BONUS: Staying True to Fat Liberation While Caring for Your Health with Kacee M Markarian LMFT

Too often, conversations about health start and stop with weight loss. There’s little room for anything else—like metabolic health, quality of life, or what it actually feels like to live in your body. That narrow focus leaves so many people feeling stuck, frustrated, or invisible—especially when they’re doing all the “right” things, and nothing changes.

And for those who’ve worked hard to unlearn diet culture—to separate health from weight—medication can bring up a whole new kind of conflict. It can feel like you’re betraying your values just to feel better. But what if taking care of your health didn’t mean shrinking your  body or giving up your beliefs? 

In this episode, psychotherapist Kacee Markarian shares her personal story of navigating fatty liver disease, GLP-1 medication, and life in a fat body—while staying rooted in fat liberation. Her journey reveals what it actually looks like to care for your health on your own terms, from dealing with food noise and medical gaslighting to finding body neutrality in a world obsessed with the wrong metrics.

References

https://copperunionapparel.com/

Audio Stamps

01:09 - Psychotherapist Kacee Markarian shares her journey with fatty liver disease, GLP-1 medication, and the complex emotions of body change while staying committed to fat liberation.

07:50 - Casey reflects on how body changes affected her place in the fat liberation community.

09:35 - Kacee opens up about the complexity of navigating fat liberation while using GLP-1 medications for health, not weight loss.

20:02 - Two sides of food freedom: Kacee and Dr. Rentea share completely different experiences with how GLP-1s changed their relationship to eating.

24:13 - Challenging internalized shame, recognizing the power of medication, and redefining success through neutrality.

32:25 - Kacee’s advice for anyone caught between wanting health and refusing diet culture.

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Premium Season 1 of The Obesity Guide: Behind the Curtain -Dive into real clinical scenarios, from my personal medication journey to tackling weight loss plateaus, understanding insulin resistance, and challenges with GLP-1s. Plus, get a 40+ page guide packed with protein charts, weight loss formulas, and more. 

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Transcript

4:12

Welcome back to another episode of the podcast. So we have very special guests today, Casey Markarian. Again, we just recorded an absolutely amazing episode that I encourage you to listen to that as well if you have found yourself at this episode. But Casey is absolutely incredible because she is going to also share some of her personal story. And I have to tell you, there are so many unique things about her story that I find highlight. so many amazing aspects of a health journey that are not highlighted right now. And so Casey, can you start out just introducing yourself a little bit? If people haven't heard the other episode, don't know who you are, and then we'll kind of go into your story a little bit more. Sure. Sure. Thank you for having me. My name is Casey Markarian and I'm a psychotherapist in private practice 15 years. And I primarily see the queer non binary trans community. And I also do consulting, worldwide. with, one of my favorite topics, which is the correlation of ADHD and binge eating disorder. So I love your work so much. Everything you do is just, oh, it's such a great, all the areas that you're in are just so incredibly needed right now. And so can we start off with, can you tell us a little bit about where your health journey started here a few years ago? Because what I really. despises that. I feel like a lot of what always gets told in the media are people that are going after thin, a thin pursuit, right? It's like wanting this body that's a lower size, but it's not ever about health or anything else involved. So I wonder if you would share with us kind of where you started a few years ago and kind of what, what journey have you been on? Sure. So I have had a fat body in my whole life. And I definitely had more weight gain when I went into puberty, right? And I am true and true, fully a fat liberationist. Like I was so not. Pursuing weight loss that when I had been diagnosed with a metabolic condition and the doctor said, you know, do you want to try a GLP one medication? I was really thinking to myself that if the medication would cause weight gain, I would do it. And if it did something different, I would do it right. It was for me about, um, I had a patient, who was a ER doc and was talking about how I was diagnosed with fatty liver disease, non alcoholic fatty liver disease, and somehow, and just in passing in the background, right, she just casually mentioned that the high percentage of folks that need liver transplants start out with fatty liver disease and it takes, 20 plus years, but at some point and I just thought to myself, Whoa, I have this organ that's really sick that every doctor is acting like is not a big deal. And then I hear, from such a beautiful person that gives so much of her time to the community, in medicine, talking about how it starts there. And so I decided very early on. Okay. So this is like the beginning of. 2022 to start taking a GLP one medication. And see if I couldn't figure out the fatty liver disease. Because everything I did that was recommended to me, I'm talking food, Peloton, all of it, nothing did anything. Right. And so for me, I just really wanted to see those numbers change. So I could feel better about this organ that I was really concerned. Was so sick. Yeah. Yeah. It's really interesting to me even then. It was not being touted as a weight loss medication. And I have to be honest with you that if it was, I'm not sure that I would have done it. Yeah. Oh, that's so fascinating. Right. But it is true that so now liver transplants, that is being taken over as the main reason and not alcoholism. And so this is something that we really don't talk enough about because. A lot of people that if their weight set point is up, that might be something that they struggle with. And the other thing, I'm just going to bring a medical thing here for a second. The thing that people don't realize about the liver, by the time the liver numbers are going up or we realize that there's a problem, you, a lot of your liver is affected. This is not like, Oh, it's just starting. And so I don't think people quite understand how significant it is. And so they were so casual. Because they're kind of numb to it is the problem. So physicians are seeing that all day long. They're seeing pre diabetes all day long. They're seeing all of this all day long. And they're kind of seeing things individually and not collectively diagnosed as insulin resistance, right? Or whatever is actually causing it. So you were at this intersection where you'd say, hey, whatever tool is necessary for this. So how did you feel when then the wait set point was going down as well? Like one thing was getting helped, but something that were, did you feel weird about that? Because you had always, for so long. Horribly, horribly weird. I mean, basically. The way I understood it in 2022 is that it was a peptide that I was taking that was going to deal with inflammation. And the minute I took it, I'm not kidding you. It was a complete and total light switch. Like in that moment, you know, I had always thought to myself, like, this is not a moral failing there. I really have done a lot of work to try to just be like, this is. It's just who I am, how I am. And just kind of like push out the noise of providers that would tell me that I needed to change my body. I needed to do something different. You know, and I, I always joke that it felt like they were telling me that I needed to grow my hair faster. And I don't know if you've ever had a haircut you didn't like, but that shit does not happen quickly. Okay. And so I just, you know, I was like, I, I'm going to try this. Right. Yeah. But back then it. It was one of those things that I didn't focus on the weight loss. There was nothing about it that felt like weight loss to me because in the beginning, it felt like it was definitely inflammation, right? I was very inflamed. I had an ankle that was always swollen. And like 15 minutes after taking the medication, it, wasn't anymore. Yeah. And so it was a mixed bag to answer your question. I felt really good about not feeling inflamed, right? Cause that happened almost instantly. But Yeah, it's been really strange because I am not focused on weight loss. And so to have that experience has felt really strange to also be such a fierce advocate for any part of fat liberation community. Yeah. Has also been interesting because I don't know how else to say this other than when I think about myself back in 2022, I feel like that person, and this is a very honest statement would hate. The person that I am today, not the mind stuff, but what has changed about my body. And then the kind of privilege that I experienced from finding clothing, being in the world. It really is a mindfuck. I don't know a better way to describe it. No, you, you hit on something that I think with you when I hear it, it's, it's more pronounced because you were involved in this movement, right? But I think that everyone actually experiences a version of this because I know for me, I think Well, it is easier to go shopping right now, or they do suddenly have the size available. When before I had to order something that, would come weeks and weeks. And, and then I think about, well, is this in my head or not? How people are treating me? The world really is different. And that's really sad to me because I don't want that to be the reality. And so it's this grappling where you still have all the same beliefs, but now, I don't know. It's like the beliefs didn't change, you know, I don't know how else to say that either. No, the beliefs didn't change. I find the most, it's the least interesting thing about me, what size I am. And I think the other piece is like, It does feel like I need to name it as a privilege because there's so many people that go on a med like this and really don't have any difference beyond a medical like blood panel, which is so profound. It's so amazing, but it doesn't mean that you go out into this world due to systemic oppression and anti fat bias, and it doesn't mean you're treated any differently. And we have a major problem around how we're talking about this because the medication is prescribed often by GPs. It's not somebody who is board certified in the disease of obesity. And I just want to make it really clear. I don't think that, people with adipose tissue have a disease. I just want to talk about the idea of a metabolic condition, no matter what size your body is. Right. And that feels really important to make that distinction. Yeah, yeah, definitely. Do you think that something that I've wondered about is that I feel that sometimes because people are in communities where they're using labels that they might be holding themselves back from. Like you said, potentially a treatment, right? So I wonder, have you seen that at all? That sometimes people, because they sort of don't want to abandon because of how it's being, I don't know even the words how to say this, but because of how the media is portraying this and how it's being talked about, that they don't even entertain these medications. Absolutely. I mean, not only do I see it often in my practice, I see it in my community. I feel that way. I really meant what I said. If it was brought to me as a weight loss medication, I don't think I ever would have started it because I had gotten to a place in my life where, I mean, what is the demand from society? Am I supposed to hate my body? Am I supposed to hate myself? Is that what they want? Yeah. I mean, and I, I don't, I, I live, I live the same way I live now. I love myself. I love my body. But I love myself and I loved my body, you know, three years ago. Right. Totally. Totally. So yeah, I think it, it holds them back. I think they get very concerned about what is, it's going to mean in community. I think we have these really wonderful, belief systems and ideals that happen in fat liberation around, you know, like staying fat and no lose, which are so important. And I will forever advocate for people's right to have those groups. Right. Because. In a world that is constantly trying to get you to change your body. It is a liberated radical act to be with a collection of folks that have the same mindset where they're not going to change their bodies. They're not going to subscribe to this idea that you have a bad body, you know, and truly like I miss so much about my body that is very true since it has changed. There are many things that I miss. Um, and. Yeah. I think it holds people back and I wish it didn't. And I hope that this conversation might help folks to think about it more like, okay, for me, it was not about size or weight. It was about, well, I need to heal this liver. I need to heal my metabolic condition. Yeah. I have found personally very attacked by that community in the past. I'm going to give an example here because there's a lot of people that I followed in that community, what's always brought up is how medical diagnoses are missed. And this is true. Like, we know this fact that if you're living in a, if we can say larger body, whatever you want to call it, that you, everything will get blamed on that. There's very narrow scope of what they're thinking anymore, the healthcare person. And so, you know, People were saying, well, but where can we find doctors that will still look at us fully and not actually care about the size? And ironically, that actually is me. It's an obesity medicine physician, right? Because we're looking at your blood sugar. I'm caring about how your arthritis is doing. I'm caring about inflammation levels. Like, I'm caring about all of that. I actually, like you were saying, Not everybody's getting quote unquote amazing results on these meds. That's actually not happening. So for that to be the only goal is craziness, right? And so in one of these, I kind of made a comment in underneath, and this was a larger creator, meaning following, like the following that this lady had. And I kind of said, you know, well, maybe you want to seek out, you know, a physician like me that's da da da. And I sort of wrote this out. And then there was a witch hunt in the comments. And they said, look at her website. One of the things she mentions is weight loss. And it's like, yeah, because that is one of the things that might happen. Right. Do you say weight loss? I feel like you say weight management. Don't you? I do I say weight management, but maybe they took it as weight loss. Well, I'm just saying like, I, I don't, this is where I get confused because, and I say this. With a very clear understanding, that the rights and dignities of fat bodies are not really at the forefront of any policymaker's mind. But the other reality is like, our bodies are always changing and I want to fight for the liberation for that to be okay. Um, the other truth is weight management and being obesity board medicine certified is the only time I have ever gotten appropriate healthcare. I'm going to tell you that right now. Yeah. I have an amazing doctor here in Portland, Oregon, and I send her cards. I write her love letters because I am telling you that so many providers missed really serious things going on with my health because they were able to really kind of berate me about my size. Yeah, completely. I, I think what's tricky is that it's hard to say, well, someone's website shouldn't say weight loss or fat loss, anything like that. The reason being that 99 percent of the population isn't going to be woke to the fact that you can put weight management or what to look for. So you, you actually can't create these websites that don't have anything on it because they don't even know what they're looking for, right? Because a lot of patients that come to me. They will think it's about reducing their size. And then when I really talk to them, I say, So what is it that you actually want? And they want to be able to not have urinary incontinence, get off the floor okay, go to Disneyland and walk around with their kids, not die early, sleep quality be better. Like I could go on and on, right? Their mental health to improve. Because we know that a lot of these things are linked. And even if it's just no, no size change, but we feel better about ourselves. Right? Like there's, it's like so deep. Okay. Even like blood sugar being managed better, you don't feel as bad. So all of this, I feel like you. It's really hard in these communities. If you're saying, well, you can never even put that on your website. You have to because you won't actually find the people that need help. Like this, unfortunately, because the whole world has not changed, you can't use language where no one will understand it. You see how it's such a tricky thing. And this is where I'm conflicted always. Cause I know. You having been in my world for a minute, you know completely where I'm at and how I, like, I don't care about, you know, there's just like such a difference of health and caring about that. But it's hard because the world has not come to that yet. And so you do, I find, still have to meet people where they're at. And then it's not a bait and switch. But once they come in, then you're like, okay, now let me explain. Then they're like, oh, but if I had come at you day one with that, you would not have understood. Well, I mean. I think, again, it's the systemic oppression. I think it's the challenge of having a fat body in a culture that really hates fat bodies. mean, even just think about it. Like these medications, and I will say this forever is really a public health failing to call them weight loss medications. They're called weight loss medications you go to have them covered by your, insurer, right? And, you know, fine for some people, and I'm going to say that in quotes some people, if they have a metabolic condition, that's like some kind of diabetes., maybe you can get them covered maybe, but it is the only acceptable form of discrimination in insurance companies. to say, no, we're not going to allow you to have this medication because it is not approved for all of these other conditions around metabolic syndromes, which I will also add happen, no matter what size your body is. Right. And I think it must be hard for, for the position that you're in. Because I know I say I'm always all myself, right? But I think about myself and my experience back in 2022, where it was like me and one other person. I don't really engage with social media due to my career. It's just not something that I want to do, but I became friends with all of the early adopters of the GLP one medications. And it was, it was very, I was alone in that. Why are we focusing on weight so much? Everybody. Like why can't we come back to a reality where these are all of our bodies and they're going to be different and I will fight forever for them to be different. One of the things I wonder is, because this is what I struggle with, is The language is very hard to succinctly get across. So, for example, if I'm making a video online that has to be 90 seconds or less, I mean, first of all, let's just all have a moment and realize that's insanity. Okay, so this short form content quote unquote online. So how do you get across in 90 seconds the importance of all these different intersections? And I think that that's a tall order. That's why I see it's always very polarized. Who's sort of coming to the top of my feet. It's someone that's completely against weight loss or someone that's completely for the before and after, but there's no in between because that doesn't convert well. Like there's not a good hook with that. It doesn't work. And so I think that the language around it is actually really hard to like, to get it right. Me too. Well, and I can only speak for myself in this capacity, right? I was tortured. I was truly tortured to feel like such a failure in my morality and my being like, you know, I talked to you before about this idea that even the word obesity means eating oneself fat. And I was not really engaging in any kind of food behavior that I would say was different than any of my peers. But I did absolutely have a metabolic syndrome and I absolutely had a hormonal imbalance and I had, binge eating disorder, which I am almost a thousand days binge free, which is so unbelievable, like, yeah, it's, I'm going to be honest, that's really unheard of. Right. Cause like at least when I'm working with people with binge eating disorder, where our goal is less, but not zero, but it's. Frankly, I don't care, Vyvanse, FDA approved, all these other options, I, they are not delivering on that. I'm just telling you. No, they're not, because it is, I, I have to say for myself, it has taken a long time, and it is a multi, level, way, way too many different ways of thinking. Thinking about this to name, um, and it is a daily commitment to, just trying to be the healthiest version of myself. I can. And even back then, even if I go back to Casey in 2022, I feel like the word healthy was weaponized. I felt like I was really being triggered in every aspect of my being with all of the language that was basically like boils down to there are good bodies and there are bad bodies and you Casey have a bad body. Right. And so you need to be punished because the community. community at large punishes themselves, and then, look at you and want your body to be different. And I never wanted my body to be different. I just wanted to not have to have a liver transplant. Like I do not want any of that if I can help it. I love, so I, this is why I wanted to have you on and I'm so grateful that you're sharing your story because I think everybody thinks that we're running away from our body and it's like, no, we just don't want to be tortured with certain things. For me, I'll tell you what was just life changing when I got on one of these and I too, like really fought myself before getting on one, right? I'm in the field and I'm like, no, you just have to work harder. I've talked about it before. Oh, awful. It's awful. Literally right away with being on a med within that first few days, I was like, what is this where I'm not having to every single minute of the day think about food? Like people, when I hear people use this, oh, food noise is normal, what are you talking about? You don't struggle with this. Because every, what are we going to eat? When are we going to eat? Is this enough? Is it too much? Is it, like, I had no idea that people, that everybody didn't do that. Okay. Like I had no idea that I was engaging in binge eating disorder, or disordered behavior until I stopped doing it. Yeah. Which I find fascinating. Right. I had no idea. That's what it was. I see a lot of folks in my practice that really impact me around. They'll get on a GLP one and then feel very depressed about how they're not interested in food. I'm always really honest with them. You know,, if they ask me, I will disclose if I'm on a medication, if they ask me directly and I'm always really honest that like, I don't understand that depression personally because I have never been happier feeling neutral about food. It is. Oh, I understand it. I'm on the opposite side. I'm on the opposite side. You know why? And I wonder if this wasn't the case for you, but for me, like it was a hobby. Like it was fun. Like I I've described this before. It was literally fun to like sit down on a Friday night and have like the chips, the ice cream, the whatever, and just be like, we're going to have a blast and it's going to be great. And there's a Netflix show. It was really integral to it. So then when that's not there, what do you do? Because you've taken away a whole hobby and so we're like a friend. I mean, it's, it's so deep. So this is, I love that we're different on this. Oh, me too. Me too. Right. Cause it sounds like, it sounds like for you, this was a friend that you looked forward to seeing that like, you felt like you wanted to catch up with, that you spend some nice time with. I don't feel like this was my friend. This was. You know, and, and the work that I do with binge eating disorder, I talk a lot about getting into a trance. That's what it was. It was trans behavior. it was like a haunting. It was something that came over me where I was absolutely and totally not grounded or available and like I said, I didn't really have the language for it, but for me, not having it has been, has felt like the best friend I could ever have. So that and I feel like this is really interesting when you bring this up because I think it's almost like you have to experience these things to understand what button is going to get pushed or what was actually going on. Right. But I remember growing up I was always fascinated like you said with people that didn't struggle with this I'll never forget. I was with my sister and her husband this was the summer between first and second year medical school, and I was doing some research at her university. And so I was living with them for a few months and there was this big Dorito bag in the pantry and. He had like five, okay, like the smallest handful, okay, he had five, and then he just closed it up, put the clip on it, and put it back, and I thought he could never do that, and I just remember being like, this cannot be a willpower thing. He has no interest in this. He put it away. He's not going back and checking. He's not getting it again. He's not getting a bowl so that it's smaller, like he's not doing any of these gymnastics. It's easy. It's exactly right. It's easy for him. I mean, this, this, for me, it was really a struggle. It was truly a struggle and it was something that was around for me very young and I didn't really. Understand about it. I couldn't really talk about it because I didn't know what words to put towards it. It's fascinating. Yeah. I remember we had orchestra teacher that I felt like she tried to like overfeed us. And I often wondered, like, does she struggle? Because I just remember being like, this is, it was not a normal amount of food, which like, so she, I think had some type of a restrictive something going on. Because it was so overdone what she would bring in, I don't know, there'd be maybe 20 kids and they were like 10 gallons of milk. I'm thinking myself, we can't make our way through this. You know, like it was just something that made no sense, but it's really fascinating how we all have a different relationship with this, but coming back to the health part, it's really interesting that I still think there's just this really strong hold on the judgment of ourselves that somehow this is a choice. And I would love to, Help people get past that, but I don't know, what to say to them to sort of like loosen that and just be like, Hey, there's insulin resistance. there are things going on that are medical that you did not, I'm sorry, you didn't pick it. Mom and dad got together. Okay. There's some genetics swapped. And then something happened and you are expressing some things and not, and it's like, you're not picking all of that, you know? No, and it's so easy to think that you are. I have a hard time because, when I think about myself, I feel like I have done a ton of work, but that work has been really supported by medication, right? Yeah. Yeah. I don't understand what to tell people that either don't have access to medication, the medication doesn't work because it really is, kind of like when you have somebody dealing with depression and, I have. I'm just thinking of one of my, my favorite patients likes to say, don't want a raw dog reality. So I'm going to go ahead and take an antidepressant, but you know, when you have people with depression, then antidepressants don't work. I mean, it is very hard. You can not say things to them like, Oh, well just don't be depressed. I mean, it's, it's, it's pretty similar, right. And we very much understand that we need medication to treat certain things where you brought up Vyvanse. I think that's an excellent medication, but it. It doesn't work on its own. There's all these things that have to happen as well. If there's one thing I'm absolutely sure of with my own experience and really, truly having the privilege to sit with so many people around this topic, it is not your fault. It is not your choice. And the reality of this situation is the more you believe that it is, the more self harm you're going to engage in. Yeah. I mean, like that's actually, that's been proven in studies and that, that is always fascinating to me because people want to believe that holding onto that is helpful. Here's how they'll argue with me, but no, I did buy that at the store and I'm like, but what is driving that there's urges and cravings. Like there are hormonal things that are going on that are making you want that everyone doesn't want the same things. There are, there's a reality going on there. So yes, that you, what about food noise? 100%. 100%. Like we don't, yeah, I, I, I still feel like when I go to a restaurant, even though like the hunger isn't there in the same way, like I still want to try the different stuff. And there's like this aspect of me that I feel like just doesn't exist in other people. Right. So it's just interesting when you really come at it from a perspective of like, there is some pathology involved, but then also there's some humanness and it just kind of where's the intersection of all of this. Absolutely. And why, why do I have a disease that I am not allowed to treat? That's a question that I think about why. And it is something I talk about with folks. I'm like, okay, so you have a thyroid thing. You would go ahead and get on some thyroid medication. You have a rash on your skin. You'd put some medication on there. I mean, it is completely clear to me. There is a self of mine that was Before medication and then a self of mine that was after medication and I could not have gotten to her without it That is very true. I think this is something that because in the past I did just like mindset weight loss coaching Well fat loss. Okay, whatever you want to call it. Okay, but what I came to over time was like you couldn't thought pattern your way out of some things. I think it's a very critical tool. I think it's 100 percent needed. I believe there's definitely like so many different pillars if you would to what is going to work long term. But what I came to is that. I really believe that some people, based on the level of metabolic dysfunction that was happening, we could not do enough planning, thought work, decreasing stress. There was not enough that we could do no matter how many areas we affected that was going to handle that. And so that's why I think I moved more into the kind of medical realm because I just saw that that was a missing piece. And so not everybody's on a medication nor maybe with either side effect profile affordability contraindications. And so there are many tools, many, I want to stress that, but, but there's this aspect where it's like, okay, it's enough at some point when. There is truly this broken bone happening and we're not helping that like that is to me I guess I got this place as a physician where I think that's why I didn't even want to but I started to be like That voice or the you know Sort of like a GLP one does exist and here's what it can help with because I'm thinking what why did people even want to? Hear my videos like it's not super amazing What's being said because no one was saying it a few years ago, right? I think and that was it is like I couldn't stand the fact that we continue to be like It's just the calorie number. It's like, no, it's not because you can eat that. And your metabolism might go down disproportionately compared to other people that don't struggle with it. Right. Right. So it's all of that. And why do we have urges and cravings the way that we do? I come from a family that, they're just differently sized than I was my whole life. And I have a parent that really does deal with an eating disorder with restriction. And I mean, there's been tons of times in my life where it occurred to me, like, well, I think that something is going on physiologically around just like, which is special to me. Right. Yeah. And I don't understand often why we don't talk about it like we talk about anything else. And I really meant what I said. It wasn't until I, and I went to my GP in the beginning when I got this diagnosis and I said, I want to try this med because I had read a, study about it. There was one study in 2022. And she was like, no, they don't work and you won't do it anyway. I mean, it was very, very disappointing how it went. Right. But it wasn't until I found somebody who was obesity board medicine certified, but then,, I do talk to folks and they're not inclined to really seek that out. And I think that it's the harm from the language and the discrimination, because in order to. Say, go see this doctor. You have to use the O word and that word is really tough. And to your point earlier, you know, I do like on your videos and you're in your podcast, you do talk about how this is not a search for fitness, right? It's one of the reasons why I so appreciate being here with you. That's never been something I've been interested in. And I think we're looking at the wrong thing if we are. Because somebody's that's not right for them. Yeah, I always say it's not about shape shifting because it's like, it's just I'm sorry we're aging things are shifting. It's just a perfectionistic fantasy as Carol Lowenthal calls it right it's like you're never going to achieve it you're just constantly go go go. And I'm like, can we just get some appreciation for what's happening right now. Or let me rephrase that it doesn't need to be appreciation. It doesn't need to be love or like your body, but just neutrality. Because I think, I don't know, I'm a fan of just the hate, I think is holding you back with hurting yourself. Yeah. But other than that, I'm really, it's all negotiable as far as where you want to get with body image and just everything else. Because who knows where you're starting? It might be, you might have had to do like a 10 year lift to get to a place where you have neutrality with your body. Absolutely. And that's phenomenal. I don't need you to, to love your body or to, I don't know, then there's that other movement, right? Where it's like everything needs to be, it's amazing. And I'm like, no, that's, I mean, that is so unfair because it's just like another thing for you to have internalized self hatred about because you're like, oh, now I don't love my body. And it's like, I love neutrality. I had no idea in my life I would ever get there, um, because I did always feel like high emotion around, food. Food. But. I am so neutral. It is so not even remarkable, and I love it and I feel so grateful for all of the work that I do and all of the support I've gotten. I've been in binge eating disorder recovery for almost three years. Like it's amazing. And honestly, a lot of the work that I've done that I've taken from that recovery, I've, helped other folks with all kinds of dopamine seeking behaviors. That's all it is. Searching for dopamine because you have a dopamine dysfunction and I wish we could talk about it like that more. Oh, that's beautiful What do you think someone is needing to hear right now? That's was you years ago again We're not like evangelizing and things like that. I'm just saying but like For them to maybe understand it differently, like we're not, because we're not talking about shapeshifting, we're not talking about putting labels on things, but is there something that you would have been open to hearing? I think that I would have been open to, with backed information, because my brain was tricky then. I like that. I, I think that I would have been open to hearing that it wasn't a moral failing. I think the idea that you have failed in your morality is so rampant when it comes to body size. Oh, true. And I also wish I would have been told that, like, it doesn't really matter how much you move your body. It doesn't matter what you put into your body. Nothing is going to change. Like, I can't tell you how weaponized movement was. I mean, it really was. It was weaponized for me my entire life growing up. It was then weaponized internally to myself. Things would be so different if I just did X, Y, and Z, and that is a mirage. That is a lie. Can I tell you when I did my obesity medicine boards and I learned that literally you could be five hours in the gym and your weight set point wouldn't even go down by more than 3%. And I'm talking like, imagine you went from nothing to suddenly hundreds of additional calories burned, right? And when I got rid of calories burned in the gym equals weight loss, that was so what? freaking helpful. And learning that data was massively liberating because before I would always think the same thing where I was like, I grew up with this. Like you need to do the bike longer. You need to, you know, like it wasn't about keeping muscle. It wasn't about emotional regulation, moving my body because it's good for, you know, keeping your brain health, all that. No. Again, no one meant to do what they were doing. Okay. But the point is that knowing that data was so incredibly transformative for me to be able to hold on to that as I, as I took a new path and I still move a lot, it's different now, you know, I think it's really so hard because when you're, when you're in a fat body, And this is just. So important I think to name you feel like people are really coming at you systems are coming at you and it's everywhere all the time like, I'm queer and I remember, when Obama was in office and,, I was living in San Francisco at the time and it was really amazing. Like there was just such an air of Oh, how wonderful, but then I remember, beautiful, amazing badass Michelle Obama started talking about childhood obesity. And all of those memories of going to like Weight Watchers inches away, do you remember inches away? That was a torturous situation. I was fortunately not subjected to that, but you please, that makes me feel so happy curves. I mean, I want my body was up for discussion, made plans for put on eating plans for my entire life. Yeah. And it's been so healing to take control of my own belief system around it being in fat liberation. But then also like, you know, this is the most important thing. My labs, they're perfect. My liver healed itself. I don't have a metabolic dysfunction at this point. And I am very much under really a lot of doctor's care, very thoughtfully managing my insulin resistance and, my chronic disease. Yeah. And that's where there's nothing more to say about it. But if I go back to myself in 2022, it really did feel like Everything was weaponized. Everything. Even just watching television. Constantly they talk about, you know, they're using the O word and they're talking about this and then there's commercials for that. And it's like, change your body, manipulate your body. It really was a radical act to actually think I was pretty, pretty fine, you know, pretty good looking, pretty, uh, fine body. I love it though. I think we need to be there though. Cause it's just, I'm sorry, you can just never achieve whatever it is. And I know that even people in the, Other spectrum that struggle with their weight like they too feel judged by society and there's someone I follow online and She's like, listen, guys, I'm naturally an act of morph, stop commenting like she just, and I was sitting, it's so funny, right? Like, it doesn't matter where you are. There's always a comment, right? So evidence based information potentially would have gotten through. And I'm seeing this trend to, at least I've seen this the past few years where people will say, cite the study, right? They want you to like, put the studies that they can know if they can believe you or not. But listen, any study, yeah. Can be good or bad depending on is it large or not? I mean, like, I'm sorry, like you can find whatever you want. And also like, what about a well rounded view when you go to a pediatrician or you go to a GP? Like, I can't tell you how I start. I felt like a caged animal going to the doctor. I would have, white coat syndrome. I w I cause I knew the minute I would go there, they would put me on a scale and then start talking to me about how I had one foot in the grave. And how is that helping anything? Oh, I know. I had the same thing with primary care doctors, and I think we might be turning the corner on this most recent one that I have. But you know, she said the nicest comment, because I remember, this was literally in December. And I'm like, well, you know, I've had all this progress, but you know me, it's like, you gotta like put yourself down a little, but like. I'm still going to, and then she's like, she's like, Matea, you're doing great. And you've been kicking ass. And I was like, it was just like a nice phrase or two. And she, I don't even think she realized, like, I mean, I burst into tears. Like you don't even realize how impactful that is because you're up against something where for all those years, you always. And you just got judged and you know, all of that. And what you internalized and this is, I see this all the time is, Oh, I didn't maintain that plan. And if I would have, my life would be so different. And it's like, wait, but if you, if it was easy, you would have continued that plan. The whole thing I've been doing for three years, I mean, not the easiest thing, right? A lot of work, but I always tell my, my partner, I'm like, I remember eating, you know, the recommendation of a fatty liver disease is that you don't eat carbohydrates often. And, you know, and also I hear all kinds of things around that that are untrue, but I remember eating half of something and wanting to eat the whole thing. And now I'm feeling like, how torturous is that? But now I don't even care. I don't there's no pressure. And that's where the neutrality I think is really just such a gift. Yeah, yeah, I think, thank you for having done the second part with us and just having talked about this a little bit because I think that a lot of people that are listening, they're going to relate to a lot of parts of what you're talking about and hopefully. We just cut one more cord of sort of holding ourselves to certain societal standards or,, just gave a different perspective that maybe someone didn't think about to help break them free, honestly, from this jail that we've all sort of been put in, you know? Yeah, it's so true. It's really necessary and I love all the parts of me and I'm just glad to talk about it. Oh, I love that. Okay. Tell everybody, how can they reach out to you just in case again, they didn't hear the other episode. What's your best way for people to find you, uh, tell us everything. My website is, dopamine demystified and, you can reach me there. There's a web form. And that's the one I use when I do the consulting work for, ADHD and binge eating disorder. But I also like. Help a lot of folks that are either thinking about going on this mad are on this mad, or even just like trying to understand where they are in fat liberation community, thinking about potentially dealing with a diagnosis they might have. Yeah. Oh, that is so powerful. Like cause that help is needed to even figure it out. It's forget even the physician's stuff. Like what you're gosh, I feel like, I'm sorry. We need to stress this for a second. If, if people knew the level of anguish that I had about getting on a med and it sounds insane because I know the data, right? Like I know all of this stuff, but it doesn't matter. I was still struggling with it. Right. And I'll never forget. My friend was a physician. We were at a conference and she said, Matea get on the med. Yeah. She's like, I've seen, cause she had known me three years up to that point. She's like, I have seen how hard you work. I have seen that you're doing your walks every day and you're eating all the, not processed food, dah, dah, dah. Like I was doing everything that I knew would better my health. And so many things, by the way, I want to stress this to people just in case someone's not on a med right now. And. of thinking, you know, they can't be on it for different reasons. I still reversed my pre diabetes, still lost, you know, 10 percent total body weight. All those things could still happen, but there was a point to where I couldn't go anymore. So I want to stress here. If all you can do is focus on, health promoting behaviors and the weight never changes. Hallelujah. Yeah. All of this, right? But sometimes you're then up against this wall, right? Like, especially where I was starting, I couldn't. fully get resolution on some of the things that were happening. And so I needed help from another tool. And the fact that I was denying myself, there were so many months where I said, no, I'm just going to crack down. I'm going to work harder. And it was like. I had for years been giving big investment in like multiple areas and doing all the things. And so that's what I just want to stress is like, I think that Casey, you are such an amazing source for that, that if someone needs to sit down and have that conversation, just amazing that you're able to help someone navigate that. Thank you. Yeah, I really I feel like this work is like so much larger than I am and I appreciate it so fully and I understand it in my own body, which I think is with this one. I think it's really important. You know, yeah, I really do. Yeah, I'm sorry, I think some things you have to have had the lived experience part, otherwise it's very hard just from a cognitive level, and I'm sorry, maybe I'm, I'm probably judgmental, I'm not talking about like that every physician needs to have struggled with it, but certain things, I think if you have not had, like, you just cannot understand my perspective. So I mean, I don't think that's judgmental. I think that's just being honest. Especially when I think about, like, I probably would have really struggled even more if I didn't have what I had in my mind as a medical reason, but the truth is struggling with any metabolic issue, and even just food noise. And, especially with binge eating disorder. You know, the trance I had talked about, like you have the right to regulate your nervous system in all these different ways. And medication is just one of many. Oh, okay. We're going to end there. That is brilliance and perfection. Thank you. So everybody reach out to Casey. We're going to make sure to have all the links. Thank you again. Your time is just incredibly valuable here and, we need to have you back for sure. Thank you. I would love it.