Physician and writer Mara Gordon joins us to discuss diet and wellness culture among medical doctors, why she took Ozempic for weight loss (and what made her quit), how she came to practice weight-inclusive care, and lots more. Behind the paywall, we get into why she was initially reluctant to write about weight inclusivity, her perspective on Ozempic and other GLP-1s now (and whether she prescribes them to patients), her upcoming book, and more.
The first half of this episode is available to everyone. To hear the whole thing, become a paid subscriber here.
Dr. Mara Gordon is a family physician and writer based in Philadelphia. She is a frequent contributor to NPR and often writes about size-inclusive medicine, fatphobia in health care, and is at work on a book about body justice. She also writes the Substack newsletter "Chief Complaint" at maragordonmd.substack.com.
Resources and References
Contains affiliate links to Bookshop.org, where I earn a small commission for any purchases made.
Christy’s second book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for extended interviews and more
Mara’s Substack
Christy’s online course, Intuitive Eating Fundamentals
Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: Here’s my conversation with Mara Gordon. I'm excited to talk with you today about your experience on Ozempic and your transition to becoming a weight neutral doctor and all that that entails. But before we do, I'd love to set the stage and hear a little bit about your history with wellness and diet culture growing up.
Mara Gordon: Oh, man. Where to begin? So I guess I'll start and say that I feel very, very lucky that I grew up in a family that I think, above all, sort of praised and emphasized my academic accomplishments, my mind. So I think that I grew up with a really, really strong foundation to resist diet culture in many ways. And for that, I am eternally grateful to my wonderful parents.
And my mom is a physician, as am I, and I think growing up, I really had a role model of a professional woman whose identity, in many ways centered around her professional accomplishments as a psychiatrist rather than body or beauty or size. And thank you, Mom. If you're listening, you. You really set a great tone for me growing up.
Christy Harrison: As a mom myself, I'm thinking about this too, as such an important foundation to set for your child.
Mara Gordon: Totally. And I'd love to talk about it in our role now as parents. I know we both have kids at home, so we can totally get into that, but I'm very grateful for the foundations that my family set. That being said, I'm a baby of the 80s. I'm an elder millennial, so I think some of it was sort of inescapable. And I remember my mom going on diets, talking about buying low-fat Triscuits. I think low fat was very much the dogma of the day, which is so funny how these trends wax and wane. It just shows how little we understand about nutrition in so many ways.
In the 90s, I read Seventeen magazine way before I was 17, of course, as sort of a tween. Did you read those magazines growing up, too?
Christy Harrison: Oh, yeah, for sure. I mean, I did somehow get my hands on Sassy, which I feel like was a little better than some of the other ones then. Yeah, Seventeen, I think, was a thing. Teen Vogue, Yeah.
Mara Gordon: Teen Vogue.
Christy Harrison: Yeah, Teen Vogue.
Mara Gordon: Yeah. I mean, Seventeen is the iconic one. And I don't know, this is a little bit of a deep cut, Christy, but do you know the Delia's catalog? Did you look at that as a teen?
Christy Harrison: Oh, I love the Delia's catalog.
Mara Gordon: Totally. And I actually saw some images of it online recently, and it's just shocking how all of the models are just extraordinarily thin in a way that actually, it was kind of positive to look at, because I feel like we've come such a long way, which is really, really cool. But I love a Delia's catalog. I sort of had this vision of myself, of wanting to be like a little bit of like an hipster. I mean, hipster wasn't a thing, but my ideal teenager role model was Julia Stiles from 10 Things I Hate About You. Like the sort of badass, takes no shit feminist teen, but who also was very thin and kind of like wore hipster adjacent clothing.
Christy Harrison: I was super into Gwen Stefani and ska music.
Mara Gordon: And that's what I wanted to be. I wasn't that, but anyway, so that obviously messed with me growing up. And I feel very lucky that I've never had any sort of clinically significant disordered eating. But wanting to make myself smaller has been a habit of essentially my entire conscious life, I think, from preteen onwards. So I think I've escaped the worst of it. But it's omnipresent in the culture, particularly in the 90s, as a woman in America.
Christy Harrison: I'm curious, what led you to want to become a doctor? Was that on your radar in your teens? And was there any sort of medical reasoning behind wanting to be smaller at all or any sort of medicalized thinking?
Mara Gordon: Yeah, as a teen, my experiences with doctors were pretty negative. I remember vividly going to the pediatrician when I was a teen and she told my mom, you know, you really should be buying non fat milk, not 2% milk, so that everybody can get thinner in your household. I sort of dreaded visits to the doctor as a teen. Luckily there weren't too many of them, thank god. I didn't have any medical problems. So this is just sort of like routine wellness visits and occasional aches and pains or colds growing up.
I sort of had an association of primary care as being a space of sort of an audit of body size and an assessment of body size. That was the primary role that it played in my life, which I think in many ways I'm lucky because it's a testament to me not having medical issues as a teen. So there's nothing else to talk about. But I think that's true for many people and I see that in my own patients every day, that the sort of cultural conception of what happens in primary care is fat shaming, frankly, so I'm on a mission to end that.
I didn't really think about being a doctor when I was a teenager. My mom is a psychiatrist, so it's a little different than primary care, which is what I do now. So my mom's interest was always mental health. Although I will joke, and mom, if you're listening, she loves to go onto like a database that I use all the time, it's called UpToDate, and it's about up to date medicine. And my mom, still to this day, psychiatrist for 40 years, loves to go look up medical stuff and diagnose herself, even though she hasn't done medical stuff and does mental health stuff. And so mom, I love you, but there was some of that going on in my teenagers too, which is fine.
Christy Harrison: It's fascinating because she has the medical degree, right? My mom does not. My mom is actually a therapist also, but a clinical social worker, but also was very much into doing that kind of stuff, like self diagnosing and then finding alternative remedies or whatever. But it's funny that even someone in the medical system or with a medical degree, like still.
Mara Gordon: Oh, totally. I mean, honestly, I do it too, right? And it's also funny that we're both the children of therapists, so maybe there's something to unpack there. But I started thinking more seriously about becoming a doctor actually towards the end of college. I was not pre-med in college and I went to work in public health in east Africa actually. And I wasn't sure what my long term career goals were, but I knew that I wanted an experience of working and living abroad and I moved to Tanzania. I worked for an NGO that worked in global health.
And just as a side note, it's a field that I haven't worked in for 15 years but it is devastating to read about the ways that global health is being gutted by the Trump administration is really profoundly unethical.
So yeah, that was a past life for me. But anyway, I was working in public health, which I really enjoyed, but I realized that I didn't see myself in a long term career in global health for a variety of reasons. I didn't think that I wanted to live abroad forever. And I really like talking to people. I'm such a people person. And I don't think I had really acknowledged that about myself. And so many of the people I saw, I worked with a lot of doctors, I met a lot of doctors while I was working in Tanzania. And so then I sort of got in my head that I wanted to go to medical school, so I came back to the US and did my science classes and then ended up applying to med school. So it was a little bit late to the decision compared to some people who know from birth that they want to be a physician. That was not me.
Christy Harrison: That's interesting, though. It was like a more of a life experience that led you there.
Mara Gordon: Yeah, definitely.
Christy Harrison: I'm curious what medical school was like for you in terms of diet and wellness culture. Because like you said, doctors and the doctor's office are sort of ground zero for diet culture for a lot of people. It's where some people experience the most fat shaming in their life. And that there are some studies that have shown doctors are the number one or number two source of fat shaming for people. And so I'm curious what you experienced in medical school that might feed into that.
Because it comes from somewhere. It comes from, obviously, people grow up in this culture, grow up in diet culture. Doctors are people too. They absorb all that's around us and all the messages about bodies and body size and all that. But I think there may be some things happening in medical schools, certain medical schools still, that contribute to that as well because it comes from somewhere, obviously, people grow up in this culture, they grow up in diet culture. Doctors are people too, they absorb all that's around us and all the messages about bodies and body size and all that but I think there may be somethings happening in certain medical schools that contribute to that as well.
Mara Gordon: Such a great question. And I've been thinking about this a lot because I am writing about it. So I'm working on a book about size inclusive medicine, and I'd be happy to talk more about it as we continue this conversation. I've been digging deep into my memories of med school, because I think we learn fatphobia in med school. I think many med schools are very intense places, but my med school experience was just extremely accomplished type A people. I mean, there was an Olympian in the class below me. There were college athletes. Ppeople had won Rhodes scholarships. It's a very intense place.
And I mean, fatphobia is just ubiquitous. So medical school is sort of organized into pre-clinical and clinical experiences. And now I'm a medical educator too, so I can talk about it from the faculty side too. So we're sort of in the classroom in the first two years and going to lectures. We're doing anatomy lab. And I mean, first, I'll just say everyone is insanely into exercise in a way that sort of surprised me. And I think exercise is extremely important to me. It's a big part of my life. But I have never seen anything like what my med school class was like and never since too.
Just to give you an example, I remember going on a trip to New Hampshire with some of my med school friends and we were going hiking and we did this 10 mile hike. I felt really accomplished and I was like, okay, I'm looking forward to drinking a beer when we get home. And a subset of the group that had gone decided to run the Presidentials.
So the Presidentials, I'd have to look it up, but they're like this set of mountains named after US presidents in New Hampshire. And I think it's like 25 miles or something. To hike the Presidentials is like a multi-day hike for most people. And they ran it in one day. Mad respect to them. I could see why people want to do that, right? They want to push themselves. I respect that it's a challenge that people want to take on, but I just remember being like, oh my God, I am not in Kansas anymore.
Christy Harrison: I don't want to have you throw your friends under the bus or anything, but I'm just curious, sort of in general, in this med school cohort that you were in and all of the sort of emphasis on exercise, did it feel disordered in any way? Do you feel like people had body image reasons or an idealized version of what the body should look like type reasons for doing this? Obviously not everybody in that class was a monolith, but I'm just curious if you saw any of that kind of coming up.
Mara Gordon: Yeah, I mean, I can't speak for any one individual, of course, but I mean, I will say that people drank a lot. So I think there was this sort of like, work hard, play hard kind of mentality that you see in a lot of elite institutions, elite workplaces that people drank heavily. There's sort of a party culture on the weekends. I definitely heard rumors of people buying Adderall so that they could focus. And I never witnessed it firsthand, and it's not something that I did, but there was sort of word on the street about that. And so I think the exercise sort of like fit into that culture.
There were hundreds of students in the school, so I don't know everybody's experiences, but I think that sometimes in grad school settings, this also happens in workplaces, in settings where there's a lot of pressure, you're also being told how brilliant you are all the time, our professors will say you're so smart that you made it here, it's just a high pressure environment. And I think that can lead to a lot of grief for a lot of people in different ways, whether it manifests in body image issues, in alcohol or substance use problems, or just anxiety and sort of mental health struggles too. So I think med school can feel high pressure.
Christy Harrison: I've definitely heard that about med school in general, that it's a total pressure cooker situation. And then that added level of the sort of eliteness of it, maybe felt there's an extra level of pressure there, I don't know. But it sounds like people were under a lot of pressure to perform in a certain way and maybe exercise was an outlet or also a way that they could kind of feel like they were performing up to a certain level or something like that.
Mara Gordon: Yeah, it's a lot. And it's interesting now. I'm an educator and I work with students as a mentor and as a teacher. And my sense is that the culture has changed a little bit. This is my 10 year anniversary of graduation from med school. And my sense is that the culture has changed in the last 10 years. I will say I'm not on faculty at the place that I went to med school, but I will say one thing pretty concretely, which is it's much more normative to openly discuss mental health struggles. And that seems like a huge change in the last decade for the better.
My students now openly talk about going to therapy, openly talk about practices to protect their mental health in a way that didn't feel quite as ubiquitous when I was a student. So that's good. Feels like definitely a positive change.
Christy Harrison: That's huge. What about on the diet culture side of things? I mean, obviously the fact that you're teaching where you are and you're bringing in, I'm sure, a weight inclusive approach to how you teach. Do you feel like that has shifted also in the last 10 years? Do you feel like there was a lot of diet culture baked into what you learned in medical school?
Mara Gordon: I do. I really think there's a culture shift and it's really galvanizing. So just to give you a little context, I was talking about the pre-clinical years where we were in the classroom and then when we start working in the hospital, it's such a profound shock, I think, for me to understand what hospitals were like. I had been in hospitals in my public health work. I had walked through hospitals, been on hospital wards. But I think to really have more intense experiences in hospitals and understand what it's like to be hospitalized was extremely humbling for me. And I think I didn't understand how awful it is. And I mean, I had intellectually, but I sort of hadn't absorbed the emotional weight of what it means to be sick and to be hospitalized.
I'll just say at the outset, the vast majority of my experiences in med school are really positive. I have many great friends still from med school, many mentors who are really wonderful, exceptional, caring, kind doctors. But there was a lot of fatphobia too.
And I was just thinking about one story from one of my very first rotations. So I was like totally brand new to the hospital and I was working in a general surgery rotation, which include bariatric surgery. And I remember sitting in clinic, actually, so this was like a post op visit for a patient who had had bariatric surgery with the surgeon. She was upset that she wasn't losing weight and she was chewing on a candy while she was in the doctor's office.
And I remember she said to the doctor, like, I want to be able to cross my legs like you. He was sitting cross legged. He was a very thin man. And she said, I can't do that, I'm too fat. Why am I not losing weight? And he wasn't hostile, but he said, like those candies you're eating, you're giving yourself a continuous glucose infusion. You have to stop that. You're never going to lose weight if you do that.
And it was just such a silly example because I remember vividly the thing about crossing the legs, like that was her goal. And then also the way that he sort of continued to shift the blame for her body size onto the patient even after she had had this major invasive procedure to try to make herself smaller. And I don't really remember what happened after that. It sort of ended. But interactions like that were just constant.
Christy Harrison: Ugh. Also just to point out, I feel like after bariatric surgery, people have such a hard time keeping food down, getting enough to eat with the small size of their stomach, the nausea and dumping syndrome and all that stuff can be very real. So, who knows what was going on for her? But having a candy, sometimes maybe that's the only source of glucose she's gonna be able to get in that moment, or she has to have kind of continuous small amounts coming in because her stomach can't handle anything else.
I'm a dietitian. I don't specialize in bariatric surgery, but I know enough about it to know that it completely alters your relationship with food, your ability to take in food, your ability to keep down food, processed food. So it seems a little bit callous that the doctor would shame her for having the candy and sort of not take all that context into account.
Mara Gordon: And a lack of curiosity about what was going on in her life. I've been reflecting on many of these incidents as I've been working on my book, and I think a lot of it comes down to a sense of control. Doctors, we sort of create this dichotomy between doctor and patient. Right? We talk about patients as a monolith as if we aren't patients. And, of course, we are humans with bodies.
And I think that that dichotomy is multifactorial, right? The doctor is highly educated. Many patients in the hospitals where I trained were poor people of color. And not that the doctors were all white, but the medical institution was a very white space. So the people of color were very comfortable in white space spaces in order to succeed there.
And I think that's part of the story that we tell ourselves about our patients, like, they're not taking care of themselves. They don't understand as much about health as I do, and it's their fault that they're fat. Because I think ultimately this is the conclusion I've come to, that it's sort of a story about our own mortality. That it's like a way we weave a narrative, that we're somehow different from the inexplicable and often random suffering that we see in the hospital. And we say to ourselves, okay, if I can just be a marathon runner, I'm gonna protect myself from this suffering and illness and death that I see in the hospital, which is obviously not true because we're all gonna die.
So that's sort of my psychological hypothesis about a lot of the fatphobia that I witnessed, that it wasn't that doctors woke up every morning saying like, hey, I really want to make my fat patients feel terrible. I genuinely believe most doctors don't want to do that. I think it's this complicated sort of othering of our patients that is a means of sort of preserving our own sense of control in our own lives.
Christy Harrison: Yeah, that makes so much sense. I really resonate with that idea. The othering serves a sort of defensive purpose for the person doing the othering. It's like, oh, I couldn't possibly be like that person because I do all these things to take care of myself and they're the way they are because they're not educated or they don't know or whatever. Yeah, it's so much more complicated than that.
It makes me think about what the experience would be like for doctors who are in larger bodies, which as we know, it's a rarer thing to have larger body doctors. I mean, I think increasingly people in larger bodies are going into medicine, but I think it's a pretty unwelcoming space in a lot of ways to higher weight people. And so I wonder, how do you see that playing out in medical school now? Do you see more higher weight people coming in to train to be doctors? And how does that shift the dynamic with their patients around food and body stuff, weight stuff?
Mara Gordon: I'm not familiar with any scientific literature on this topic. I'm sure it's been studied, like the percentage of people with higher BMIs who work in healthcare. On the one hand, there are fat people everywhere, right? Most of us in the United States are considered overweight or obese. And just as an aside, I know many of your listeners are familiar with some of the reclamation of language around body size. And I try, it's hard, but I try to use the word fat as a neutral descriptor like I know many of your listeners do.
You'll hear me talk about BMI and obesity simply because those terms are so ubiquitous in my field. So I use them because they're often like the terms in scientific studies that sort of describe different body sizes. But there's a lot of limitations to them, which I'm sure your listeners are aware of. But I still use them because I find that it's a way that makes sense in my field and that people understand in my field.
Christy Harrison: I do as well, if I'm referencing a scientific study or talking about the concept of "obesity," and I'll usually put it in quote marks or whatever. But yeah, I think it's important to be able to have to sort of bring in people who might be still steeped in that kind of language or talk about things that you really only can talk about if you're referencing it in that way.
I will typically say higher weight or larger body as neutral descriptor just because I am a thinner person, a smaller bodied person and I know that sometimes people can have complicated feelings about hearing a smaller bodied person use the word fat. And I don't want to like put that on anyone or come across as stigmatizing in any way. But I fully support using that and I will use that with someone who uses that term for themselves. I'll join them and support them in using that term. But in my public work I tend to say larger bodied or higher weight.
Mara Gordon: It's complicated, it's very emotional. I can see an argument that there are fewer people who live in bigger bodies going into medicine. But on the other hand, I also am a primary care doctor. I try not to go into the hospital as much as I can because I like my clinic. But in my role as a medical educator, I do find myself in our big academic hospital at times and looking around, I mean, there's plenty of people who live in bigger bodies too. So I just don't know the stats on this topic. But I will say, I'm always reminded that two thirds of Americans are classified as overweight or obese. So obviously that's reflected in healthcare, which is a major industry and our country.
So all that being said, I do think that there's a lot of normative assumptions about trainees and about people working in healthcare that are false. And oftentimes they have to do with body size and oftentimes they have to do with body size as sort of like a marker for "health." For example, one of my students told me the other day that she was having a lecture on sleep apnea, which is a condition that's associated with having a higher BMI, but often associated actually with having a wider neck circumference, which can correlate with BMI but I have pediatric patients who have sleep apnea who are not considered overweight. So it's, it's a complicated disease, like many diseases, like all diseases. And it's sort of taught like, oh, obesity is a risk factor, but I think the reality is more complicated.
Anyway, the lecturer was talking about sleep apnea, and he sort of looked out at the audience and he said, oh, well, you guys are all healthy. You don't have to worry about this. And it was a student who lives in a bigger body who told me this story and just sort of how stigmatizing that felt. And I even catch myself doing things like that again. I am unlearning a lot of my internalized fat phobia. It's a work in progress. But, you know, I'll say something to a student like, oh, well, you have healthy kidneys, so you could take this medication without changing the dosage for somebody with kidney disease. And then I'll say, wait, wait, wait, wait. I actually don't know your medical history. I don't know anything about your kidneys.
But in healthcare, we often assume that our colleagues are the portrait of health and our patients are all ill. That may be some ageism too, right? Most of my students are in their 20s. There are some who are older, but for the most part, my students are in their twenties too, so maybe that's my own ageism as well. But anyway, the point is that this dichotomous thinking about doctor and patient is very deeply ingrained. And I'm trying to unlearn it. I definitely think, going back to your question, which is our students, a new generation of Gen Z students changing the game, they're much more interested in size diversity.
There's an amazing organization that actually was sort of born out of the med school where I teach, which is Cooper Medical School of Rowan University, which is in South Jersey, in Camden. And one of our students founded this now national organization called Medical Students for Size Inclusivity, which has chapters at med schools all over the country. Really cool.
I'm reluctant to weigh in on Gen Z fashion trends because it's outside of my area of expertise. But I sense that my students are dressing not for the male gaze. I think in the same way that I grew up, with skinny jeans or whatever. I think the culture feels a little bit different in the way that people live embodied lives. And I hope that that's changing.
Christy Harrison: I hope so too. For sure.
Mara Gordon: Yeah.
Christy Harrison: I want to talk about how you got to this weight inclusive approach because as you said, you're still unlearning some of the fatphobia you intern internalized. And it is pervasive in medical schools and in society and just everywhere. It takes a lot of unlearning, for sure and an ongoing process for all of us, I think. But I'm curious what brought you to that approach in the first place? And how was that shift in your practice?
Mara Gordon: I would say I think there's two threads in it for me. One is professional and how I sort of matured as a clinician and learned to relate to my patients as a clinician. And the other is very personal and sort of how I've tried to shift my own thinking about my own body. And they kind of happened in tandem, as many of these things do.
I guess I'll start with a professional and I really had been trained to sort of recommend weight loss to everybody who had a BMI over 25, which is sort of crazy now that I think about it, because, I mean, that's almost everyone. Truly, it's crazy. And I think it does so much harm that physicians really, really underestimate. So, I was sort of parroting these talking points to my patients, like, have you jumped on the treadmill more frequently? And I just really started to notice over time that it really wasn't working and it wasn't helping them lose weight. And we could talk about whether or not that's the goal, which I've sort of shifted from thinking that should be a treatment goal. But even if it is your treatment goal, the recommendations I was making were not working.
Christy, so much of your work is about how weight loss is very, very difficult to achieve and diet and exercise are often not particularly long term effective tools to achieve weight loss. I started reading more about the efficacy of a primary care intervention, like a primary care doctor saying, hey, eat some more broccoli. And the literature really shows that it's ineffective for weight loss. And I didn't know that. It's just so basic and it was such a cornerstone of my training and we think of ourselves as people of science, but yet it's quite unscientific.
Christy Harrison: It's interesting how these things just get passed down by professors who might not be up on the current literature or whatever, or who knows how it gets disseminated, but it just sort of becomes standard practice and we don't think to question it until we do.
Mara Gordon: In many ways, many of my professors were extremely up to date on the current literature and prided themselves on being so. But I think there's also this thought that's a little more subtle, which is like, well, it may not work, right? Like me telling somebody to exercise more frequently may not be that effective in helping them lose weight, but it's not going to cause any harm, right? And it's free. It's not a medicine. It doesn't have side effects. Like, it takes me two seconds to say in a visit.
And that's where I think we get to the point of doctors underestimating the harm, right? That they think it may say, huh, well, I'm not sure this is super effective, but at least it's harm free, right? And we know that it's not. It's really not. And I think it's dramatically underestimated how much harm that kind of diet talk in clinical settings can be.
So I was sort of noticing over time that this just wasn't really working and that people sort of disengaged with me. And I had learned a bit about the health at every size movement. And it's funny, my first introduction to it, I'll just show a really brief story. I worked with a doctor in residency in my training who's wonderful, who I'm still in touch with to this day. And we were seeing a patient together and the patient said, oh, I come to see you because you are health at every size doctor. And she sort of said, yeah, great, I'm so happy and then we leave the exam room and Dr. M turns to me and says, what's health at every size? I have no idea.
And to me, I love that story because I think what the patient was responding to was just her bedside manner, right? That she was not judgmental. She sensed bodily autonomy and letting the patient define their treatment goals was just like the core of the way that she approached care without even thinking about it, without needing to give a name to the ideology. And now this doctor has a thriving practice where many people seek her out because she, as I like to say, doesn't yell at them about losing weight.
I think it showed me that you don't necessarily need to have a label or an ideology to practice in a way that is more supportive of our patients bodily autonomy. But then I googled it and sort of learned about it and I was a little skeptical. But yeah, I started reading more about it, reading more online and meeting other doctors who practiced in more of a size inclusive approach.
And I think the shift in my practice was very subtle. I didn't post anything on social media. I didn't write anything about it. And I will note that I've been writing about so many issues in medicine for many years and was writing pretty prolifically at the time that I started making the shift but I still felt kind of scared to write about it publicly, which is interesting because I was writing about racism in healthcare, I was writing about reproductive health, all these hot button issues, but this one is really stigmatizing and taboo in a way that I'm only starting to really wrap my head around.
Christy Harrison: What about it made you afraid to touch it? And does that perhaps play into your own personal journey of kind of unlearning weight stigma and your experience with taking Ozempic?
Mara Gordon: Yeah, you hit the nail on the head. It's absolutely does.
