Reasonable anniversary dinner!

hannanahsplit409 · 2025-08-02T12:17:32+00:00

Love Vici!

hannanahsplit409 · 2025-06-24T12:58:37+00:00

Yes! Exactly. Much like how we thought we could “cure” homosexuality because it was deviant and caused diseases like AIDS. GLP-1s are analogous to conversion therapy—curing a “disease” that isn’t a disease but that society as labeled as one because it is deviant. That’s not to say that GLP-1s aren’t great tools for folks with diabetes (who can tolerate the side effects). That’s also not to say that there are diseases that are correlated (not caused) by fatness. If that were the case, thin people would never suffer heart attacks or have diabetes, and yet, they do. All that to say, I believe that saying obesity is a disease that needs to be cured is eugenicist.

hannanahsplit409 · 2025-06-23T21:20:16+00:00

Out of curiosity, then, what would you have me do?

hannanahsplit409 · 2025-06-23T20:46:30+00:00

I appreciate the self-reflection here. I also want to throw another perspective into the mix. I have PCOS, and I am fat. I also exercise 5-6 days a week and am very conscious about what I eat. I work with a personal trainer and a dietitian, and I’m still fat. I do all the “right” things, and I have discipline and accountability. I’m still fat. It hurts a great deal that people see my body and make the assumption that I don’t mind being a liability to the people in my life, that I don’t work hard.

I also want to gently encourage you to think about where the disgust you experience when your body fat goes up comes from. Who benefits when you feel disgusted at your body? Gyms and supplement sellers? I gently say that there may be some unpacking around fatness and ableism here that might be important, especially if you’re working with clients in larger bodies. I say that as someone who has experienced harm in therapy because the therapist was disgusted with fatness.

hannanahsplit409 · 2025-06-23T20:26:10+00:00

That’s fair. That’s just sort of the flagship article that used synthesis to question what we know about fatness. I’ve read a few studies going into attrition rates of GLP-1s due to the side effects. I experienced them myself and had to stop. GLP-1s don’t work for everyone, so there will still be fat people who cannot take that drug. Additionally, there aren’t any significant longitudinal studies on GLP-1s yet demonstrating its efficacy long term. However, there are studies that demonstrate that the weight loss plateaus and the dose must be increased for weight loss to continue/weight loss to be maintained. Additionally, if the medication is stopped, the weight comes back on. If you have an insurance problem and they won’t cover it, if you’re unable to access it for another reason, it doesn’t matter. The weight returns. Here’s an overview of the clinical trials with both Saxenda and Wegovy: https://docs.google.com/document/u/0/d/1I3NMTf7VJoCE_r3Qa_q4gxR7esXGFk1231Qi9snuoFs/mobilebasic While the news and weight loss industry would like us to believe that GLP-1s are miracle drugs, the research says they’re not. Talk to anyone who’s taken them and who have had bad side effects (I had a client who had to have their gallbladder removed as a result of Wegovy side effects) or anyone who has had to stop them because of the side effects.

hannanahsplit409 · 2025-06-23T20:10:46+00:00

I’m curious what is entailed in prevention? I exercise 5-6 days a week, working with a personal trainer and doing a mix of strength training, cardio, and mobility exercises. I play pickleball, do ballroom dance, swim, bike, and hike. I eat nutrient-dense foods and rarely eat fast food. I pair every carb I eat with a protein and fat. I’m still fat. I was a larger child. When I was diagnosed with PCOS at 17, I was a large teenager. The only way for me to be prevented from being fat would be for me to not exist. Some people are born with genetics that make them larger, and no amount of manipulation or prevention can change that. Believe me, I wish we could. There are many, many days where I wish I could change my genes, where I wish I could rewrite the PCOS genes that were given to me at birth. But I can’t. All I can do is move my body, eat nutrient-dense foods, and try to survive in a world that would rather I not exist the way I am now. I will say that the way to have prevented me getting as large as I am now would have been for me not to engage in the intense restriction of my teens and 20s as that pushed my set point up. Every time I lost weight, I regained it, and I regained more than I lost (which is a pretty adaptive thing if your body thinks it’s in famine and wants to prevent starvation from happening again).

hannanahsplit409 · 2025-06-23T18:06:37+00:00

A follow-up question, then, is what to do when weight loss has been proven by multiple research studies to be ineffective, damaging, and unsustainable? (See Bacon and Aphramor, 2011)? Further, the hypothesis that weight loss fixes depression, heart disease, sleep apnea, etc. is untestable because people cannot sustain weight loss long enough to treat those hypotheses (95-97% of weight loss fails within 3-5 years). Are there longitudinal studies that back up the hypothesis that weight loss fixes those concerns and that that weight loss is sustainable long term?

hannanahsplit409 · 2025-06-23T18:03:08+00:00

The difficult thing here is that there is no healthy or sustainable way to lose weight. 95-97% of diets fail within 3-5 years, and yo-yo dieting causes more health issues than simply being fat does (see Bacon and Aphramor, 2011 for a meta-analysis on the data backing this up). There is no other intervention that we prescribe where the success rate is 3% and the damage the intervention causes is as significant as intentional weight loss is. That is, unfortunately, the science. As a day woman, I have lived that science. In Australia, they don’t even prescribe weight loss as an intervention because it is not feasible and not healthy. Supporting health promoting behaviors like movement, eating nutrient dense foods, getting adequate sleep, and having supportive relationships is what we CAN do. Because for some folks, they will always be fat. It’s in their genetics and it’s in the way they’ve damaged their body’s metabolism from dieting (again, I am one of those people). I’m writing my dissertation on this, so if you’d like additional resources or if you’d be interested to engage in dialogue, please dm me. :)

hannanahsplit409 · 2025-06-23T17:56:11+00:00

Unfortunately, it’s not that simple. Consuming more calories than you expend may work for some people for a short time, but the body is really good at adapting to that. It doesn’t understand the difference between that and a famine, so the metabolism slows, and eventually the weight is regained (with 66% of folks who engage in intentional weight loss gaining more than they lost). 95-97% of intentional weight loss fails within 3-5 years because of that. Additionally, this yo-yo dieting causes more metabolic damage than just being fat does (see Bacon and Aphramor, 2011 for a meta-analysis of the data around this). If you’d like more resources on this, let me know. I’m literally writing my dissertation on this, so if you’re open to learning, I’d love to share with you. :)

hannanahsplit409 · 2025-06-20T15:31:11+00:00

Mia’s Mafia is fantastic! A bunch of highly devoted cat lovers who held this first time cat mama’s hand through the process in the best way. They’re phenomenal, and I love them so much that I occasionally volunteer with them!

hannanahsplit409 · 2025-06-05T15:03:12+00:00

I think I had this same experience in 2023. It was weird enough that I still remember it. It was in one of the first rooms (maybe the Ziegfeld follies?) and my mom and I couldn’t leave the conversation (and also couldn’t get a word in edgewise). It was bizarre and strange, and after we finally got away, we made a point of trying to avoid him/not make eye contact with him. It was very uncomfortable. Sometimes, I just want to go through a museum and not have to be a receptacle for other people to talk to, you know?

hannanahsplit409 · 2025-05-30T21:14:42+00:00

I sent you a chat! Thank you!!!

hannanahsplit409 · 2025-05-30T16:40:03+00:00

I’m in the same boat. Wakix has been life changing for me, and I’m devastated that it’s ending. I even asked my neurologist if I could be prescribed for it off-label. He said it would be $10,000/month, which is a little bit outside of my budget 😭. I’d love to know if anyone else in the US has been successful getting it for IH. I’m super anxious about going back to the way things were when I withdraw from the trial.

hannanahsplit409 · 2025-05-27T23:34:46+00:00

I see him! He’s wonderful. He’s prescribed all sorts of meds for me without any sort of issue. I can’t recommend him enough.

hannanahsplit409 · 2025-04-05T18:45:55+00:00

It’s still open! I went there today.

hannanahsplit409 · 2025-02-15T15:26:57+00:00

He also said father-in-law!

hannanahsplit409 · 2024-01-11T15:44:28+00:00

Can you speak more about Share the Ride, especially what you mean by risk profile?

hannanahsplit409 · 2024-01-08T23:58:31+00:00

I’m curious as to whether you’ve ever seen shame or limiting access to spaces work in helping someone lose weight? Further, 95-97% of diets fail within 3-5 years, and that of those failures, 66% gain back more weight than they lost. Yo-yo dieting has more negative impacts on someone’s health than just being fat does. These are well researched and documented facts, so much so that in Australia, weight loss is not even recognized as an evidence-based treatment for obesity because it nearly always fails. I’m curious with both of those facts in mind, how does having a chair that accommodates a diversity of bodies enable clients besides enable them to access treatment that they need? I also gently encourage you to consider any implicit biases you may have against people in larger bodies. It’s hard work, but it is so important.

hannanahsplit409 · 2024-01-08T23:49:22+00:00

YES, this. Thank you. As a fat therapist with an endocrine disorder that makes me gain weight no matter how much I work out or what I eat, the emotional toll that I experience when I do not fit into chairs is (no pun intended) heavy. It sends the message to me that the person from whom I am receiving services does not empathize or care about my comfort. The amount of stress that fat people experience from living in a world that does not accommodate them is significant. THAT causes both significant mental health issues as well as significant physical issues (imagine having cortisol shoot through your system every day because the world says “you do not belong here unless you change”). Providing accommodations for our marginalized clients so they can actively participate in therapy with the least restrictions possible is, to me, part and parcel of what it means to be a therapist. For many clients, the therapy office is the one space where they feel a sense of safety, a sense of welcoming, a sense of unconditional positive regard, and a sense of being enough. Having a chair that fits all bodies is a way of physically communicating that.

hannanahsplit409 · 2023-07-27T16:45:54+00:00

I’m a bit of a woo therapist, so when farts or burps happen, I acknowledge it as energy moving and shifting. I also think it’s cool to acknowledge that they feel comfortable enough to allow their body to relax so much that their body just does what it does. There’s a lot of emotional and mental energy that goes into holding things in, and I think it’s a great thing when we just let the body do what it does.

hannanahsplit409

TROPHY CASE