genetic and epigenetic situation, so they wanted to see if the grandchildren had differences in their body weight, their BMI or their health, when their grandparents experienced the starvation experienced starvation when, during their pregnancy, so when they were born when they were conceived. It was during the they were conceived during the famine.
Okay, so they were conceived. So the grandparents were conceived during the famine. And now we want to know what happened to the grandchildren 2 generations later. What do you think happened?
I actually, I mean, you might be like, well, Ashley sort of gave it away at the beginning. And so it did find that the grandchildren of fathers who were undernourished before birth were heavier. Isn't that crazy.
So if you were born in 1944, and whilst your mother was carrying you in her womb, in their womb, they experienced famine. They were starved. Your grandchildren are more likely to be heavier.
The people talk about survivor genes that those who survived famines, genocides, wars, these kind of things will often end up heavier generationally, will end up heavier, and this kind of supports that. But you know what's so interesting. It's not seen in the grandchildren of undernourished mothers. Only fathers make that make sense. Only fathers, not mothers.
Don't forget. These were the children of people who were experiencing famine. They were born during the famine, but it was they didn't experience the famine personally. They were born to parents who were experiencing the famine. So the grandfathers passed it down. But the grandmothers didn't make that one make sense. Transgenerational epigenetics, fascinating stuff. We, of course, don't know much about it at all, but I always just love learning about this stuff. This stuff kind of just excites me. I don't know. There'll be other people out there that will find it interesting, and there'll be other people. People like what the fuck Asher, who gives a shit.
Okay, ask me anything. What steps can I, as a healthcare professional, take to move away from from stigmatizing patients, and especially when it comes to nutrition and weight.
So I didn't ask that. It was kind of a really long question, and I tried to abbreviate it, and it made it worse. Never mind. So I really like that you've asked this question, and that you've acknowledged that we grew up in a culture of weight stigma, and that we are used to stigmatizing our patients. And I'm really glad that you're trying to take a step away from that, and acknowledging that it's not that easy, and that it takes some time, and you specifically asked about the language.
So I, and in particular, when discussing nutrition and weight. So first things first is, I don't believe in discussing weight ever, but you know that's obvious. But when we're tall, let's make it - lifestyle factors. Let's talk about diet and exercise in particular. How do we steer clear of stigmatizing language? Well, first of all, if you have to remember that our job is to provide information, not to judge.
And so every you know, you need to ask yourself, am I judging this person? Ask yourself honestly, am I? Am I judging them? And chances? Are you probably? Are we all judge people. And so it's okay. But you need to start asking yourself. And then you have to remember in the consulting room in this office. It's my job to provide information. I cannot provide information until I know what information I need to provide. So the first thing you need to do is ask.
You don't want to be talking to people about diet if you haven't asked them about their diet first. You must ask, then then you can talk. So it's listening first, then talking. It's about recognizing whether or not you are coming from a place of judgment and all, and correcting that, and just, you know, remaining neutral during this consultation, providing information in a completely neutral way, using neutral language.
Don't talk about bad food, junk food, you know, fast food, anything that sort of has negative terms. Food is food. When you're talking about nutrition, you can talk about like the benefits of good nutrition, of balanced nutrition, of enjoyable nutrition, enjoyment. Food is enjoyment. You can talk about movements, and you know there are just certain words that you can use that I think are much more neutral and perhaps even positive, because if you want to encourage people to adapt their lifestyle, for example, then you want to sort of make it sound positive. You don't want to focus on the negative. Don't do this and don't do that. You want to be like, well, you know, if you thought about doing this and doing that, and it should be fun and enjoyable.
And I think I think it's really important to practice like in front of a mirror or like you can write your own scripts, or like I really did like have to learn this stuff. I think that the best way to practice is with ideally with fat patients who are willing to let you practice on them. But that's not always very practical. Don't forget there is the association of weight and size, inclusive medicine, also specifically for healthcare professionals who are interested in becoming weight inclusive. So you can practice your communication with us.
But ultimately, I actually think we need to circle back to this entire podcast which is that we've got to take the blame and the shame out of medicine, out of healthcare. And so I think that if you can reassure a person that they are not to blame for their condition, I think you're halfway there. I honestly like I don't want to speak on behalf of all patients or all fat people, but if a nurse or a doctor were to say to me, "Ashley, your diabetes isn't your fault." I would fall over.
I would fall over myself, even if I haven't sitting in the chair, I would weep audibly. There would be snots if one of my doctors, nurses, whatever were to say that to me and mean it. That like that would change my life. It would be a life-changing experience.
So just taking the blame and shame out of again is probably a really good start, and that's something I try to do, you know, especially when people bring their weight, I'm like, "Oh, no, it's not your weight that's not weight. Let's not blame it on your weight. Come on, now you've got nothing to feel sorry for. You've got nothing to be ashamed about. You shouldn't be blaming yourself. This isn't something that you could have controlled." I will say these things repeatedly to reassure patients that they are not to blame for why they're here, and I think that that makes a big difference.
You might have another opinion. Listener, you might be thinking, I think you missed that out, or I think you needed to do that, or you should have done this. Fair enough. Please just get in touch. Get in touch. I love to hear from you. If you've got more questions, I want to hear them.
So actually today, at 5 pm, so today, if you're listening on the day that I have released this, it's weight inclusive Wednesdays, yeah, I did it again I did it again. I went for some illiteration, this time, weight inclusive Wednesdays, so weight inclusive Wednesdays is a private, confidential, safe space that I am hosting and facilitating on Zoom on the second Wednesday of every month at 5 pm. It is for members of my masterclass membership. It is for members of my no way membership. And it's for anyone else who wants to join in as well. There's usually a theme for each month. But we can talk about absolutely anything. We're there to support each other. There is. It's not recorded because it's confidential. So you come if you can, and if you can't, then you can't. And yeah, so it is today at 5 pm UK time. So if you want to know more about that, you will have learned about it in my healthcare - my No Way Newsletter, which you get every Friday. Now I've done the 3rd one.
Did you enjoy it? What did you think I've had some really good feedback. Actually, I've not done newsletters before, so this is quite good fun. But yes, I did mention it in that newsletter. If you're not signed up to my newsletter. If you're not getting my emails regularly, you're going to miss out on some of this stuff all this stuff available, and I don't want you to miss out, so please make sure you're signed up, and it'll be in the show notes your way to sign up to my newsletters.

And I'm trying to think of anything else is going on this week. The theme for this month's masterclass was idiopathic, intracranial hypertension, and that's been released now, the masterclass is on there. So if you're part of the masterclass membership, you can find all about find out about Idiopathic intracranial hypertension, and if you happen to have IIH and you're thinking, "Oh, that's me. I have that. I really want to know more about it in a weight, inclusive, non-blamy way." Then masterclass membership folks. What can I say?
I've also released this month's No Way chapter or the beginning of the No Way chapter where we were talking about how weight loss doesn't prevent illness, and we focused predominantly on diabetes, high blood pressure and cholesterol. So if you're signed up to the No Way membership, then make sure you catch that, it's video, and you can get the slides as well. And then, of course, I'll be sharing my first draft of that chapter later on in the month.
So yeah, hope you've had a good week so far. I mean, I'm obviously recording this in the past. The world could have ended by now, who knows but I hope you're having a good-ish week, or at least that you're having a week, and I look forward to hearing from you and see you next week.