S02E02 Transcript: Dr Joshua Wolrich on Nutrition and Stigma

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intro

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Gemma Styles: Hello, I'm Gemma, and welcome to another episode of Good Influence. This is the podcast where each week you and I meet a guest, who will help us pay attention to something we should know about as well as answer some of your questions. Before we start, I want to let you know that this episode discusses topics that some people might find challenging. If you think that might be you then check the show notes before listening. [CW: This episode features discussion around food, weight stigma in medicine, dieting, mention of calories, disordered eating and other related topics. If you need support please click here for support resources from Beat.] Please do look after yourselves. This week, we're talking about nutrition and stigma, how weight stigma affects society and medicine, the origins and problems with using BMI to determine health, and what doctors might sometimes be missing about our relationships with food. Joining me this week is Dr. Joshua Wolrich. Josh is an NHS doctor and the author of best selling book Food Isn't Medicine. He dedicates a lot of his time online to debunking bogus claims about nutrition, or as he calls them nutribollocks. And helping people sort of fact from fiction when it comes to diet claims we've all heard.

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Dr Joshua Wolrich: It all boils down to this this thought that our health is completely under our control, and that our health is a personal responsibility. And it's not.

discussion

Gemma Styles: Well, thank you very much for coming on the podcast!

Dr Joshua Wolrich: That's all right. Thank you for inviting me. Nice to chat.

Gemma Styles: Yeah, I'm excited to chat to you. After Yeah, reading your book very recently, and then immediately, almost forcing it into the hands of my friend Liv to be like, you need to read this book. Everybody needs to read this book. I was very, very excited by what I felt I learned from it.

Dr Joshua Wolrich: That's not to say that that's what I'm I'm loving hearing those I was, I was always slightly worried when kind of writing it releasing it that it was, I was going to be proud of it. But no one else is going to really care. You think of these things of the things that you create, don't you but hearing people passing it on is like really means a lot to me. That's, that's that's what I always wanted. Like if I had to, if I had to have said, What did I want the most it would be for people to read it and then go, you read this too. This is good. Like this is this is great. So that yeah, that's exciting to me, I like that.

Gemma Styles: So we’re obviously talking about your book, Food Isn't Medicine. And you are, of course a doctor. But could you maybe tell us a little bit more about your background and how you came to be so passionate about sort of dispelling these myths around nutrition and food?

Dr Joshua Wolrich: Yeah, well, how far back do you want to go?

Gemma Styles: How far back do you want to go? [both laugh]

Dr Joshua Wolrich: Well, when I was six… [laughs] but I might touch on some of my kind of early teenage years because I think it's it's relevant in terms of what where I've come from and kind of why I do what I do now. But I think from a social media perspective, I started my kind of social media accounts and getting involved in kind of online spaces, just out of medical school. And it wasn't- for people that don't know me, but kind of roughly know I talk about now it would be it might be a bit of a surprise to know that it started as a as a full on weight loss account. And I had grown up a larger kid than most I'd gone through medical school, being classed as obese on the BMI scale and believing that when I left, I was I was kind of I was going well, I want to be a really good doctor. Like that's kind of the point I was like, I'm not, I've gone through all this stuff. I'm revising for these exams. And I was like, I feel like my weight is holding me back. And I thought that being fat meant that I couldn't be a good doctor. And I'm not really entirely sure where that had where that had come from. I wasn't entirely sure how that had become ingrained. I know that I’d internalised a lot of the stigma that I'd received over the last kind of decade around my size, starting to believe that I was lazy, starting believe that I wasn't worth anything, that I'd never have kind of long term relationships even though I was in a long term relationship, because that makes perfect sense, doesn’t it? But it kind of spilled out into believing that I therefore couldn't give health advice because I thought well, it makes me a hypocrite. And it was it- looking back on it. It's really sad that that was the that was the feeling that I had. But it became this weird motivation of like, well, if I'm going to be a good doctor, then I have to lose weight. I owe it to myself I owe it to my patients. It was, it was, it was not fun.

Gemma Styles: It doesn't sound fun.

Dr Joshua Wolrich: Well, it gets better! I started the — well I'd say better at a slightly a British sarcastic way — but um, I started the the social media account, essentially to capitalise on using shame to keep me accountable, which again, that's what I meant by it gets better. [laughs]

Gemma Styles: It makes me hurt for you to hear it.

Dr Joshua Wolrich: It's just, I mean, I'm not the only one like it's you know, I know, on social media saying it's what weight loss accounts are like if we're honest, like it's, it's I'm going to post really healthy food, because I want to I want to make sure that people know I'm eating Good food. And if I eat something bad, I'll post about it. And then people will tell me off. And then I'll remind myself, I shouldn't have eaten something “bad” in quotes, obviously. I mean, it was all a lie, because I just didn't post the stuff that I thought I was going to be condemned about, right, like, so I did. It was so… from going from, from starting thinking I was a hypocrite for being a fat doctor to actually being a hypocrite online, was the irony there, just going What am I doing? So yeah, I created this account, it was called @unfattening, I thought I was really clever in terms of the name. And I went down these routes of, of essentially, hiding some really disordered eating behaviours that I was, that I developed that I was kind of undertaking, because I thought that losing weight and being thin was what I needed to achieve at all costs. And, like, I felt like my career rided on it. And I got to a point where I just had a really crap relationship with food. Like, it wasn't, it wasn't good. Every every decision I made around food was based on fear. It was all based on whether or not I thought it was gonna make me fat. It was based on whether or not I had, it would fit within my calorie counting for the day, or for the week. It was incredibly stressful. And I started coming across accounts that talked about actually, the relationship with food being a thing, because I hadn't really thought about that before. I just thought of food as food, I didn't think about having relationship with it. And these accounts, were talking about low calorie ice creams and items that I just, in a way that I'd never thought about. I'd always thought of things like low calorie ice creams as being amazing things. They were like, yeah, this is these, this is nothing but good. It's perfect. I can eat ice cream, and I won't get fat and I don't have to feel guilty about it anymore. And these accounts are going well. Why are you feeling guilty in the first place? Like why? Why do you need to replace an item of food with something else that that is only okay for you because it's labelled as low calorie? Why are you being encouraged to binge eat and eat the entire tub of something? Because you “can”. You're allowing yourself to in quotes, when actually it would you'd have a much better relationship with food if you were eating in moderation and respecting your fullness around normal ice cream. Like, why why are you placing this on a pedestal to the other? I was like No, I don't like this this line of thinking I don't want to admit it.

Gemma Styles: That’s uncomfortable!

Dr Joshua Wolrich: Yeah, yes, I this is this, No, thank you. But for some reason, I, it resonated with me, I couldn't ignore it. And I, I accosted people who were talking about this stuff and went and met them. And, and, and I slowly fell into this thing of Actually, you know what this stuff matters, this stuff is really important. And I also then started challenging my beliefs that had become ingrained around my weight and around what that meant, in regards to whether or not that was the defining factor in my health, whether it defined my worth. And it's, it's been a wonderful if not stressful journey, since then, and one that is one that is still continuing. But it's it's one that shapes my my work online, it's one that and I do kind of think of it as work now rather than just having a social media account, because this stuff is… this stuff challenges people's preconceptions around their health and their and their food. And I think this stuff is is really good to be having conversations about. And essentially, that's what my book is, with the added nuance of, you know what, I think there's a theme here as to why we treat food, why we put food on pedestal and why we believe all of these lies around food when it's not just comes to our weight, but comes to our health. And I think that that that statement of ‘food is medicine’ is one that that goes throughout this, which is why I called the book Food Isn't Medicine, half semantics and also half like this is an important thing to be talking about.

Gemma Styles: Yeah, I mean, while we're saying that, do you want to give a small overview of you know, what do you mean, when you say ‘food isn't medicine’? What are you trying to break through with that title? What are we getting wrong?

Dr Joshua Wolrich: When I say that a lot of people go well, but food is can be really good for us. And I'm like, Yeah, no, we can No, that's fine. Like it's this, this statement of food isn't medicine isn't meant to disregard the impact that food can have. And that food can be really, really useful. And food can even in some circumstances, potentially be therapeutic in the way that it gets used. But it's not medicine. There are some very, we can go into kind of the semantics of specific definitions of medicine. But actually, I think the more important conversation is, what does that phrase food is medicine actually lead to? Because it doesn't lead to people having a newfound respect for food and having an understanding of what food can do in context of the wider narrative and how our food and how our diet patterns are important, things like that. It doesn't do that. What it makes people think because it makes People think that food can cure you of stuff. It gives people this assumption that food can be like medicine, because the statement is food is medicine. And so it makes us think that we can replace drugs with it, it makes us think that we can replace traditional medicine with food, rather than an understanding that they can go hand in hand. And they can go side by side, but one doesn't replace the other. And I've seen and I continue to see an awful lot of the misinformation that gets spread around food and our health, relying on this fact of food as medicine. If we just take if we take some of the some of the more extreme, but I think it is important to address some of them because they are real, and they're there. We talk about things like celery juice curing cancer, or detoxing your liver or curing skin conditions. To believe that you kind of have to believe that food is medicine, if you realise that food isn't medicine, but it's important than that, the whole celery juice curing you just doesn't make sense anymore. Like it's, it's, it relies on that being true. And so that's was one of the reasons why I think it's so important to challenge that because there's so much harm that gets done, not just online, but also just between friends when you're trying to share things that you think are right and it, you know, you're trying to you're trying to help other people, but it's coming from a place of not really understanding this this in a wider context. And, and you go well, actually, you know, I've, I've been taking turmeric supplements, and they're really good because they reduce inflammation. And so you should probably like recommend them to your mother because she's got arthritis, and that'd be great for her and, and it just it just escalates. And before you know it, you're no longer just taking turmeric supplements, but you've you know, you've you've got this lump on your thyroid, and, and then you go and see somebody and they recommend that you change your dietary pattern because actually food is causing your thyroid issues apparently, and, and it becomes so easy to believe this stuff. Because we start we start with a little a little pea sized like lack of nuance lack of understanding, lack of context. And suddenly it balloons into this thing of believing that food can replace medicine. And that's kind of one of the reasons why I say like, it's it's half semantics, it's half not because people will go that's not that's not what I believe when I say food is medicine. That’s great! But that's what people are picking up from it. And that's, you know, we might get to a point in the future where that phrase doesn't mean, doesn't matter. We could use it. But not only do I, I believe it's just inaccurate, but it's causing a lot of harm. And if things are causing harm, the outcome matters more than our intent. Like, I would argue that till the cows come home, like it doesn't add a bit like my name, like my original Instagram name being @unfattening. There was a point where I wasn't talking about weight loss anymore, but I still kept the name because I was like, well, it's, it's attracting the right people. And I liked it. And my ego didn't wanna let go of it. And I had to kind of go, Well, actually, what is it causing? Like, it doesn't matter what my intent is, my intent wasn't harm at that point. My intent wasn't to actually make people think that unfattening was the ultimate goal in life and fat was bad and unfat was good and all that. But that's what the name insinuated. And so my intent kind of became irrelevant, versus well what's the outcome and Okay, well, I need to change what I'm doing. And that's, that's the conversation I'm trying to have around the way we talk about food and when we talk about health, because I think it's really important and I think we've we've we've got down to this wellness narrative. Now even something as simple as drinking water has become like capitalised on in terms of like, becoming this wellness trend. And it's so ridiculous, like, it's just water! [laughs]

Gemma Styles: Yeah it’s, it is a funny thing, the water thing does in a weird way make me laugh now, because it has become this odd thing that's like a symbol of wellness. And yes, being hydrated is good for you. And yes, drinking enough water is good for you. But it's become this kind of weird internet thing now that I find that even if you'll get like random, you'll get like a message from someone and they'll be like, hey, hope you're having a good day, make sure you've drank enough water and it's kind of like synonymous with like, take care of yourself. Now it's this whole hydration cult.

Dr Joshua Wolrich: It's weird, though, right? And it’s something as simple as water. And yet, it's just, it is the way that we think about our health and the way that we think about our bodies. And it's, I think that all of it boils down to and I perhaps could have called the book this as well. But it all boils down to this, this thought that our health is completely under our control, and that our health is a personal responsibility. And it's not. Like that might sound quite scary for some people, but it's but that's actually a really good thing. The main thing that defines our health and how long we live, is who we were born to, and where in the world we were born. And we don't like to admit that but it's true. Like and it's you know, I can do as much health seeking behaviours, health promoting behaviours as I like. But the main thing that's going to define how long I live and how well I do is because I was born in into a white middle class family and and that's that, you know, we don't talk about that, but we like to talk about- keep hydrated!

Gemma Styles: Yeah, and I mean, that's, that's not comfortable either. For a lot of people, we don't like to give up that level of control. And we've have always been told that, well, it's “you are what you eat”, isn't it, this is what we've always been told, you know. So if there's anything wrong with you, it's your fault. And it's not great is it, it's not a great place to be.

Dr Joshua Wolrich: Obviously, all of that stuff brings with it a lot of guilt and shame. And that stuff in itself is really, really harmful. But then out of that, gets birthed this this thing of, well, now we can sell you something to help you gain that control back. And that's where it becomes a bit sinister, where, where we need to challenge both. And I think challenging, the crux of it is really important. And that's a lot of the reason why I'm having these conversations around weight and health as well, because I think a lot of it is so wrapped up around what we believe around our body size. But at the same time, that's, once we start challenging that stuff, we realise how all of this, all of these, these charlatans actually are able to take grip and go, Well, let me sell you my plan. Let me sell you my new, my new solution to your autoimmune disease, or let me sell you this this new solution to cancer that doesn't involve you having to have horrendous chemotherapy. But you know, obviously, it's crap. Like you don't even want to unless you had to. But it's but but it gets birthed out of that. And yeah, I think that the water wellness stuff kind of just fits in weirdly to that whole narrative as well.

Gemma Styles: Yeah, yeah, you can see how it gets there. And it kind of leads me into the rise of these wellness gurus, if you like on Instagram, or TV or wherever else who are kind of dishing out these claims to people. Let's, let's discuss a little bit about one of your favourite online pastimes, I would say, which is challenging the claims of some of these online people and trying to kind of like break through the myths. And people don't like it, because they're trying to sell you something.

Dr Joshua Wolrich: Well, that. Yeah, that is that is a common theme, unfortunately, is that the I mean, the internet is a wonderful place, it can be an incredible place to, for community and for for kind of reaching out and finding support around things and, and help and things around like chronic conditions. I've seen a lot of there's been there's amazing communities around things like lipedema, around kind of autoimmune diseases, it's amazing. But at the same time, it's also this, it's this new and it is still new, although we kind of feel it as having always been there now. But this, this new phenomenon of giving everyone a platform. And we I mean, we I don't want to sound like I'm making out that people shouldn't. But it's it means that there's so much more potential for harm when people use that platform to talk about things that they not always deliberately but don't realise aren't true. We, we find it very difficult to distinguish between who is trustworthy on the internet. Having a title doesn't always mean something anymore. And I try my hardest not to, not to play off the fact that I that I have a doctor title too much, because I think that this, this kind of authority bias that is often used where, well, I'm a doctor, therefore you must listen to me. Ironically, the people I think causing a lot of harm around this kind of space are people who do have titles like that. And that was one of the reasons why I grew when I first started an Instagram, even though I was, you know, misleading people by not showing my disordered eating habits in the background was because I had the word doctor, you know, in front of my name. And so people were like, oh well, I can trust him. But it's… I think I think these, it's hard to kind of know how to talk about these conversations, because everybody has a, everybody has an opinion around this stuff. And it doesn't mean that people's opinions aren't valid. But I do think we need to be cautious about about what's known as this whole upward social Comparison, where before the internet came along, we used to compare ourselves to our peer group, we used to kind of look at look at like our town or our or our like village and wherever we used to live or our community and, and the most kind of attractive person in that community was the person we’re like ooh they look great, I want to look like them or you know, the person with the most defined abs, oh I want to look like them. And now we have the whole world to compare to. And it's led us to this very strange situation where we think that somebody on the other end of the world who has ridiculous genetics, who, you know, like just just looks the way that they do. We think that that's what we should look like. And it's become so visual because of the internet too.

Gemma Styles: Yeah.

Dr Joshua Wolrich: And I know I've steered away from the whole food and health advice but bringing it back in that desire to look like a certain way, I think has fed a lot of the information that gets spread. Because people don't realise just how much of an impact things like genetics and, and stuff that's out of their control has. And so they think, well, I want to share what I'm doing because I look this way, everyone's always asking me, how do I look like I do. And well, this is what I eat. So I'm going to do what I eat in a day, and I'm going to share all my food meals, and I'm going to share my exercises. And it's, and we just we feed off it. And people make money from it, people do really well, really well. And so it's super easy to go from this is my exercise plan that I do to, and these are the supplements I take. And this is the way of eating that I've chosen to do. And this is how few carbs I eat. And it just yeah, just, it escalates so much.

Gemma Styles: It snowballs.

Dr Joshua Wolrich: Yeah, yeah, we do need to challenge it. We really do. It's just, it's so hard. And I don't know, I actually don't know, I don't know if I'm doing it in the right way. I don't know how people are asking me how am I I don't know, like, I just, I think we need to be asking questions. And when we're confident about something, then then challenging it is good. But there are so many things I don't challenge. And I don't think people quite realise that. I hold back on an awful lot of stuff. Because I don't feel confident enough to have those conversations around topics. And I and I don’t want to sound big headed. But I think that's something we don't quite do enough where we, which we get involved in everything.

Gemma Styles: Yeah.

Dr Joshua Wolrich: And, and we end up getting to a point where we don't actually know how to talk about something anymore, because we didn't actually know as much as we thought we did. [both laugh] And so I think we need we need to pick our battles, but we need to, we need to challenge stuff within our lane that we do know about because not challenging it is it has led to where we are at the moment. So yeah.

Gemma Styles: I mean, that leads me quite nicely into very specifically in your lane, in the lane of medicine and doctors and people who are in charge of our health a lot of the time. So when we're talking about, you know, the beliefs that you had around food and the relationship that you had with what you were eating and what you weren't eating. That was that was still the case, when you'd finished medical school. So you were a doctor by that point, which then kind of leads me into the thing of… do doctors not always know what they need to know about food? And I don't I don't want to say that in a negative way. Because obviously-

Dr Joshua Wolrich: No no, valid question!

Gemma Styles: - doctors do an incredible amount of training and are wonderful people generally. But I know that you are now doing further study into nutrition, if I'm right in saying that, specifically nutrition.

Dr Joshua Wolrich: Yeah yeah.

Gemma Styles: Do you… Is it right, do you think, that that is a specialty in itself? Do all doctors need to have slightly different training around nutrition? Is there something missing at the moment from what we're maybe getting from our doctors? Because I know that it's a very common situation and a common question around weight stigma in the field of medicine and how that then affects the care that people get. I feel like I've probably asked you about six questions in one.

Dr Joshua Wolrich: Yeah, there's two topics there. No, no, no, that's good. So there's a conversation around the training that doctors get in regards to nutrition. And then there's there's a separate conversation around weight stigma. And there is a link between the two. But I think they're they're broadly two different topics. So to take the take the nutrition one, it is a common thing, right? where people are going well, what do you mean, doctors only have this much training in nutrition? That's ridiculous. You do tell me they don't know about food? And like, yeah, like we actually don't have that much training in nutrition. And I talked about this in the book in the sense of, I'm not sure it's so clear cut in regards to whether or not that's a bad or a good thing. And the reason being is because we kind of assume that anything that has to do with health, doctors should know about. But but but there's only so many years of medical school that we can do. And if we're going to take all of the time to learn all of these different pathways in the body that all the different drugs and metabolites that affect just, let's just take one organ, the thyroid, like if we learnt taking all the time to learn that there is so much to learn, so so much. And that stuff, actually, when it comes to working in the hospital, and dealing with disease, that stuff is more important to know. We don't like that because again, we have this assumption that food is medicine and that we should be able to — that food should actually be the most important thing in all conversations and that's an issue in and of itself, but there are such things as dieticians and nutritionists, like they are, they are a profession, and they are a very important profession. Just like, you know, so my partner is a physiotherapist. And we learn a little bit about physiotherapy at medical school. But we didn't learn loads. But nobody's kind of coming up to me and going well, what do you mean, you don't know what exercises to give me? Because my, you know, because of this particular condition, but you're a doctor, you should know, like, Well, no, because that's not my that's not my job role. I need to know enough to be able to have an idea as to when you need referring to a physiotherapist, right, like I need to know enough. But not too much that I think I'm the expert, and you don't need referring. And that's one of the issues that's currently going on where there are lots of doctors that are learning a bit about nutrition, and suddenly believing that they don't need any help. And suddenly thinking one now I because we like, people might not like this, but I felt like I can say this, doctors have big egos. As a statement in general, that's a pretty solid one.

Gemma Styles: I feel like I watch a lot of medical dramas even [both laughing] and I feel like that's, you know, what people say like, to be a good doctor, sometimes you need a big ego, because you've got — you're saving people, that's what you need to do.

Dr Joshua Wolrich: Yeah. So like some of it, I think comes out of a protective nature of, you're making decisions sometimes that are incredibly stressful, and you can get wrong. And unless you have some form of ego, you almost can never make those decisions, because that's a lot of pressure and a lot of fear. And so if you don't have enough belief in yourself and belief that you're correct, then actually you end up being kind of almost frozen in not being able to make any decisions. So I think some of it has been born out of that. But also, I think it just gets born out of the fact that we feel like we're I don't know, maybe it's the type of personalities that attract get attracted to studying medicine in the first place. I'm not sure I'm not going to get myself in trouble with other doctors. But we do, we have big egos. And so when we start learning about something, we then think, Oh, well, we're really clever. Like we've done medicine, like we've learned about science, we know how to read research papers. So now I know about nutrition. And I can, it's great because my my patients love it when I talk about food because it's so much nicer than drugs. And what I've read so far has kind of made me think that food can be medicine. So this is great. And now I'm a nutritionist, and I don't need to refer, I don't need to. And actually, every other doctor should know about food too. So I'm going to now talk about how it's a really bad thing that we don't teach medical students about nutrition. And this is really bad. And it's a failing of medical school. And, you know what, I'm gonna go and teach everyone about nutrition, because because I'm the right person to do that, right. Like, I'm a doctor. So that's one of the big problems too, is that we like to hear and learn from other doctors, that's kind of like a thing in medical school, is that it's doctors teaching doctors, there's a big teaching mentality. And that's great. But not when it's not your specialty. And there are too many doctors starting nutrition courses that haven't had proper and official nutrition training. And they're going and they’re teaching other doctors about food without an understanding that it's a completely different scientific discipline, whether we want to believe it or admit it or not, you can't, you have to know how to read nutrition literature and nutrition research in a different way. It's not the same thing. You can't just take somebody out of medical school, and give them some nutrition papers to read. And then they’re a nutritionist. It's a learning process. It's a learned science. And so I think we we do need to be teaching medical students a bit about nutrition. But I think that we need to have dietitians and nutritionists teaching them, first off, that's really important. And I think we need to teach them in a way that gives them an understanding of the complexity here. That actually and a real, almost like a bit of fear, they need a bit of fear instilled in them as to food is good and it's important, but you know what, you can do a lot of harm here, if you don't recognise not only people's relationship with food and the impact that your advice can have. But also the way that you might lead people down a path that is, you know, there's a reason why no dietitians use the phrase food is medicine. Like there's a reason that doesn't get used within the professional people who have actually trained in it. It's just doctors saying that. So, yeah, that would be — I don't know if I really answered your question but like

Gemma Styles: No, I think you did.

Dr Joshua Wolrich: There's some issue there.

Gemma Styles: Yeah, there definitely seems to be something going on. I mean, and that's even, you know, from my privileged position of not being someone who's ever been sent away from a doctor and, you know, told, oh, you just need to lose weight, for example. It's very confusing and people, you might not always know where to start. And if that like blanket advice from a doctor and it doesn't take into account like you say, you know people's relationship with food, it doesn't adequately explain what's going on there. I don't always think it… I don't know, it's it feels like a difficult, difficult area.

Dr Joshua Wolrich: Yeah. Also well, this is where I think there's been a link between this conversation around nutrition and the, the blanket prescription of weight loss, weight loss advice that happens within within medicine. We practice medicine in this country and and relatively globally in a very weight centric manner. Which means that we we considered weight to be one of the most important factors about our health. And we often think of it as the first thing to look at and the first thing to change when it comes to our health. I mean, I'm going to go, I'd say, go out on a limb here and say, I think this is wrong. Like this is not the way that I believe that medicine should be practised for many reasons. And this is irrespective of whether or not weight and fat tissue might actually be having an impact on your health, because I'm not here to kind of go down a route of going well, weight can never impact health because it can do, but this is actually not the point of the conversation here. The point of the conversation is well… and then what? What do we do next? And what is the advice that we're giving? And are we actually doing any good through this advice? Or are we doing harm? We have a real… we have a problem within the medical community of stigmatising patients for their size.

Gemma Styles: Yeah.

Dr Joshua Wolrich: Both deliberately, and consciously. And unconsciously. There's both, there's bias on both sides of the spectrum there. Conscious in the fact that we've grown up in a society whether we're doctors or not, that glorifies thinness, that puts it on a pedestal that makes it something that should be that is seen as something to attain at all costs that it's like, this is what you're This is what your purpose is in life almost, for some people, that's the way that they see their relationship with their body and what they look like. And we also have this assumption that weight is really easy to control. We see it as something even though it's obviously not. Even though it's so clear that it's not, for some reason, we just we don't want to believe that. And we, we treat it as something that is a personal responsibility, and is easy. And neither of those things are true.

Gemma Styles: No.

Dr Joshua Wolrich: And there might be people listening who are like, what? What do you What do you mean, because this is this is a new thing for some people. And that's perfectly fine. It's a shame that it's a new thing. But just just to kind of touch on one of those things, then, is there is a very, very clear association between people living in lower socio economic status areas of the country in the UK, so people with, in poverty, people with a lot less privilege, a lot less money, a lot less access to things, and increasing body size. And if we're like if you're going well, so people in poverty are more likely to be larger, but this is their fault, right? Like, and this is, this is something they can change. But is it? Because there are reasons why our body size changes, and has a tendency to go up depending on about when when our amount of money and our socio economic status goes down. Because our relationship with our environment and the food that we are able to eat and the movement we are able to do and the amount of levels of stress that we have on our life changes. So you know, you're a single mother, or single parent living at home, two kids, two jobs. You get home at night, you live in an area where — we have we have issues in the UK and in many more developed countries around the world where we have what's known as food deserts, or more appropriately named food apartheids where you can't access food that you would stereotypically think of as being healthy. If you live in certain areas of the UK, it is not that you're just going well, you're just choosing to buy the wrong things know that they physically can't get to it. Supermarkets don't build in poor areas. Like there's a reason why one of the things to determine if you're privileged enough and middle class enough to be looking at buying a house. There's a reason why the prevalence of whether there's a Waitrose there or not, has a big impact on housing prices, like there's a link there between the food, the food environment, the supermarkets that exist, and the quality of the housing, the quality of the schooling, the quality of the health care, and the levels of poverty within that within that community. Like that's not, I'm not making this stuff up. You know, supermarkets aren't going to go into locations where they don't think they can make money. And when supermarkets do, they have different items of food in that store. And so we, there's so much complexity there and you could do, we could do a whole podcast season on food environments, and it's link with with poverty, and the fact that the the highest density of fast food outlets are in the poorest areas of the UK, and all this kind of stuff. But we don't talk about any of that. We don't, we don't like to acknowledge that actually, the vast majority of the weight that we live at is not under our control, because it feels disempowering. And it also challenges a lot of the stuff that we like to believe around our health being in our control. And, well, no, but I can lose weight. If I just try harder, and I just find the right diet, and I just, I just cut carbs harder this time. And maybe I'll do keto. That's that's what I didn't do right the last time it's keto is the real, the real magic. And it's just, and doctors aren't immune from this stuff. I wasn't! Like, you know, I'm not every doctor, but we're not. They've all grown up in a society where their parents have probably dieted or they've seen friends, or they've, whether they were the fat kid or not the fat kid, they've then seen fat as being something that's not good, the fat kid gets bullied, they might have been the bully, they might have been bullied themselves. This is not something that they can just escape from magically, because they're now a doctor, and they've just ignored all this stuff that's sitting in their brain from years and years of growing up as a kid and learning what self worth was. And, and then you get to medical school, and it's about health, and you go, Oh, this is why I can now justify my feelings around weight, because it's now about health. So it's okay. And, and it's one of these things where, if you can find validation in what you believe it's much easier to carry on with your life, it doesn't mean what you believe is necessarily wrong. But when it is, it's a lot easier to find arguments as to why you can just keep believing it than actually challenge it. And and, and we live in a society where weight is seen as as I said, something, we can control, something that's easy, something that causes ill health, and something that we should be doing everything in our power to change, and that filters into the medical profession. And so we lose all the nuance of, well actually, it really matters where the fat is on your body, because some fat is really protective of your health, some fat can be more harmful to your health, we lose the nuance of, well, actually, there are other things that we can do that don't have anything to do with the number on the scales that will improve your health. But weight loss is the thing that's mentioned first.

Gemma Styles: Yeah.

Dr Joshua Wolrich: But that's the problematic nature of the way we talk about this stuff. And it does stigmatise it whether we want to believe it or not, it causes people to feel harm, causes harm, it causes shame, causes guilt around what people think they look like. It causes us to have this really rubbish relationship with our bodies, with our food, with exercise, with sleep, or even with water.

Gemma Styles: Ah the circles we can go in!

Dr Joshua Wolrich: I know!

Gemma Styles: I feel like I could honestly talk to you all day about this, because there's so many different bits in your book and the factors and the learning how to sort of break down these headlines — there's so much stuff I want to ask you about one thing I want to definitely make sure we get to because I think it's something that people more generally are just starting to realise. And that's around BMI. Very hot topic or conversation and also that I had quite a lot of questions in about so I think it's, it'll be good to answer them here. So kind of as you were saying about, you start talking about weight in terms of health, and it always makes me think, you know, in any comment section of anybody who dares to be fat in public or on the internet, like anybody who dares…

Dr Joshua Wolrich: Dares to exist.

Gemma Styles: Dares to exist! You know, yeah, exactly. Any comments section, you will always have the people in there who shout and shout about how it's not about image. It's not about body image, it's about health and, you know, try and berate people and tell them, tell them about their own body under the guise of health one, you know, everybody knows, excuse my language — they don't give a shit about the person's health. If they're talking to you. They really don't.

Dr Joshua Wolrich: There's a great phrase for it. It's that it's the whole ‘concern trolling’ thing.

Gemma Styles: Yes.

Dr Joshua Wolrich: It's where they're they are, they are pretending to care, pretending to have concern, as an excuse to troll someone for their size and to and to actually belittle them and speak down to them. But it's fine, because it's about health, right? It's not about No, no, no, I think you're great. And you should be, you're beautiful, but you're unhealthy. So you need to sort it out.

Gemma Styles: Exactly that. So this was one of the sections that I- I don’t want to say enjoyed the most, but maybe it enjoyed the most? in your book was where you talked about BMI and why for the individual it doesn't necessarily work and also a multitude of studies that were included that show you know, even among larger groups of people why BMI isn't the be all and end all, I want to say, that we think is. Would you be able to talk a little bit about that…? If we even can say a little bit and not another hour?

Dr Joshua Wolrich: Yeah, I mean, I can try. It's, we like numbers, and we like scales. And we like these, we like these definitions. And we like to put people into brackets, and we like to put ourselves into brackets. But just because we like to do, it doesn't mean that it's useful. It doesn't mean that it's actually helpful. And look, the BMI itself was was never created as any sort of measure of health, it was some guy back in the 1800s, who a mathematician who wanted to look at whether there was a comparison between people's height and people's weight. Just like, you know, if you take your, if you take your foot, and you place it on your forearm, like your foot will be almost always the same size as your forearm, like, there are relationships between are the proportions of our body, and that's interesting. And the BMI was interesting for them back then.

Gemma Styles: Yeah.

Dr Joshua Wolrich: But, you know, insurance companies in the US needed a new way of charging people more for their, for their, for their insurance, and the BMI became something that was used for health. And it became adopted by medical professionals as well, because again, we like scales, we like numbers, we like being able to, to have an easy tick box of like, oh, they're under this number. Okay, cool, that's fine, we can move on to the next ‘problem’, in quotes. And it's become so ingrained in society as this thing that we just accept, like, even though we know full well that the vast majority of it is complete nonsense, like, how does it make any sense that magically from the number 24, to the number 25, you're suddenly at a point where you should try and lose weight now? Like, how does that make any sense? Like you can change, you can change BMI categories overnight, depending on how much food you ate the previous day. You know, and so and so. And so, or, you know, or how much water you've drunk or you know, how much alcohol you've had, if you're dehydrated, or whatever, you can change overnight. And so, you measure yourself, the next day, you see that number? You work out you’re like oh I’m 25? Shit, I must be unhealthy, because I'm categorised as overweight now. But that makes no sense. Why? Why is it at 25? This is not something that is reliable. And there are many reasons for that. One of them, generally, the BMI is just a measure of our weight. And that's not- our weight is determined by all sorts of different things. And we have muscle, we have bone, we have fat tissue, we have all sorts of things in our body. But it doesn't tell us where that is. And fat can be as I've said already, fat can be protective, based on where it is, fat can be potentially harmful based on where it is because fat can almost be seen a bit like an organ, where it can produce hormones, it can produce substances, and if those hormones are causing, if there's too much of certain hormones, and that will depend on where in the body it is, sometimes that can be detrimental. It’s one of the reasons why why people, when they get to a very low body fat percentage, they can often find that their periods stop, because we require fat for hormone production. So the opposite can sometimes be true. And so depending on where that fat is, if there's lots of it contains cause too many of those hormones and so, you know, it becomes something that is then might be causing some issues with with certain symptoms, but the BMI doesn't tell us about that. The BMI has no ability to be able to tell us where that fat is, it just gives us just gives us a number. And it means that there are so many people that get told to go on diets, that even if we were able to be black and white about this and go well let's let's suspend disbelief for a second and say diets work, diets are easy, diets will make you lose weight, diets will make you keep all the weight off, cool. Even if that was true, we've got lots of people who aren't unhealthy, despite the fact that they are over a certain BMI category. Yet we give them blanket advice to lose weight. And if diets weren't harmful, then maybe that would wouldn't really matter so much. But the reality is is that they often are. Dieting is not this neutral intervention that we like to think about has dieting, not only really negatively impacts our relationship with food, but it also does all sorts of things internally physiologically as well to our health to our to the way that our body reacts. There's a reason why we often gain the weight back again, because the body is, thinks that something is happening, that is bad. And hormones change and different levels of things change to try and get that weight back on because you're going, it's panicking. Because we were designed to to survive like and from an evolutionary perspective, you don't want to lose weight, losing weight would be terrible. Like we were designed to keep it on. Like we're fighting a losing battle and we'd often be a lot healthier if we just stopped trying to lose weight and stop trying to diet. But BMI? [both laugh] There are — see this is what you said about if we got another hour? This is the problem with these conversations. There's so much there. But I hope these are these are prompting things and thoughts and questions in people because that's the point here. But yeah, there's a whole, you know, if you take everybody between the kind of the category of BMI of 30 to 35, which we see as quite stereotypically, well, you must be unhealthy because that's categorised as obese. 30% of them have no issues whatsoever, when you're looking at them from blood, blood tests perspective, you know, heart rate, blood pressure, things like that. They're perfectly metabolically healthy. But we're telling them all to diet. And on the other end of the spectrum, you've got people who have what are, you know, classed as a normal BMI, and 30% of them are actually unhealthy from a metabolic perspective. But they're assumed to have health.

Gemma Styles: Yeah.

Dr Joshua Wolrich: So this reliance on BMI, does everybody a disservice. Obviously, it has more of a negative impact on those who are, who are seen as overweight or seen as obese. But actually, it even impacts people who, who don't fall into those categories, because it leads to them being investigated less. And so it's kind of in everyone's best interest to be fighting this stuff as well. You know, you think it's not affecting you, it probably is, you know, we all know that friend who we think is healthy, we think is fine, just because they're thin, it's like this assumption that they must be, but you look at what they're eating, and a lot of them that probably don't have much nutrients going in, I had that friend at school, who could eat anything they wanted, and always looked exactly the same. And they often were just eating pizza. And you know, food isn't medicine. But it can be important that if you're just eating pizza, that is, you know, where’s the veg? Like tomatoes, don't count on a pizza, can’t justify that one. [laughs] But so we make these assumptions, these assumptions go both ways. And to kind of bring it in a bit of circle and bring it home a little bit, because otherwise we could just keep ranting all over the place around this stuff. BMI gets used to discriminate, it gets used to discriminate when it comes to health care access. Be that things like fertility treatment, be that things like joint replacements, it gets used to discriminate when it comes to things like adoption, whether or not it's officially in the criteria or not. It is used, I have had many, many stories shared with me from people who have, it's very clear that the way that they have been assessed when it comes to trying to adopt is that it’s seen as a marker of their health. And so we're not going to let someone who might be unhealthy to adopt a child, we need to give it to a healthy family.

Gemma Styles: Ugh that's given me goosebumps that's horrifying.

Dr Joshua Wolrich: Yeah, yeah. You know, people will use these things to go, Well, but we want children to go to healthy families! It's like, Yeah, but the BMI is not a marker of health! And, and, you know, what, if you give what if, what if a family adopts a child, and then they and then they take up smoking? Are you going to take the child away? No, you're not. Because that's seen as a choice! Like, it's like, you know what, you know, you've adopted them now. So it's fine. Now, you can be unhealthy if you'd like, but we make these snap judgments on people based on their size. And that's not a, that's not a determining factor. That's not a judgement of whether or not that's a loving family that they might be going to and you know, it's it's, that's just one example. And it's it's more under the radar, because it's because people will deny that that takes place. And it's not officially a part of the criteria. But then you just look at something like fertility treatment. And you go and you go, there is a conversation to be had around, for some people because fat can impact hormone levels. For some people, the placement and amount of fat tissue on their body might be impacting their fertility, however, even if it is, is the solution to refuse them help and to tell them to diet? Because that makes no sense to me. Because it's not just a matter of well, we haven't found the right method of dieting yet. We're just gonna keep looking because once we found it, it's fine. We can get into lose weight, they'll magically be healthy again. And and then we can help them with fertility treatment. Bullshit. That's like, that's such nonsense. It's like, we know that for the vast, vast majority of people, their weight is not going to change drastically, it's not going to suddenly reduce because they go on a new diet. And so what we're doing is essentially permanently refusing them to have any help in a condition that isn't entirely under their control. That it may or may not be impacting their fertility, but we're just refusing help. Because we’re going well, no but you need to lose weight first. And it's it's like it's horrible. Ethically, the only way you can justify that from a moral or an ethical perspective, is if weight is a personal responsibility. And it's not. It's not even if we go to the people that I'm using the extremes, but I think it's important because it proves that proves the point. And it's relevant. You take somebody who is in a in a lot of poverty, right? Who might be at a larger end of the weight spectrum, because of a lot of factors that involve in around the life that they live, etc, etc. And you're just going to refuse them to have any sort of fertility treatment? That feels very discriminatory to me. Like, it's not that you — I don't know how that's justified. And again, I don't want people, I don't want to harp on about the poverty stuff too much, because then people are like, but, but then therefore, weight is just a poverty thing. It's not, it's just an example of how it can impact the environment we live in, and how it can impact our relationship with our bodies and what our bodies look like and things like that, because this stuff isn't simple.

Gemma Styles: I know. It's it's one of very, very many factors that you then discuss, but like you say, one podcast isn't isn't long enough to go into. I think it's, it was definitely something that I wanted to highlight, because even on kind of like an abstract basis where you can look at things and say, Okay, yeah, obviously, not in all circumstances, BMI is going to work. And people sort of have their own justifications for that. And the one you always hear is something like, Oh, well, you might, you know, tell a bodybuilder that they had their BMI is, quote unquote, too high. Because they've got a lot of muscle mass or whatever. It's like why is that easier for us to accept and not just that it doesn't work for necessarily anyone? And that that was something that I took away and felt was really valuable, because you gave a lot of statistical and scientific and backed up and very understandable reasons why that wasn't the case. And I feel like it just gave a lot more backup to be able to confidently say things like, you know, somebody who weighs more, isn't necessarily unhealthier. And that's like, that's something that we all need to know and to get into our heads to just leave people alone to live their own lives.

Dr Joshua Wolrich: Yeah, and that's, again, that's one of the to go back to one of the questions we had earlier that, like, that's one of the issues with the internet, is, I would argue it doesn't make okay. But I would argue a lot of it just comes from people's own insecurities about what they look like, and given this ability to abuse someone for what they look like when it comes to their size. With the justification of Well it's not abuse, because it's about health, it's okay, I'm just trying to help. It makes people feel more confident about themselves. And so it's often not about the person that they're attacking or talking about, it's often very much about them. And, and it's about their own insecurities with their body and what they look like and what they how they view themselves. And it doesn't give them a pass. But I think it's I think it's interesting to understand some of that stuff and go, Well, actually, we, we need to we need to start challenging this stuff, not just not just the concern trolls, who are think that they've won some argument by throwing the word diabetes around online. But actually, it's we need to start challenging this from the boss from from the ground up of going well, how do we, how are we teaching kids about this stuff? Like how are we? How are we just allowing this stuff to exist within traditional media? Why are we allowing bloody Michael Mosley yet again to do another 21 day diet programme on the BBC? Why? Like, what, why, why, why? Why are we doing that? Like, why are we doing it at the point of coming out of lockdown when everybody is incredibly insecure around their body size because the government have made a very abusive statements in regards to people's body size, and it's a “responsibility” that we have, and we “owe it” to the NHS to lose weight. Like, why why are we not? Why are we not sticking up for not just other people but ourselves around this and going, we need to cut this stuff out. We need to stop allowing people to sell their next diet book that claims to have found a solution to weight gain. We need to stop allowing people to blame individuals for their size, be that on social media be that on traditional media, we need to stop inviting people on talk shows that clearly have an a very abusive attitude towards people, but it gets views so, Oh we’ll just keep inviting him. We You know, this this goes much deeper than just than just, you know, one conversation around around BMI and fertility treatment, but but it all, it's all related. And I think I think we need to start we need to start having conversations about it, we need to start recognising that it's not okay to just keep going the way that it is. Because it's even if you completely disagree, not you, the Royal you, even if you completely disagree with me and are like, no but being fat is unhealthy. What's changed? Like what good has come out of the last 10 years? What good has this increasing narrative of telling people they're fat? And they should change it? What has that done? Has it caused any sort of societal weight loss? No. Has it caused people to have a better relationship with their food? No. Has it caused veg sales to go up and people to eat more nutritious food? No. Like, you know, the only thing it might have directly caused is ironically, more people to choose a plant, a plant based diet because they believe that eating vegan is going to cause them to lose weight. Do you know, there’s stuff — I like to be a bit inflammatory for certain things. But you know that, that that is it is undeniable. Unfortunately, it's, there are many, many good reasons to eat lots of veg, but the fact you think it's gonna make you thin is not a good one. Like, this is the stuff that there hasn't been any real good outcomes from this over the last 10 years. All it's done is made people feel more afraid to exist in the body that they have. So even if you disagree with me on the health stuff, like, like, wake up like this is not, it's not okay.

Q&A

[music]

Gemma Styles: Every week, my guests and I will be answering your questions. And the first one comes in from Trina Louise, who asks,

Is eating brunch unhealthy? I am unnecessarily woken up by my mum because she thinks if I eat breakfast past nine o'clock, I'm trying to be unhealthy already.

Gemma Styles: [both laughing] Anything to say?

Dr Joshua Wolrich: End of question. No, no, not at all. You don't need to worry about that. We get bogged down with with food timing. And I think the craze of intermittent fasting has encouraged some of that. And not a good craze. So yeah, intermittent fasting has encouraged us to be a bit more worried about when we eat at certain times and things like that. The only general advice is trying not to eat just before going to bed. Because it can be good to have a period of time before going to sleep to allow our kind of things to digest a bit before we try and actually go off and sleep and things, it can improve our sleep quality. So that's great. But it's not going to magically make things make us unhealthy. Eating brunch is fine. You can actually be a bit facetious with your mother if you like and say well look, Mum, anytime I choose to eat after I wakeup is technically breakfast.

Gemma Styles: Uh huhhhh!

Dr Joshua Wolrich: Because that is the word! It’s break - fast. All it means. So whenever your first meal of the day is it is technically breakfast. I love brunch. It's Yeah, it's great. No, don't worry about your timing in the morning. If you're hungry, eat some food. If you're not hungry. You don't have to eat unless you want to. You can wait until lunch? Like, honouring your hunger is a good thing means get back to listening to our bodies and what it's trying to tell us and not trying to fit to rigid rules just because we think that we should.

Gemma Styles: Next question is from Barbora. And she says,

I'd like to ask Dr. Wolrich what they think of detoxing, e.g. your liver. I've recently seen some quite influential model taking quite a radical approach, undergoing a colon cleanse once a year, drinking very high amounts of water, taking supplements, and almost no food for a few days, and then claiming that in a day or two, they felt amazing. I was quite sceptical.

Dr Joshua Wolrich: Yeah, you have every right to be sceptical because it's utter nonsense. At best it does nothing. and at worst, it can be really harmful. You cannot detox your body through food or drink or starving yourself or fasting or whatever you'd like to call it. It just doesn't happen. Your liver does that, your kidneys do it. Your body sorts itself out the only thing you need to detox, potentially is alcohol. But that's because alcohol is actually a drug. The ethanol is a drug within alcohol. So yeah, food is not drugs. Food is not medicine. Strange that isn’t it how it comes out full circle. But uh, yeah, you can't detox with that kind of stuff. It's nonsense. Colon cleanses, ironically, can be incredibly harmful to you. They can completely mess up your gut microbiome because you're flushing a whole bunch of stuff out. Especially the coffee enemas, that people have decided that they want to be doing. Stop it! Stop — wrong hole. [Gemma laughs] Just No, it's not. It doesn't work. Like it's just silly. And people have started to be a bit sneaky with it like oh no, you're just supporting your body's natural detoxification pathways… Look — eating food, getting exercise and sleeping, supports your body's natural detoxification pathways, not some weird juice cleanse, or, or, you know, supplement only food regime for a week. So it's nonsense, complete nonsense. But it makes people feel in control. But don't do it, please, please don't.

Gemma Styles: So you're quite right Barbora, not necessarily the one that you that you want to be following. Last question is from a listener who asked to be anonymous. And they asked,

Is there any diet you think is actually a healthy way to lose weight or a healthy lifestyle? Or are you against any form of dieting?

Dr Joshua Wolrich: So there's two things there. Firstly, I'm not against dieting, I'm against people not being informed as to what it actually can and cannot do. And what I mean by that is people have body autonomy, like if you want to intermittently fast, and, or just not eat food for two days. I'm not here to tell you what to do. But I'm here to ask you why. That's why I like to do, I like to ask like, Well, okay, so But why do you want to go on a diet? What is the reason? Do you want to do that? Because you think you need to lose weight? Do you want to? And if that's the reason, well, why do you think you need to lose weight? Or do you want to go on a diet because you want to be healthier? And I'm not here to tell your reason’s wrong. Because our relationship with our body and food is complicated. And if and, you know, you might be really uncomfortable with the way that you look. And you might feel that that is going to improve matters. And I might point out that, you know, if you ask people who — it doesn't automatically improve things, but that's a separate conversation, but usually what I’d say is, well, let's, let's focus on something else. Like if you're my patient, and you're asking advice, and I can give advice in a personal manner. Let's, let's actually focus on things that are going to improve your health. And if your body size changes as an outcome? Cool. So what? That's not the point here, let's let's focus on getting some more nutrients in, let's focus on so nutrition, let's focus on looking at your dietary pattern, if you'd like to change that. Let's have a look at what else is going on in your life. The last year and a half has been incredibly stressful. And you might think that the reason you feel unhealthy at the moment is because you've put on weight, but actually it might be because we're spending a lot of the time sitting down in front of the TV, or we haven't really been out and about, or our mental health is, is has been suffering. And they're all linked. So maybe getting a form of routine into your to your life that — and the important thing here — that isn't linked to what you look like, might be really good. That might be far more sustainable if it's not related to what you look like. Because that's that's, exercise shouldn't be purely about changing your, your your body size, we can have a different goal that isn't necessarily as problematic, you might want to get stronger, you might want to build some muscle, that's cool. We might need to look at your sleep and your sleep patterns, your sleep habits. And so you know that I think we forget about this stuff we forget about actually, well, why does weight always have to be the conversation? Why does weight loss and dieting always have to be like, the like I get I get doctors who push back? And they're like, Yeah, but but I want to be but this is about health. Okay, cool. Well, let's focus on health then! What the hell are you doing?

Gemma Styles: Yeah.

Dr Joshua Wolrich: Like, okay, cool. For some people, though, it's not about health. And it is about what they look like. And it is about their size, because because we're conditioned to think about that stuff. We're conditioned to be obsessed about that stuff. It has such an impact on our worth. And then actually, I'd go with Well, you know, what else is also incredibly useful for health? Mental health. Things like therapy, things like talking about this stuff thinking, like identifying where these thought patterns come from? Because this stuff matters, too. So yeah, I'm not I'm, again, to kind of sum that one up. I'm not here to tell you what to do. And I am, and I do care about your health. And if this isn't, this isn't like I'm not throwing away weight loss because I don't care about health. And I just and I want to, I want to be an “activist” like it's not that's not the point. It's because I do care about your health. And it's not healthy to be obsessing over what we look like and to be obsessing over weight loss being the goal for everything. Because it's objectively it's not a good plan. So let's let's work together and actually get to a place where you feel better in yourself. And if your weights changed, cool. If it hasn't, you'll still feel better. That's great. Yeah, that's the point!

Gemma Styles: Yeah, I really like that, that’s nice. It’s just so, like, this is what you wish everybody was told by their doctor and… it… isn't.

Dr Joshua Wolrich: Yeah, I would. Yeah. Because also, you know, what if we had these conversations, and we had these conversations in these contexts, in situations where weight might actually directly be having a big impact on health, we can have these conversations in far less problematic manners. We're no longer, when we no longer have all of this background noise of being discriminated for our entire lives about what we look like hanging over our head. That means that we have no ability to discern what is real and what is not anymore. We don't know what's just stigma anymore, because it's so hard to understand, because we've caused the problem like, you know, ‘we’ as in doctors, but also society, in general, we've caused this problem where we need to take two steps back to be able to go one step forward. And where we're, we're just, we're just pushing ahead, because because it feels because we don't like to go backwards. But we're never going to get to a healthy place unless we start undoing some of this stuff first. Both healthy in terms of language and healthy in terms of actual health too, it's just not going to happen. You know, things like government targets around food environment, some of those are really good. But then you throw in the whole, let's put calorie counts on every single food item in restaurants.

Gemma Styles: Ughhhh.

Dr Joshua Wolrich: We go and we go with hang on but- But food advertising like, food advertising to children? Yeah, we need to put a stop to that stuff because it is about our food environment. Putting calorie counts on on every item? What’s that going to do?

Gemma Styles: Nothing good.

Dr Joshua Wolrich: Even research says it doesn't make any difference. America’s had calorie counts on their food items for years. Doesn't make any difference. People just ignore them after a while. So so what what what do you think's gonna happen?

Gemma Styles: [sarcastically] It's almost like there's no scientific basis behind it whatsoever! [both laugh]

Remember, if you want to get in touch with us or have any questions for future episodes, email me at goodinfluencepod@gmail.com.

Recommendations

Gemma Styles: Before you go, I've got three things that I ask every guest. And that's if people listening want to find out more about what we've been talking about today? Could you please recommend us something to read, something to listen to? And something to watch?

Dr Joshua Wolrich: Uh, yeah… Read, I am going to say my book. And the reason being is that even if you don't like it, I've linked a whole bunch of other books at the end of the book as well, which I think are helpful.

Gemma Styles: Very good very good.

Dr Joshua Wolrich: So I I honestly, yeah, I honestly do think it's a good place to start. That's the purpose of me writing it. I've tried to go from a, from an assumption that you don't know anything about this topic. So So that would be my, my recommendation to read. It's called Food Isn't Medicine, sold at all good bookstores, and something to listen. So you're just going to be big headed again. But I would I would like to plug my podcast because it's called Willing to be Wrong. And I'm trying to have conversations like this. So conversations around these topics, talking to people about their background, their relationship with food, their relationship with their body, things like weight stigma, things like conditions like lipedema, that aren't talked about very often. Things like the way that food can be sold as a cure for things like multiple sclerosis. And I don't think these topics are talked about very much. And so I think that these are — we don't pretend to have answers. It's asking questions. And I do think we need to do that more.

Gemma Styles: Yeah.

Dr Joshua Wolrich: So that would be my my thing to listen thing to watch. [laughs] I don't know… Less TV. Can we go the other way around?

Gemma Styles: [laughs] I mean Yeah, of course!

Dr Joshua Wolrich: Can we just go? Things to watch? Less TV. Let's let's let's stop watching the the the barrage and slew of dieting programmes that keep coming out at the moment. And instead? I don't know. Let's Let's read a book. Let's go outside. Let's, you know, let's let's chat with a friend. Like, I don't know, I think. Yeah, that would that appropriate. It sounds like a really cheesy thing to say. But, but I think we watch a lot of stuff already. [laughs]

Gemma Styles: Yeah. Yeah, no I get what you're saying in terms of, you know, if you want to watch something that's related to weight, maybe just… don't? Like I do, I get what you're saying in a weird way.

Dr Joshua Wolrich: The problem is, is it's it's there's not much out there that isn't, that doesn't, that doesn't put weight loss on a pedestal. Yeah. And, you know, because weight loss sells. So, you know, I'd love I'd love to see programmes where we talk about health of people without weight loss being part of the conversation. I would love to see that! They don't exist yet. So So yeah, I think I think it would be good. Just avoid all of the health documentaries on Netflix as well. Just like so, that's I mean about not watching things. It's probably better to avoid some of them. Because they're not, they’re, a lot of them are really problematic unless you have a good background as to being able to, to see some of this stuff when it comes up. It's very easy to, you know, TV, and film and documentaries can be very well laid out, they can be very persuasive. And they, they touch on your emotions. That's why we love film so much. But, you know, it means that it's hard to be able to separate fact from fiction a lot of the time, and we leave with a certain feeling at the end of a programme without remembering. Yeah, but hang on a sec. Didn’t they say that? And that sounds like nonsense. Like you just you don't remember that because you leave going, Oh, that person was so happy when they lost weight. I should probably do that. And it's we forget a lot of the stuff around this. Yeah. So less, let’s watch less.

outro

Gemma Styles: Thank you for listening. And thank you to Josh for joining me. If you enjoyed the episode, I'd love you to subscribe to the podcast on whichever platform you're using. And if you've got an extra minute, you can leave a rating and a review as well. Your reviews make a big difference and help other people find the podcast. See you next week!