How Not to Lose Your Mind

1. Fat-shaming contributes to poor mental health. Weight-based stigma was associated with increased scores of depression in individuals with obesity [1]. Unsurprisingly, weight stigma has also been associated with increased body dissatisfaction, and decreased self-esteem [2]. 

2. Fat-shaming works against weight loss on a metabolic level, and may contribute to chronic disease. Exposure to weight-based stigma and fat-shaming statements has been shown to increase cortisol levels. Cortisol is a stress hormone, and has been shown to inhibit weight loss. It also works against insulin, thereby increasing blood sugar levels. [3, 4]

3. Fat-shaming makes people exercise less. Research has shown that the more weight-based stigma people experience, the more they avoid exercising [2, 5]. There is no evidence that shaming people for their weight motivates them to exercise, and in fact, it seems to do the opposite. 

4. Fat-shaming makes people eat more. Exposure to weight-based stigma leads to increased caloric consumption [6, 7]. This directly challenges the notion that shaming individuals to lose weight will have any sort of positive or motivating effect. 

5. Do you really need a reason to be kind? Fat-shaming has been associated with a myriad of negative effects on mental and physical health, and has never been shown to have a positive, motivating effect on individuals. Most importantly, though, all people are worthy of respect and should not be judged, shamed, or pressured to act differently due to their weight or appearance. 

The next time you’re thinking of making a comment about someone’s weight out of a desire to ‘motivate them’, or supposed concern about their health, consider the points above. You’re only doing harm to people’s mental and physical health when you engage in fat-shaming behaviour. 

References are included below the break, and I’m happy to chat about any of the above in more detail on request. 

so I’ve decided to compile a non-exhaustive list of things NOT to say to foster parents! these are all things people have said to me; I didn’t make any up to extend this post.

What happened to them/Why are they in foster care? Bad stuff. Bad stuff happened. If a kid is in foster care, it’s because bad stuff happened. The details are not your business. 

Were they born addicted to drugs? For some reason, people ask me this all the time. Too much media coverage about this particular issue, I suppose. This is not your business.

Are you going to adopt them?/You should adopt them! This is not your business and is usually a very sensitive and painful subject for both the foster parent and the child.

Sometimes I wish I could give my kids away!/Do you want to take my kids? We get it, kids are annoying and difficult sometimes. Parental commiseration is necessary. But don’t joke about the serious pain and grief that comes with kids losing their families and families losing their kids.

They look just like you/you could really be related! I suspect people say this as a sort of compliment, but it risks sending the message that genetic ties are what really make a family. It’s just sort of icky.

Where/how did you get them? I’m happy to answer questions about the foster care system and process; but let’s not phrase it as if there’s a ‘kid store’ I went to and picked one up.

They are so lucky to have you! No, no they are not. A kid is with me because they are in foster care. A kid is in foster care because bad stuff happened. Placement with me only comes after serious trauma and loss. I am the last, worst option.

They get to do things with you that they wouldn’t otherwise - what an amazing opportunity! Foster care is not a summer exchange program. Being able to go to Disneyland is not better than being with your family. A savior complex feels good to indulge, but it’s not healthy for either party.

I do something similar - I rescue/foster/adopt/volunteer with animals! Rescuing, fostering, and adopting animals that need homes is an awesome thing to do, but it’s insulting and disrespectful to compare it to foster care. These kids are not shelter dogs being “rescued,” and they need their humanity, trauma symptoms, and connections to first families to be honored in all their complexities. Please, definitely show me your rescue cat, or tell me about your foster puppies! But don’t talk like it’s the same thing.

You pass by a small crowd of hungry children, and decide you’d rather 455 apples go rotten than give them to some snotty brat who isn’t your problem.

It doesn’t matter how hard you’ve worked for your 500 apples, or that you aren’t the parent of any of those kids. in the moment you decide to walk away, it doesn’t matter why they’re hungry, or who owes who what.

You had the opportunity to help people, you had the ability to help people, you had the resources to help people. You had everything you needed to make a small, tiny little difference in someone’s life, and you decided not to.

Hi there anon!

1. Your sisters are badasses, and I hope they know this. 

2. YOU are a badass probably help a LOT and you don’t even know it! You (and any family member, friend, loved one) help a physician who is burning out/burned out when:

-you take time to just listen to us vent. People want to help us, but sometimes before you offer advice, just hear us out. You have no idea how much an active listener helps

-you recognize that they’re not okay. We docs are smart at certain things, but not everything. And we’re usually the LAST person to realize that we’re not okay. When you see that they are in distress and you let them know that you worry for them and you care about them, you are helping. 

-you make time for them. This kind of goes back to the other stuff. Because in our jobs, no one really makes time for us. Especially not in surgical residencies. 

-you encourage them to do things they like when they’re not at work to re-humanize them. Even if it’s cooking dinner, watching a terrible movie, letting them take a nap on your bed, feeding them snacks, etc. The little moments of humanity during residency have been the ones that heal me the most; I think most residents would agree. 

3. You want to help more! To every person like you who worries about a loved one or friend who is a resident physician/physician/med student who is burnt out, burned out, here are some things to start with:

-learn about the financial and institutional structures that entrap and hurt us. Read about the current state of US healthcare, the state of residency training, medical student loans and debt, physician suicide, resident and physician burnout, what medical training entails. 

-learn about our experiences. I know it sounds superficially so stupid that any doctor, resident, or med student would whine. It sounds lame that we smartasses would whine about anything. After all, we put ourselves in this mess, right? NO. Medical training is not TV medicine. The American conception of medicine, medical training, and physicians is erroneous and dangerously so. I recommend reading articles written by physicians, residents, and med students (like @intrainingdoc​, KevinMD, or other medblrs and read about our experiences). Widening our breadth of experience makes us all better people. 

-If your loved one tells you they need to step away from medicine or quit, hear them out before offering your opinion. Don’t dissuade them. No one walks away from this profession, the 6 figure debt, the 10+ years of training casually. If we’re walking away, we are usually doing so because we see no hope if we continue. 

-if you think they are going to hurt themselves or others, call in professional back-up: therapists, suicide hotlines, etc. It’s for their own safety and others if it gets to that point

-do not victim-blame. Residents, med students, and physicians in malignant programs/jobs are victims of an oppressive, antiquated training and healthcare system that is still controlled mostly by old white baby boomer men who have enjoyed the Golden Age of Medicine and think we’re, on the whole, a bunch of whiny privileged porcelain dolls. Fuck’em. The “advice” or “words of comfort” I got when I was burning out that I hated the most was “this will pass” or “just bear with it until the end of the rotation” or “maybe you’re forgetting that this is residency, not a walk in the park.” 

I hope this is a place to start. You’re a great sibling and I hope your sisters know how amazing they are. 

Best,

this was so emotional and heartbreaking and i absolutely love her 💖

Franz Wright, closing lines to “Night Walk” from God’s Silence (via lesgardenias)

these same ppl also excuse all of their shitty actions with “I have X so it’s not fair to hold me against these standards of basic human decency” and as much as they claim to hate the romantization of mental illness they are actually the worst ones, because instead of posting black and white gifs or whatever they constantly glorify their destructive way of life almost as if it’s a competition of who suffers the most. 

For the MS1 spending their first holiday away from family, for the R5 spending yet another holiday in a hospital, and everybody in-between: I see your sacrifice, I know it hurts, and I think you’re amazing. 

The third was that Tessa Thompson has this scene where she’s thrusting mightily on a ship with a giant strap-on, I mean gun!

NO. Huge big NO.

“Just” 3 years is a long freaking time to be unhappy.

I felt like my life and emotions had completely unraveled within 6 months of starting my previous job. By 12 months I was ready to resign and by 18 months when I did leave I thought that each day I had to stay there was a week off my life. I absolutely do not believe that I could have made it through my 3 year contract without ending up in a psych hospital.

Do NOT sacrifice happiness for prestige.

When you’re unhappy and in a toxic work environment, your performance suffers. People around you notice and it affects your reviews and test scores. That also affects your ability to get fellowships. When you’re happy you do good work and attendings can truthfully say you were an excellent resident. It’s not all about scores and name-brand residency programs.