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Novelist, editor, and longtime friend of the pod Jonathan Vatner joins us to discuss his experience with a chronic autoimmune digestive condition, his ups and downs with diets and alternative medicine, nuances in the research on probiotics and acupuncture, the mind-body connection and how it’s helped in his healing, and more. Behind the paywall, we get into how he came to develop acceptance for his chronic illness, how he’s been able to take pleasure in food despite his digestive troubles, his appearance on Christy’s first podcast way back in 2014, how his relationship with food has evolved, the new novel he’s working on, and how he’s rethought wellness after everything he’s been through.
Jonathan Vatner is the author of THE BRIDESMAIDS UNION (St. Martin's Press, 2022) and CARNEGIE HILL (Thomas Dunne Books, 2019). His fiction has earned praise from People, Town & Country, The New York Post, and the Los Angeles Review of Books. He is the managing editor of Hue, the magazine of the Fashion Institute of Technology, and teaches fiction writing at New York University and the Hudson Valley Writers Center. Learn more about his work at jonathanvatner.com.
Resources and References
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
Jonathan’s website
Jonathan’s NYC reading series, Village Story Salon
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: So, Jonathan, welcome to Rethinking Wellness. I'm excited to talk with you.
Jonathan Vatner: Thank you. I'm excited to be here.
Christy Harrison: To introduce the listeners to you, if they don't know you, we have been friends for 20 years. I think we met each other back in, like, 2004, 2005, something like that. So it's hard to know where to start. But I think it would be good to start by talking about your history with diet and wellness culture and with chronic illness as well, and sort of how that played into that.
People who've been listening to my podcast may know you from way back in 2013. Anyone who's been listening that long gets a gold star because it's been a long time. But you were on the pod way back then, talking about your relationship with food and chronic illness and stuff. But I think most people listening to this will not have heard that. So feel free to go into as much detail as you like.
Jonathan Vatner: And things have changed. It's been 10 years.
Christy Harrison: Exactly.
Jonathan Vatner: Well, I can tell you kind of how it all started. I grew up with a pretty food, healthy family. I think that I was never on a diet. No one in my family was on a diet, basically, until I was 13 and I was diagnosed with Crohn's disease. I had lost an incredible amount of weight from the illness. So my first diet was really to help me gain the weight back.
And I think getting the illness really scared my mom. I think because we had been in this sort of utopia where me and my brothers were in good health, and then suddenly I was very, very sick. And I think she was very anxious about it. She used the word anorexic in terms of me not eating. I wasn't eating because I felt very, very nauseous. That felt very shaming to me, even though it was like a clinical term.
Christy Harrison: Because anorexia, it actually just means loss of appetite. Anorexia nervosa is the thing that we'll colloquially call anorexia, which is the eating disorder. But just straight up, anorexia technically is just not eating.
Jonathan Vatner: Yeah. And my parents are doctors. So they were very clinical about the whole thing. But I had only heard that word in one context, and so I felt a lot of shame. I felt like I had kind of let my family down by being sick. And the other thing that happened was they asked me not to really tell anyone. They said that people would see me differently if they knew I had a chronic illness. And that also felt very shaming. I was already in the closet about one thing, which maybe your listeners can guess, but this was like another situation where I was in the closet. I was sort of hiding myself from everyone, and it was very isolating.
So I say all that because I don't think I was treating my body right for really the first couple decades of having the illness. There were some diets that they advised in order to kind of keep symptoms down and gain weight, but for the most part, there just was not much information about nutrition and about paying attention to what I ate. So I just kind of ate whatever the heck I wanted, except when I was really, really sick.
So they put me on some steroids and I got better. I think I didn't realize the connection between what I was eating and my health and my long term health, my longevity, really, until after I had had two surgeries. When you have Crohn's, often you have to have surgery to remove some intestine that's scarred over and kind of blocking the food from going through. And I had one when I was 19 and one when I was 31. And it was like I was slowly learning what food sort of triggered my illness.
But it really wasn't until after that second surgery when I realized, oh, like, I actually am going to have to really take very good care of myself, because a third surgery could mean I would have not enough small intestine to absorb food and I would die or I would be on a very limited diet, like an elemental diet or something that would just give me nutrients, but I wouldn't be able to eat food. And then the other thing is if they took out too much large intestine, I would need an ostomy bag for the rest of my life. So I kind of wised up. I think most of my learning about my illness and most of my healing happened since that third surgery, which was now 13 years ago.
Christy Harrison: Wow. I remember you telling me when we talked 10 years ago or whatever back in 2013 about this, that you had found that there wasn't any sort of standard Crohn's diet. There was nothing that was really scientifically proven to be sort of the gold standard diet for Crohn's or whatever, that you just had to figure it out on your own. Is that still the case?
Jonathan Vatner: Well, everybody is different. And so I think a one size fits all diet maybe wouldn't work for everyone. Certain foods make me very nauseated that maybe don't for other people. It was around after the second surgery when I started seeing dietitians who specialized in Crohn's. There were two of them, and they sort of guided me toward what made me feel good. And I had never really paid attention to eating things that made me feel good or avoiding things that made me feel sick.
And I guess I want to say now that I know, Christy, that you have done a lot of research on elimination diet and that your ethos is very much to find a way to just eat intuitively. I think when I was sick, maybe I wasn't tapped in enough. But right now, there are very few foods that I completely avoid. But back then, it was helpful to cut a couple things out of my diet.
Christy Harrison: Do you feel like it was almost a way of getting in touch with your body? Cause it sounds like you were not really in touch with how things sat for you. And it can be complicated, too. If anyone listening who's working on intuitive eating and coming out of a disordered eating history, I think it can be really tricky. Or coming from chronic dieting, it can be really tricky to try to start listening to your body and notice what feels good and what is digestively comfortable and all of that stuff, because there's so much baggage on certain foods culturally. We get all these messages about gluten and dairy and this and that, and it can be, I think for some people, especially in that boat of recovering from chronic dieting are so influenced by that that it can sort of almost trigger the symptoms, or people really anxious and attribute symptoms to particular foods when maybe that's not always the case.
But I also think for sure, for people with chronic digestive disorders,learning to be in touch with your body and know what's going to feel okay and what sits right and what doesn't is a helpful part of the process. And it just can be so tricky to disentangle. I know for you, you didn't have really a history of dieting or disordered eating prior to the Crohn's so maybe that wasn't the case for you, but I'm just curious what your experience was like, of learning that.
Jonathan Vatner: I definitely didn't know how to listen to my body. And now I feel like I do, and it really makes a huge difference, I should say. After the first surgery, I asked. He was not the surgeon who operated on me, but he was the surgeon who was visiting me in the hospital. And I was like, is there anything I can't eat now? When I was very sick, I had been used to kind of eating only potatoes or whatever. And he said, no, you could eat anything you want. And so I went home and I ate six fried chicken strips, and I got really sick. Came down with gastritis. It was excruciating pain. And I had to go back into the hospital for a week while they figured out if I had ruptured something.
I was on the absolute worst antibiotics where they had to monitor me so that it wouldn't kill me. Sorry, it's so dark. There are a lot of moments where I've had to sort of contend with mortality, but that felt like a betrayal to me that the surgeon had just said, no, no, anything you want. But it also was really interesting that that's what I chose to eat food that was just going to be really hard on me. And that, I knew was hard on me. But I think because I had been restricting so much leading up to it, I think I was just desperate to break all the rules, and it kind of shot me in the foot.
Christy Harrison: And then you had this permission, too, that you can eat whatever you want. I think I told you a little bit about my birth experience and how I ended up with ileus after my C-section. And it was nothing like that, where I was barely eating and just sort of coming back online. But even the foods that I ate when I was first in recovery, that ended up coming back up and not being digested with the ileus, even that was so difficult and hard on my system. And I feel like when you're coming out of surgery, I guess my point is anything on your stomach is probably going to be a little bit irritating. And taking it slow is a good thing. It's surprising that he didn't say any of that or give any sort of caveats.
Jonathan Vatner: I mean, I think medicine at that time was just really not aware. They just thought, especially surgeons, "Oh, we fixed it." They weren't aware that actually there's some sort of mindful maintenance involved. That first full meal that got me back in the hospital actually was the first step toward having to have another surgery 12 years later
Christy Harrison: Question about the connection, so Crohn's is an inflammatory bowel disease affecting primarily the small intestine, right?
Jonathan Vatner: And large. Both small and large.
Christy Harrison: Both. Whereas ulcerative colitis is only the large. And then gastritis is a different thing. And I remember also a while ago, you saying that you also had diverticulitis. Those are all distinct things, but it seems to be that people with Crohn's perhaps are more vulnerable to those things or I'm not sure.
Jonathan Vatner: So gastritis is like an irritation of the intestine or of, I guess, probably any part of the gastric system.
Christy Harrison: Yeah. The stomach.
Jonathan Vatner: Yeah. And that was just extremely painful. I mean, I can only describe it as the most agonizing pain of my life. The diverticulitis, it's funny, I don't actually remember having that, but I know that people with Crohn's often get it, and some people just are prone to that, eating little seeds or something. What I did have, which is similar to the diverticulitis, is a fistula, which is so disgusting, but it's when a little bit of your inside burrows to your outside and then just pops open. And I will spare your listeners the rest, but just pray that no one gets one of those.
Christy Harrison: Yeah, yeah. That sounds incredibly painful. There may be people listening who've had them. And I'm sorry to anyone who's going through that.
Jonathan Vatner: Yeah, it was definitely not fun.
Christy Harrison: No. So you said that that experience then of going back in the hospital with gastritis triggered what ended up being sort of the next iteration of the Crohn's and the next need for surgery.
Jonathan Vatner: Yeah. I think it was just the first inflammation and scarring. And then after that happened enough times, again, the intestine started to close up, and I eventually did need to go back in. There was always a point when I just had to stop eating solid food because it would be too painful. But the good news is, after the second surgery, I really started to get in touch with my body.
I went into therapy. I had seen a therapist briefly in my 20s, but really, my first kind of long term, really Intense therapy was right after that first surgery. And I believe, and I don't know if this is scientifically proven or anything, but I believe actually it was the therapy that really saved me and actually cured all my symptoms because I am symptom free and I've been off medications for a couple years. I think not only has kind of knowing myself helped me just be more attuned to what I eat, but also it just seems like there's some relationship between just getting out my anger and like realizing myself as a person and just feeling fully present. I feel like there's a relationship between that and this illness sort of going away.
Christy Harrison: That's really interesting. I mean, I know that there is such a mind body connection with digestive disorders and so many other things as well. But it's not to say that all digestive issues are all in your head or anything like that, but that experience of therapy and healing various forms of trauma, I imagine, too, was helpful to your physical health. That is a common experience for sure.
Jonathan Vatner: Yeah. I mean, again, I don't know if there's data about this, and I don't want to say this is for sure what happened. I think it should be studied more, how psychotherapy does alleviate symptoms from illness. I have just felt really, really good. And I think a large part of that really has just been the mental health aspect.
Christy Harrison: You were on biologics for a while, right?
Jonathan Vatner: Mm. I was put on Humira, which is biologic, as soon as the second surgery ended as a preventative medicine. And I came off it about two years ago just because I hadn't had any symptoms in a while. It causes side effects. The doctors, they treat it like it's this kind of magic bullet that is like perfect, but actually, it suppresses your immune system. So, there's just a lot of stuff. Mostly like stuff with the skin, like warts and things. But I just thought, why am I taking this if I feel good? And my doctor was like, well, it's your choice. You can have a drug holiday. And so I am still on holiday.
Christy Harrison: Wow. I mean, that's pretty amazing. And I think by the time this airs, I will have just released an episode fairly recently with someone else who had Crohn's who was on biologics and felt that that was really the thing that made their symptoms manageable.
Jonathan Vatner: It is a great drug. I also don't want to poo poo it that I think if I were sick it would help. And actually I was on one right after my first surgery and it made a huge difference. And the aforementioned fistula got cleared up, got sort of fixed from that. It still needed like surgical fixing, but the problem went away because of the biologics. So I really think it's a great drug. It just does have side effects and I think it's maybe not necessary. It wasn't necessary, I think for me to be on it just preventatively.
Christy Harrison: Yeah. Being put on it preventatively sounds like a very different experience than being put on it as treatment for real symptoms that are happening. So maybe you are already in a period of remission before that or something,
Jonathan Vatner: I think so .
Christy Harrison: What has been your experience with alternative medicine? Because I know you've dabbled in that along the way as well.
Jonathan Vatner: Yeah, I think it was really after the second surgery that I started to do it. I've done a lot of acupuncture. I don't know if chiropractic would be considered alternative, but I've done a lot of that. And I've tried various supplements, mostly vitamin related supplements. But I can kind of walk you through these things. So the acupuncture, I actually did it first to alleviate some back pain because I had heard that it worked for back pain and massage wasn't working and I hadn't yet tried physical therapy, but I tried acupuncture and it didn't do anything for my back pain, but it like alleviated my digestive symptoms really beautifully. It wasn't permanent, but for probably like a week or two I was just feeling so, so good digestively.
And so then I started going to acupuncture regularly to calm any sort of irritations. I wasn't having like an active flare up. But after my second surgery, I definitely would sometimes get a little bit sick and I wanted to kind of nip that in the bud. And it seemed to, I don't know how to put this. I don't either, believe it or not believe it, the Power of Alternative Medicine. But it was working for me. And. And so I kept doing it.
Christy Harrison: I remember you reading the first draft of my book, The Wellness Trap and responding to it. And one of the things you said was, "Acupuncture really worked for me. But I also wonder if just lying on a table meditatively for an hour was really what I needed and what helped."
Jonathan Vatner: It's possible. I really don't know. It is a very meditative experience because you're lying there, the needles are in you, so you don't really want to move too much.
Christy Harrison: There's nice music playing sometimes. At least the place I used to go to, there was nice music. It was very calming.
Jonathan Vatner: And I think it helped to have the acupuncturist paying attention to me, and it's this sort of light, friendly touch. I mean, the little pricks of the needles sometimes hurt a little bit. But it's nice to have someone in the medical profession or alternative medicine profession taking care of me, which is something you don't really get with most doctors who really just don't have time.
Christy Harrison: Totally. Yeah. I mean, especially, as evidenced by this surgeon who was like, "Yeah, sure, anything you want," and sort of threw you to the wolves.
Jonathan Vatner: Yeah. And with the chiropractic, the adjustment seemed to mostly help, physically and muscularly. But there's all these other treatments that my chiropractor has given me that I don't know if it's what is making me feel better, but it does seem to make me feel better. So I don't know. There's this, I forget what it's called. It's sort of a heavy ring that puts, like, a magnetic field into me, and I can feel myself getting tired when it's on me, and I think it somehow relaxes my insides. I'm not sure. There's some injections of vitamin B12 that do give me a lot of energy for a short time.
Christy Harrison: Do you have nutrient deficiencies from the Crohn's? Is that part of it?
Jonathan Vatner: Right. So that's another reason the doctors actually want me to take the vitamins too, is people with Crohn's often have deficiencies in B12 and D and calcium, and there might be one or two others. So when I'm low, I do take vitamins, and it really helps.
Christy Harrison: Yeah. And I mean, vitamins are so essential for any sort of deficiency. I think that's the tricky thing about the supplement industry and how unregulated it is and all the problems with it in the U.S. and other countries, too, that people do need these things. People need supplements as well and they're not necessary for most people, I think, for the vast majority of the population, people without deficiencies or for some of the things they're prescribed for, there's really no good evidence there. But for deficiencies, it's essential. And to be able to get something that's well manufactured and a correct dose and you know that the dose they say on the bottle is going to be what you get, all of that is really important for people who actually have a medical necessity for these things.
Jonathan Vatner: Yeah, totally, totally. And it has really helped to get the blood panel to see what's deficient and to take that stuff. I go on and off with probiotics. I feel like there's something there, but then sometimes it does something and then sometimes it doesn't. I guess what I'm saying is I'm kind of willing to try stuff and to do stuff as long as it's not too expensive. And mostly it's all been pretty reasonable and sometimes it feels like it's helping.
Christy Harrison: Yeah, I mean, there's definitely, I think with some of the stuff, there's not a lot of good evidence behind it. But the power of the placebo is very real. And also the power of just relaxing and having someone take care of you and all of that, that is actually part of the sort of larger family of placebo effects, is the care effect of feeling like you're being cared for and being empathized with by a provider and having your concerns taken seriously and being listened to. All of that is so healing in and of itself, regardless of what the treatment actually is.
Jonathan Vatner: Yeah, totally. Like with acupuncture, for example, I have seen some acupuncturists that did nothing for me and then some, it's like a miracle. So I don't know if it's like the connection I have with the person or if actually they are getting the needles more exactly. It sounds like maybe the studies show that it doesn't really do anything beyond the placebo effect. But then I wonder if they found the right acupuncturist. Maybe there are some for whom it's really effective.
Christy Harrison: It's interesting. There's systematic review of systematic reviews on acupuncture that I looked at that looked at just general adult health conditions from 2013 to 2021. It was a very comprehensive review of all this science, and it found that the certainty of evidence was low or very low for a lot of these things. There were conflicts of interest. There were studies that weren't really blinded or randomized or whatever. So it was sort of like, "Well, who's actually enrolling in these studies?"
And it found basically for most health conditions, that there wasn't really any good evidence behind them. But interestingly, a lot of the studies that look at real acupuncture versus sham acupuncture, some find there's some difference and there's actually a little bit of a benefit from the real acupuncture versus the sham. But most find that there's no difference. And some studies will conclude that that means regardless of whether it's at the traditional acupuncture points or not, which is what some sham acupuncture studies will do, is they put the needles in, but they're growing at different points that have nothing to do with traditional acupuncture. Or some of them will do fake needles that don't pierce the skin, so they look like they're going in, but they actually don't pierce the skin.
So there's various ways of doing sham acupuncture, but oftentimes the studies will find that there's no difference between real and sham. And so then it becomes like, okay, it might be the whole ritual, whole process of acupuncture in and of itself. And maybe there are differences in the providers and how they not necessarily administering the needles, although again, maybe in some studies there have been some small differences with the real versus sham acupuncture. But more broadly, some practitioners are just gentler and kinder and more empathetic or give you more in that exchange for whatever it might be.
Jonathan Vatner: Yeah, I mean, it's so such a big black box. And it's not that I don't believe research studies, of course I do. But then it's always like, well, maybe it's my acupuncturist is better than that. I feel the same way about psychodynamic and psychoanalytic therapy. When I was in college, the research was that CBT, cognitive behavioral therapy, was the gold standard and like other types of therapy, where you lie on the couch or whatever, were not as effective. But have they met my analyst? He is so good. I can feel myself changing in a way that I just don't think that other types of therapy would do it. So I listen to the study, but then sometimes I just want to do my own thing and experiment.
Christy Harrison: And actually, with therapy, there's been research showing that the therapeutic relationship, over and above any type of difference in therapeutic style is often what makes a difference. So maybe there is something to that, that it's your relationship with this one particular person that's having the effect. Maybe he could have a similar effect on you personally, whether he was doing CBT or analysis or whatever. Or maybe for you, the process of analysis is what's really exciting and part of the fruitfulness of that relationship or whatever. But I think it does have a lot to do with the person, too.
Jonathan Vatner: Yeah, I believe that. And so it makes it hard to study it I think.
Christy Harrison: It does. It is hard to study things scientifically and to control for all the variables because people are so different. And so studies aren't going to, like. I've just been writing recently about observational research and how tough it is to control for every variable. And studies will try to control for education and race as a proxy for socioeconomic status, but leave out income. But even if you bring in income, does that really capture the fullness of what someone's experience is, what someone's socioeconomic status is in a lived way? Not really. It doesn't fully explain it.
Jonathan Vatner: Yeah, no, I agree. Once you get out of the petri dish, everything is harder to control.
Christy Harrison: Yeah, even randomized controlled trials sometimes. Because designing control for something like acupuncture is really tricky because people know. They can see and feel what's going on.
Jonathan Vatner: Totally.
Christy Harrison: You talked a little bit about probiotics and supplements and stuff. Do you still feel like that's useful or you kind of go back and forth on it?
Jonathan Vatner: I think that's another one where I got into this belief that some were better than others, some did nothing. For me, some really worked. It seems like all of them, even the ones that really work, stop the benefit after like a month or two. So I just don't know. That's another thing. I just don't know. I don't take one currently. It seems like it must have an effect because it's such a large industry. There was one I was taking that I felt so good for a long time, and then after a while, it was over. And so I just don't know.
Christy Harrison: Yeah, I looked, actually, because I knew we were going to be talking today. And so I waslooking at some of the research on this. And again, there was a 2020 systematic review that found no evidence of a difference between the use of probiotics and placebo for Crohn' or for induction of remission in Crohn's after six months. I wonder if for some people, there's a placebo effect at the beginning perhaps, of feeling excited about something new. There's also potentially the sort of regression to the mean effect or the natural history of disease where people are in a period of remission that's coinciding with starting a new medication. And so the symptoms are ebbing just at the time when the new medication has started. And so it can sort of feel like that's what it is, even if it's not.
There are a few indications for probiotics, especially after taking antibiotics, for example. That can be one thing, that if people are having diarrhea associated with taking antibiotics, there seems to be some benefit of taking probiotics.
Jonathan Vatner: Yeah, I could see that, that the reason it works for a little while for me is because it kind of fixes the microbiome or whatever, and then once it's fixed, there's no more benefit to be had. Maybe that's the idea.
Christy Harrison: Yeah. Although I think with the microbiome, with those probiotics anyway, you kind of have to take it long term. Once you stop, whatever bacteria were there aren't really colonized or set up in your digestive system. They just kind of go away. Interestingly, that's something with a microbiome in general, where it's very malleable to what you eat, to what you take to anything sort of going in. It's not really like this consistent community, the way that we're sort of conditioned to think of it. There may be some species that are more durable than others, but in general, the microbiome can change in radical ways in 24 hours, just based on what somebody's eating or the medications they're taking or whatever.
Jonathan Vatner: Wow, that's so interesting. I guess what I'm learning if I were to summarize everything we've been talking about, there are some illnesses that modern medicine can just cure. If you have an infection, you could take an antibiotic and you're fine. And that's so great. And then there are a lot of illnesses where there is no good cure. Modern medicine can do one thing, but then maybe the side effects are really bad or maybe it doesn't fully work. And then alternative medicine or whatever, diet or anything could maybe help in other ways. But I think sometimes I've just had to accept that there's no fixing it.
I could pour a whole ton of money into trying to fix it, and ultimately the only solution is just to wait until my body fixes it. And it's hard to accept that I'm sick and there's nothing I can do. And I bet a lot of people who are sort of caught up in alternative medicines, just really have not been able to accept that. And I realize that some illnesses are just so bad, you absolutely couldn't accept that. But it's just kind of a sad thing about health that sometimes there just is no cure.
Christy Harrison: How did you get to that point? Because I have multiple chronic conditions myself, not as severe as yours, but I think it's taken me a while to get to that place of acceptance as well. Where it's like, okay, I'm going to be dealing with this probably for the rest of my life, and there's no way to put it into remission and never have to think about it again. I might have periods of remission or periods where it's quieter but there's probably going to be an ebb and flow, and I have to just accept that and that there's nothing I can do that's going to magically make it go away.
And I remember feeling, and I've heard from people who also have had this experience or are continuing to have this experience, if I let go of that hope that something can fix it, that it can be sort of cured or put into remission, durably, if I let go of that hope, then I'm just giving up, or I can't deal with accepting and what that means. So I wonder if you went through a similar phase or what it took for you to get to a place of that kind of acceptance.
Jonathan Vatner: I think just experiencing not only the Crohn's, which really
