It was 13 years ago when a Seattle based writer by the name of Lindy West published an essay that took the internet by storm. It was called simply, "Hello, I'm Fat."

And there was this way that calling myself fat publicly made me fat, you know, whereas before I was operating like I am going to be thin. That's the cultural narrative that fat people are thin people who are failing. And so I was bought into that. So that was scary to kind of, in a certain way, announce, I'm throwing in the towel of of trying to be this other thing and waiting for my life to start.

Lindy's writing is vulnerable. It is honest. It is confessional. If you're familiar with her at all, you know that her writing is also pretty funny. She really opens up about living as a quote unquote fat person. It's a provocative message, and it was particularly unusual back in 2011. In fact, at the time, it caused a fair amount of controversy.

People are I mean, this was the beginning of internet commenters, too. So I'm like, at work. And then I have to see under every piece of my work a list of all the most horrible things people think about my body.

But we really wanted her on the podcast because Lindy's work also resonated with a lot of people. People she'd never even met. In fact, that single essay led to a New York Times bestselling book called "Shrill: Notes from a Loud Woman." In 2019, Hulu took that book and created a TV show starring comedian Aidy Bryant.

You should think about gastric bypass for your weight.

I'm sorry. Think about what? Hey, you're going to look at me for ten minutes and tell me to cut my stomach out? You're a bad person.

Nowadays, Linda is still writing about her experiences. In fact, she was kind enough to take a break from her writing of her second memoir to sit down for this episode of Chasing Life as an award winning author. She's giving the ways we think about weight a lot of careful thought. She doesn't shy away from the difficult conversations or from opening up about the stigma she has faced. Some of it is hard to hear. Today, Lindy and I are going to discuss how the way we talk about weight has changed.

I went to the doctor and I said, you know, was there a nutritionist that I could see? And she was like, you know, what would be great for you is Wegovy. And I was like, what?

Today I think you're in for a really touching conversation, one that challenged some of my own thinking. She taught me a lot about what it looks like to show empathy and kindness, no matter anyone's size. I hope it does the same for you. I'm Doctor Sanjay Gupta, and this is Chasing Life.

12 years ago you wrote this essay: "Hello, I'm Fat." It's that essay that led to the book. It led to the creation of this Hulu TV show. Obviously, a lot of people got to know you. So that was 12 years ago, roughly 12, 13 years ago, How have things changed, do you think, since then?

I think things are, you know, different and the same. 12 years ago, I don't think there was any generalized cultural awareness that maybe it's bad to stigmatize fat people. I don't think that had entered the chat at all yet. Michelle Obama was like, let's get these fat kids moving. And it was not just normal. It was like honorable to try to eradicate fat people. That's not exactly the case anymore. And there's still just a lot of structural barriers to fat people being able to fully participate in public life. A lot of that has not gone away. You know, in terms of hiring discrimination, the way fat people are treated at the doctor, the way that people think about accessibility, stairs and chairs. And, you know, I've been doing, some live performances. I wrote, like a one woman show and basically every theater I have to call them and say, hey, a lot of my fans are fat. So if you have 16 inch wide vaudeville theater seats, you're going to have to take some of those out and put some chairs without arms. And people want to laugh at that and say that it's your fault for being so gluttonous that you can't fit in a chair. It doesn't matter whether you think that or not. It's not true. But it doesn't matter, because the reality is that those people exist and they deserve to participate in public life, whether you want them to go on a diet or not.

It seems like over the last ten, 12, 15 years, whatever. Certainly since the time you wrote that essay, there have been sort of these movements almost at the opposite extremes. There's been this body positivity movement, and at the same time, the AMA as classified obesity, a person has obesity in and of itself as a disease. And I've frankly I've always struggled with that. Is it a disease? I mean and if so like are we medicalized things in an inappropriate way? What what would you say.

That's what I would say. I would say that you're you're right on. That's why I say fat. And I don't use the word obesity. It is pathologizing. And I don't have a disease. I mean, how could it be a disease when it is often a symptom of other medical conditions? If it's a disease, then it seems like there would be some kind of unifying factor across all fat people as to why we're fat, some sort of mechanism for how this disease works. And that's just not the case. People's bodies reflect so many different aspects of their lives. And if I'm fat because I have, PCOS or something, then don't I have PCOS? I don't have fatness.

Right.

And it and it's this very I think that's the issue is that it it flattens fat people into what they want us to be, which is just fat, lazy gluttons. And that's why fat people can go to the doctor with cancer and the doctor tells them to go jogging. This has happened to me. I didn't have cancer, but like, I've gone to the doctor with an injury and said, you know, my ankle hurts and I can't walk. And they have said, well, you probably just need to stretch and strengthen your ankle, so you should go walk. And then it would took years before I managed to get an x ray. And then I had a big bone spur and I had to go to orthotics and it was a whole thing. But I saw the doctor multiple times and they were like, just get out there, you know? And and that's a very, very minor example of a thing that happens to fat people all the time because we see fatness as a disease in itself. Well, what about all the other diseases that people actually need? Treat it if you know that gets erased.

I think with these medications, these GLP one agonists like Ozempic and Wegovy and Mounjaro is another one. I think I know how are you going to answer this based on what you're saying, but what do you what role do you think they have? What we're hearing, Lindy, is that they're likely to become the biggest class of drugs actually taken in the developed world. $100 billion a year. Super expensive, as you know. You know, $1,000 a month or more than that. And a lot of people are taking them already. What do you think? I mean, where does this go? And is is are we missing something here? Are we missing the forest through the trees, do you think?

Yeah. You know, I want to say upfront that I do believe in bodily autonomy. And I know how hard it is to live in a fat body. And I understand when people. Don't feel like they can do it anymore. It's really, really exhausting. It's hard to be happy to live in a fat body in society. It's really grueling. You feel really surveilled all the time. You feel like you have no privacy. Having had my weight fluctuate, I know for a fact that the smaller you are, the nicer people are to you. And it's just, like, heartbreaking to know that. And so I understand why people are tired and don't want to do it anymore. I get it 1,000%. I think the dangers are in the way that pharmaceutical companies market these medications to really vulnerable people exploiting those vulnerabilities, you know, knowing that people are desperate to change their bodies because they're treated so poorly, because the same industries perpetuate that hierarchy. You know, that's just all of marketing. Like, wouldn't you be happier if you had this different body?

I just have to say, this comment you just made that when you are thinner, people are nicer to you. I don't know, something that's just I don't know that really that touches me for some. I mean, that's that's a really powerful comment. I don't know, it makes me a little, chokes me up a little bit. Like I don't yeah. I mean, I'm, I'm sorry I never heard a put like that before. You lose weight and people will be kinder to you.

People will be kinder to you. They will, take you more seriously. They're friendlier. They're more welcoming. Think about what it's like to live your life. And no one's ever kind to you. And then you're also told that this is your fault. And that the fact that you haven't changed your body in the way that society wants you to says all these negative things about who you are and your capabilities. It's this is why I kind of don't engage in debates about this stuff anymore, because it's like, it doesn't matter. It doesn't matter about your insurance premiums. It doesn't matter about whether people are eating fried Twinkies at the fair. This is so cruel to treat other human beings like this, to rob people of basic respect and joy. And like I said, participation in in the full spectrum of life. So it doesn't matter why people are fat, you know, it doesn't matter. You should treat people with respect and kindness regardless.

I totally agree with you. And I mean, I think I'm a pretty tolerant, empathetic person. But you've made me think today, Lindy. And I just think I'm gonna..

That's nice.

It's going to stick with me, your comments. What happened to the body positivity movement? Did it end up working? Where is that, do you think?

That's a great question. I think it, you know, got swallowed up by capitalism and like everything does. And then, of course, the people who are the closest to the ideal became the most successful influencers. The sort of the smaller fat people, the fat people with hourglass figures, make most of the money and, get most of the brand deals and the opportunities. Fat positivity started out as, which is really, I think, a movement for liberation, and more of just a way to sell products, which is fine. But that's why I think you're going to hear if you pay attention in these spaces, you're going to hear a lot of fat activists now really abandoning the label body positive and saying specifically fat liberation. You know, I'm not saying I don't like to look at cute outfits on Instagram or that I don't buy products from affiliate links, but it's not a a radical movement for social change at this point. And and maybe it felt radical and maybe it was radical ten years ago and contributed to people's idea of fat bodies shifting a little bit. But at this point, it's not moving the needle in any substantive way for the most marginalized people, you know, which are fat disabled people, that black people, super fat people, people who are, you know, really not represented in media, who are really stigmatized and, and excluded, excluded from life. So it's it's just it can be a hashtag, but it doesn't mean a lot to me anymore.

I'm, you know, you are someone who's written a lot about this and then had, you know, TV shows that were created around this so I think the language and how it's communicated is, is something that, you know, you obviously know a lot about. You're quite knowledgeable about. I'm not comfortable still using the term fat.

Yeah.

And I mean, should I be? Like where you're comfortable. That was a title obviously of the essay. And you, you've you embraced the term. But should I be I mean what do you think about that.

I, I think so. You have my permission if you want to.

It feels it it feels demeaning to me. Like overweight, have obesity. It's not even obese. The person is not obese. Like I remember thinking, I take care of children with epilepsy and we would not call them an epileptic child. Because that defines them by their epilepsy. Rather, you say a child with epilepsy. Someone who has obesity, you know, as opposed to an obese person. I don't know. Do you do you, am I getting hung up on this? Is it worth, like, really nailing the language down here?

I think so, I mean, I can tell you that I bristle, but I sort of like shiver when someone describes me as obese or a person with obesity or I mean, I don't like hearing the word obesity because of what we already talked about. It feels like it's playing into this false narrative of of why fat people are fat and, and, the idea that that we have a disease. But. fat people also don't use the term overweight. Or at least fat people who are accustomed to talking about this stuff who are engaged in fat politics. Overweight implies that there is a ideal weight that we can somehow identify for each person to reach, and that's also not the case as far as I am aware. So, I totally understand why people who aren't fat are uncomfortable with it, because you've been trained not to. It's a, you know, an unkind thing to say, but. The alternatives are, to me, less kind. And I think that people have worked really hard to take the stigma off of the word fat and make it into a descriptor that doesn't have to have a value judgment attached. I do think you could say plus size if you don't want to say fat, that seems, based on, you know, real measurements. But if you don't want any fat people to get mad at you, I would avoid saying obesity or overweight. Because personally, I, I mean, I'm not mad at you, but it just alerts me to the fact that this is not a person who is familiar with any of this discourse. And this discourse is about, you know, whether or not I am a human being deserving of respect. And so that makes me nervous. You know, it makes me nervous.

You know, as a doctor, I've thought a lot this season about getting the language around weight, right. And I think what Lindsay had to say about empathy here is key. We probably just need to be kinder to one another. And maybe the language follows. Coming up after the break, my conversation with Lindy West gets even more personal.

So now I'm an eating disorder treatment, whereas my doctor wanted to put me on frickin semaglutide or whatever. And that's like, that is a disordered system.

That's coming up in just a moment.

Say screw you if you don't want to answer this next question, but would you ever take it? Would you ever take Ozemepic?

You know, I my doctor recommended it to me. I was in a really depressive episode and I went to the doctor. I had been thinking a lot. I'm writing up sort of a second memoir, a follow up to Shrill. Almost ten years later. It has a lot to do with my body and how I feel about my body, and what I've learned about what I've learned about my own mental health, and that I have depression. And so I was feeling really depressed. I'd been thinking about this. I went to my doctor and I said, I feel like I have a very unhealthy relationship with food. I feel like I rely on it in this way, that is emotional and compulsive and I think I should take a look at that. And I hadn't before, kind of because being a public fat person, you're on the defensive. Everyone's constantly telling me that I must eat 14 cheeseburgers a day, and that's why I look like this or whatever. And so I've spent the last ten years being like, no, I don't. I don't have any issues with food. I eat normally, I eat the same as my husband, and he's skinny, and that's sort of true. But then it's also not true that, you know, there's this way that I feel emotionally unsafe if there's no food in the house or if I don't know what I'm going to eat next, I feel afraid. And I was like, I think that's bad. So I went to the doctor and she was like. She wanted to put me on Wegovy. Like I explained, I described this to her, you know, like I'm a person who writes about being fat, writes about like, body positivity. I feel really uncomfortable even asking this question about exploring my relationship with food, because I feel like it plays into stigmas about fat people that I've been trying to eradicate. And I need help, and I and I said, you know, is there a nutritionist that I could see to help me take the anxiety out of deciding what to eat. Because I feel like I have no idea how people eat? I don't understand it. And she was like, well, why don't. She was like, you know, what would be great for you is, is Wegovy. And I was like, what? And it was pretty new at that point. I didn't know that much about it, but and I was super deep in, like I said, this depressive episode. So I was kind of at the end of my rope and I was like, you know what? Fine, fine. I give up, then fine. Sure. And then I got about one step down the road and I was like $1,000 a month. And then I was like, what am I doing? And then she was like, hey, I could get this coupon for you so you could get it for 200 a month. And I was like, absolutely not. I never mind, I don't know what I don't know how you got me even this far. And then I finally got her to send me a list of nutritionists that they work with. And I picked the only one that had, you know, health at every size credential. Like some kind of familiarity with fat people, And then she was like, yeah, you have an eating disorder. And I was like, oh, so now I'm an eating disorder treatment, whereas my doctor wanted to put me on frickin semaglutide or whatever. And that's like, that is a disordered system. I was so close to getting the opposite of...

Yeah,.

The care that I needed. I would have just been sent further down this spiral of disconnection from my body and shame. And absolutely, I'm sure it would have ruined any kind of healthy relationship with eating because you you can't eat in the same way at all. I was like, tempted by the devil for one second because like I said, it's hard. I'm tired. I'm tired of people being mean to me. It really messes with your head, man. But, at this point, no. Absolutely not. I would, I would never I couldn't do it.

You would not take it.

I first of all, it undermined my eating disorder treatment. So, but also, I know for a fact from my own life that it's not the solution to my problems. I have lost weight, and I have gained weight, and it only made me worse that cycle because people do gain weight back if they stop taking these drugs. And nothing has damaged my psyche more than getting slightly smaller and then getting fatter again, because then all of a sudden you have this shame compounding everything. You have this feeling of failure. You have this feeling of hopelessness. The only answer, at least for me, is to continue to connect with my body, learn how to live in my body, move my body in ways that feel good, eat foods that nourish me and I will never take it, unless, of course, if I if I get diabetes and I need it for some other reason, of course I would take it, but I would never take it for weight loss. For many reasons, but primary among them is that it would not solve any of my problems.

I appreciate that answer. It's tough. It's complicated to sort of navigate through all that. But I think, again, going back to the idea that we pathologize or medicalized all these things, if there's a medical need, then that's one thing. But if you how do you obviously when you wrote the essay and then you, you there's a the book and the TV show, there's a lot of people who were listening to you. It resonated with a lot of people out there, most of whom you've probably never met. But I'm curious, what is the advice to people out there who are kind of where you were maybe back in 2011? They want to make peace with their bodies. They want to be able to talk about their bodies the way that you just did. What advice would you give them?

So hard. Go to therapy for sure. Spend time with other fat people.

Hmhm.

Seek out fat people in online spaces and and read their work and listen to what they have to say. Specifically, centering the most marginalized fat people who really understand the extent of the the trauma and damage that the system can cause, and people who are working in really creative ways to fight back against it and to live happy lives despite it. I saw like a TikTok or something where someone was saying... Okay, don't get mad at me, but I want to. I want to know. I want to know what you think. So it said something like, you know, when you speak negatively to yourself, your nervous system interprets that as a threat and kind of shuts down, as a threat response and makes it impossible to make any changes in your. Thinking or in your life. It it sort of slams this wall down between you and the ability to change.

Yeah.

'And so if you do want to change your life, if you want to change your body, if you want to, you know, change the way that you think about yourself. The only path to doing that is to start from thinking kind things about yourself and being kind to yourself, and that self-criticism and being cruel to yourself will never actually lead to change, not just because it's a poor motivator, but according to the neuroscience of TikTok.

That they got it right. So far, what I'm hearing. I agree with that. Yeah.

So like what what's how what else is there to say? You know, like the answer is to fake it till you make it is a is free. You know, therapy is expensive. But if you can just change the way that you speak to yourself. Think about, you know, think about this is a thing that therapists always say, think about your child self. Would you say that to your child self? If she was standing right in front of you here, would you say, wow, you look disgusting today? I wouldn't.

People said that to you?

No. But people say it to me now as an adult now.

No.

Oh my God, every day on the internet. Are you kidding?

Really?

Not real people. Oh. This is. Oh, do you want to do an episode about internet trolling? I think I have PTSD, I swear.

Oh god, I just I hate people sometimes, I really do.

They're pretty bad.

You're you're an optimistic sounding person. I am sitting here talking to you. We're having this delightful conversation. You're smiling, you're laughing. Are you optimistic? I mean, do you think the conversation about weight and do you think this changes in the future? Yeah.

I don't know. I hope so. I think that, the fat people that I know who are living joyfully and defiantly are so inspiring, and there's so many of them. Of us. You know, I aspire to count myself. And that's not going away. As much as people would love to. I think, it's put ozempic in the water supply and and never have to look at a fat person again. That's not going to happen. We're always going to be around, and we're always going to keep, fighting and, fighting for our community and for each other and, and taking care of ourselves because we only get one life. Sorry. You're not going to back me into a hole and make me hide for the rest of my life? I just got one, as far as I know.

Is this is this part of what you're writing about in your new book?

Yes, definitely. It's not even up for preorder yet or anything, but, it's called adult braces because I had braces during the pandemic. And then I realized, that was a great metaphor for what I'm trying to do, straighten out my life using tools and, you know, aids that can be kind of embarrassing and painful. And pushing through that and. And yeah, it's really like reassessing everything that I thought I knew about my life and what I wanted and and the ways that I was wrong about stuff that I wrote about in shrill. I think I was pretty confident when I wrote shrill that I had done the work, and I was cool with my body, and I was done, and that was not true. So I've had a lot of I've done a lot of learning since then, and I was just barely in my 30s when I started writing Shrill, and now I'm about to turn 42. So my life is different now, and I have more perspective, and it's really just about all of those things and trying to figure out, like, how do we figure out who we are and live in such a way that actually makes us happy?

I got to tell you, this conversation is going to stick with me for a while, and I hope it does the same for you. A big thank you to Lindy West for her honesty and her perspective, and her sharing so much of her personal story with me. Coming up next week, there are so many products out there that promise to help you lose weight fast: body wraps, cleanses, juices, tummy teas, more. But do they work?

They know that if they trigger that insecurity, they could sell a product. Especially if that product comes with a shortcut and that shortcut doesn't really exist.

I'm going to ask Doctor Mikhail Varshavski, and you may know him better, as Dr. Mike, if you've seen him on TikTok or Instagram. We're going to talk about the latest internet trends and do some myth busting. We're calling it fat versus fiction. That's coming up next week.

Chasing life is a production of CNN audio. Our podcast is produced by Eryn Mathewson, Jennifer Lai, and Grace Walker. Our senior producer and showrunner is Felicia Patinkin. Andrea Kane as our medical writer, and Tommy Bazarian is our engineer. Dan Dzula is our technical director. And the executive producer of CNN Audio is Steve Lickteig, with support from Jamus Andrest, John Dionora, Haley Thomas, Alex Manisseri, Robert Mathers, Leni Steinhart, Nicole Pesaru, and Lisa Namerow. Special thanks to Ben Tinker, Amanda Sealy, and Nadia Kounang of CNN Health and Katie Hinman.