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Author and activist Amanda Martinez Beck joins us for a nuanced conversation about her experience of taking Ozempic for diabetes while also working to accept her body and break down anti-fat bias in society. She shares her history of dieting and disordered eating, how chronic conditions including diabetes as well as fibromyalgia and post-Covid syndrome have impacted her relationship with food and her body, why she started taking Ozempic in the first place, how diet culture is a new form of religion, and how her actual religious faith has influenced her eating-disorder recovery. Behind the paywall, we get into the tricky landscape of Ozempic and eating disorders, how Ozempic has fallen short of what the ads and influencers promise, the side effects she’s experienced, her take on all the GLP-1 hype, and more.
Paid subscribers can hear the full interview, and the first half is available to all listeners. To upgrade to paid, go to rethinkingwellness.substack.com.
Amanda Martinez Beck is a fat activist, educator, and the author of More of You: The Fat Girl's Field Guide to the Modern World. She runs the Instagram account @your_body_is_good, where she combines her love of hand lettering with her vision of fat liberation. Amanda lives with her husband and four kids in northeast Texas, and she writes a weekly Substack called The Fat Dispatch.
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
Amanda’s book, More of You: The Fat Girl's Field Guide to the Modern World
Amanda’s Substack, The Fat Dispatch
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: I'm excited to talk with you today about your experiences of taking Ozempic and the nuances of being on it for diabetes, while also being committed to size acceptance and working to break down fat stigma and society at large. But first, I'd love to hear a bit about your history with diet and wellness culture and sort of what brought you to this work.
Amanda Martinez Beck: So I grew up in a very fat phobic family. My parents are both in the medical profession, and there's this family history of striving to be the best physical shape that you can be. My grandfather was very into fitness and passed that on to his children. And so I lived in a larger body and that was not okay. I was put on diets as young as seven. Restrictive diets, diets where I cut out entire food groups and it just started very young for me. I remember having a dream when I was about 10 where I was begging my parents for food and they were saying, I'm sorry, no. And I woke up crying and my mom came and comforted me and I told her about the dream and she was sad for me, but it didn't change anything.
By the time I got to high school, I had pretty much internalized all of the diet culture rules, so I was on diets all the time. I remember I would only bring like one thing for lunch and I would be hungry, and so I would eat my friend's leftovers just because I wasn't providing myself enough nourishment. When I got to college, I had food freedom for the first time. And surprisingly, I really thrived in a cafeteria setting and a dorm because I could control what I ate. And I really found that that was a lot easier than my parents had made it seem it would be.
I was trained not to trust my hunger, but to prize it like it was a sign that I was losing weight. I was also involved in a church group that was very into fasting and so even though I had food freedom in the cafeteria, in my mind, I was still very much wrapped up in restriction. When I was 21, I was out of college and I took a year off between undergrad and my master's program, and I decided to do a 40 day fast.
Christy Harrison: Oh, my God.
Amanda Martinez Beck: Yes. And I made it 21 days. And then I had a nervous breakdown.
Christy Harrison: Yeah, I can imagine.
Amanda Martinez Beck: Understandably, I wasn't eating and I wasn't under the supervision of a doctor.
Christy Harrison: Was this something you were doing sort of for diety reasons, for religious reasons? A little bit of both.
Amanda Martinez Beck: A little bit of both. It's really hard not to have dieting in mind when that's what you've been raised with. And I always had this fusion of "God will help me lose weight" idea, and it never worked. And so when I had the nervous breakdown, I realized that dieting was not good for my mental health. So I stopped and my body started to change because I wasn't restricting anymore. I knew it was what was good for me because I was a lot healthier, honestly. I think we have to remember that mental and emotional health are health. So my body kept changing.
I got married, I finished grad school, a Spanish teacher by training, and had kids. I remember sitting in my kitchen thinking, "I need to lose weight. I think I'm going to stop eating bread." And all of a sudden, the only thing I wanted to eat was bread. I've written a couple books, and in one of my books I talk about this. It's called "the noticing." Oh, my goodness. When I restrict, my brain wants that only. And it was the first time I'd made that connection. So I decided that, oh, I think that I'm sabotaging my body by restricting. So I gave up dieting altogether.
At the time, I was also starting to write. I have always wanted to be a writer, and I wrote a couple of articles for pop culture magazine, but really found my stride in writing about body image and specifically at the intersection of religion, because that's a big part of my life. And telling the story of growing up in a home that my body wasn't okay, and learning that my body was valuable not just to God, but to myself, that really hit a nerve in my readership. And I thought, oh, I need to investigate this more. And so I started off and I was afraid of the word "fat" because it had so many negative connotations so I called myself a "size dignity activist" and I did a lot of good work in that time.
Over the years, I have gotten more comfortable with the word "fat." It's a neutral descriptor. I have brown eyes, I'm five foot four and I'm fat. And my body has changed in both directions, bigger and smaller, but I've still stayed fat. I learned from social media the hashtag "all bodies are good bodies" and it really started me on this journey of what does it mean that a body is good? And so probably my biggest position is that I believe that the purpose of my body is relationships with myself, with others, and with the divine.
So anybody can have a relationship. Even a person in a coma is in relationship with the people caretaking that person. Aristotle says a thing is good that fulfills its purpose. And if my body's purpose is relationship, I fulfill that every day. So I can say really deeply, my body is good even when it's sick, even if I'm disabled, because I am. Even if it's fat, because I am. It has just really turned the world upside down to believe that the purpose of my body isn't thinness. It isn't perfection. It isn't even health. It's relationship.
Christy Harrison: Yeah. I'm curious what role your faith played in that, both in maybe creating a different relationship with your body at first and in helping transform it. Because I've talked to some other people who were raised in religions where fatness was seen as something that was meant to be taken away and that you prayed to take it away. And it was a sign sometimes that you weren't as close to God as you should be or something like that. It was a marker of sin. This is what some people I know have experienced, and I'm not sure if that was your experience at all, but I'm just curious what your faith's interpretation of fatness was and how maybe you had to grapple with that.
Amanda Martinez Beck: That's a great question. I definitely saw fatness as a moral failing, which is a really common belief in American diet culture, saturated land. And because I am a religious person, that moral failure took on a religious tenor. I believed that I didn't have anything to offer in a fat body because it was some sort of outward sign of an inward lack of control. But I met my friend Nicole Morgan. She has written a book called Fat and Faithful. I met her before she wrote the book, and she had this revolutionary redefinition of gluttony. We've been told gluttony is "overeating or overindulging" but she makes the case from the Hebrew and Christian scriptures that gluttony is actually consumption that harms our neighbor.
So it takes away whether someone is eating "too much pie." That's in quotation marks as a gluttony and it structures it more around neighbor care. Am I caring for the people around me? So when I'm eating a cake or a piece of a pie, I can say, has everyone in the room had their share of pie? And if they have, there's no harm in me taking another piece. I have four kids and so this definition of gluttony really gets practiced in our house. Has everyone had their share before you take seconds? And as long as we're considering that in our neighbor care and our eating, then there's food freedom. There's food freedom, we just want to care for our neighbors, AKA our siblings in that case.
Christy Harrison: Right. That's a really beautiful reinterpretation of it and I feel like maybe also is truer too. I'm not a religious person, but I have studied the Bible as literature, found that kind of a fascinating approach to it. And I think there's a lot of historical situatedness in the teachings. At the time when these things were written, that was maybe a real concern was for people to have enough food and for everyone around you to have their share. And if there wasn't enough food to go around, then it could be seen as harmful for someone to take too much or to take more when other people didn't have enough and I think that does speak to the purpose more than this sort of notion of just eating too much and being fat.
Because it's sort of gotten twisted into fatness is the symbol of gluttony, when really people are fat for all kinds of different reasons that have nothing to do with how much food they eat and the spirit of the prohibition on gluttony. I love that reframing that. It has more to do with community care than anything else.
Amanda Martinez Beck: And if we envision our body's purpose as relationship, that is, at its core, community care. This journey took me out of body positivity, which is "I make decisions about my body and I like my body." It's a very personal thing. I like to say nobody is free to be fat until everyone is free to be fat. Until we deal with the structures that keep people in marginalized spaces because of their bodies, whether that's fatness or disability or sexual orientation or identity, those things are all wrapped up in what I call fat liberation, freedom for bodies.
Christy Harrison: Yeah, for bodies to exist just as they are and not have to be manipulated or changed to fit into some standard or ideal. Let's talk a little bit about the disability piece because you have a number of chronic conditions you've written about, including type two diabetes, fibromyalgia, maybe others. I'm curious how those have impacted your relationship with food and your body and perhaps wellness culture as well.
Amanda Martinez Beck: I had always been trained to think that type one diabetes was the "good" diabetes to have, even though that's absurd because it's a disease and we should not wish it on anyone. But there was always a lot of shame in type two diabetes because it was proposed to me that it was the person's fault for eating too much sugar. And I learned as I was diagnosed with type two diabetes that diabetes is your body's response to stress. And that is morally neutral in a way that freed me from the responsibility to bear that guilt. It's genetics, it's socioeconomic determinants of health and it's luck. I had Covid really badly in the the fall of 2020 and it messed my blood sugar up. When I was in the hospital, I was having to take insulin. But when I got out of the hospital and have dealt with post Covid realities, my A1C was still higher than my doctor wanted.
Christy Harrison: Had you had had diabetes previously?
Amanda Martinez Beck: They had told me you're on the line, change your diet and exercise. And I was so angry at my doctor because they just left it as a message and they knew that I had an eating disorder and that any talk of dieting would be problematic. And so I probably should have found a different doctor then. But finding a doctor when you're fat is so hard and so I stuck with that doctor. The symptoms of the fibromyalgia, my pain is often blamed on being fat, but I've had pain since I was a child when I was in an average to larger body and so untangling all of the blame from chronic conditions is one thing that I'm really passionate about because the shame spiral is just so real.
Christy Harrison: Yeah. Can you talk a little bit more about how you've gone about that process of starting to accept yourself for having those chronic conditions and unearthing and getting rid of the shame?
Amanda Martinez Beck: I had to recognize that the position I was in as a fat person wasn't my fault. That's a really hard jump to make in your brain. I think people who are in non-thin bodies, even if they're just average size, struggle with being communicated that the pain is all your fault. And I had to learn to sit with pain and be curious about it and say could I have done anything differently? And most of the time the answer was no. And so in those small steps of I could not have done anything differently, this is the body I've been given, I'm choosing to free my body from that guilt. I want to focus on structures of inequality that keep people in these places of blame and guilt and the cycle of shame.
Christy Harrison: Yeah, I will say, I'm thin and I haven't lived as a fat person dealing with these systems, but I have multiple chronic health conditions, many autoimmune and digestive and hormonal and skin related and all these things that are so, so blamed on the individual and so preyed upon in wellness culture where people are made to feel like if you just restricted these foods or if you just followed the appropriate diet and didn't eat all these processed things or if you just lost weight for higher weight people. But even for average people, it's like there's still this message that if you could just get thinner and exercise more and push yourself more and restrict more that it would help matters.
I mean, I have a lot of things too that larger people get that are blamed on weight that thankfully have not been blamed on weight for me, like plantar fasciitis and low back pain and things like that. Yeah, for me too, it has taken a long time to stop feeling responsible for these conditions. I feel like I'm responsible for my self care and for doing what I need to do to take care of myself and treating myself kindly and with compassion. But I'm not responsible for the fact that I have these conditions in the first place and I'm not responsible for miraculously healing them when they're ultimately things that, for the most part, are conditions that are chronic I'm going to be living with for the rest of my life and that come and go and ebb and flow and it's not for me to fix that or whatever. And I couldn't. I've tried, I've tried all the diets, I've tried all the things and just led to driving me deeper and deeper into my eating disorder.
Ironically, I think a lot of the symptoms and conditions popped up at first when I was already disordered eating and when I was in a very restrictive place and over exercising. And I think it kind of put a lot of stress on my body and sort of unmasked some of these conditions that I had that maybe, who knows, maybe would have gotten unmasked later or triggered, triggered later or not. But it didn't help certainly that I was eating in such a "clean" way and being so obsessive with food and over exercising and then just experiencing intense mental health consequences from that.
Amanda Martinez Beck: Yes. I'm writing a new book based on the Idea that diet culture is a religion, that it's kind of filled this space where the enlightenment freed us from the need for a religion, but humans are still very religious animals. In trying to pinpoint what is the goal of diet culture as a religion, I really have had to deal with the problem of pain and how we believe at a fundamental level that pain is a judgment as opposed to just a human reality. And I'm not saying that we should celebrate pain or even just accept it. I think we should try to find ways of easing pain. I have had to come to the position of my life is going to include pain. How can I respond in a kind way to my body?
Christy Harrison: Yes. I think that's so powerful and such a different lens on things. I love too, what you said about how we can find ways to ease pain, but also accept that it's a part of life, that we can't make it go away entirely. And I feel like there's this promise in diet and wellness culture that if you just unlock the secret, if you just eat in this perfect way or take these right supplements or lose weight or get the perfect diet or whatever, that you're going to somehow be free of pain forever. And that's just not realistic. That's just not how life works.
Amanda Martinez Beck: The frailness of humanity is, in an upside down way, our strength. When we bluster our way towards strength that we want, like pursuit of physical perfection, it actually yields a lot of ugly things and not just for individual bodies. And we're seeing that now with movements like the Make America Healthy Again movement. It's actually causing destruction of beneficial health practices to think that we can control individual bodies as opposed to needing a community of health. Eugenics also plays a part in diet culture, this belief that the human body is perfectible. We have to embrace our weakness because our weakness tethers us to each other. We need each other and to be a strong individual without need of other people sets you up for a bigger devastation in the future when pain does inevitably come to you.
Christy Harrison: Yeah. Well, it makes you feel like you're solely responsible for it and that you're shouldering the entire burden of it yourself, rather than being able to lean on other people and ask for help and feel like this wasn't your fault and that this happens. This is part of life.
Amanda Martinez Beck: Right.
Christy Harrison: I want to talk a little bit about Ozempic because you wrote a piece recently that was really wonderful and I'll put it in the show notes for people to check out about. It's called Ozempic and Me and it's about your relationship with Ozempic for type two diabetes and I'm just curious to hear a little bit about your experience with that. How did you come to start taking Ozempic?
Amanda Martinez Beck: I guess it's been three years, it might have been four. The years run together.
Christy Harrison: Yeah.
Amanda Martinez Beck: My doctor, as I was emerging from post Covid syndrome, which I have, which has a lot of side effects, my blood sugars being wacky is one of them. Seeing my A1C needs control and I resisted the "diet and exercise" treatment because I am in recovery for an eating disorder and I knew that if I was checking my blood sugars every day it was going to throw me into an eating disorder spiral. I would start tracking again and tracking for me was really dangerous. And I don't want to say it's dangerous for everyone because I know people are on their own journeys with type two diabetes. But I knew for me that wasn't an option.
So I wanted to see if we can control it with medicine before I would have to actually start taking insulin. And so my doctor said, well, there's this newer drug, it's called Ozempic and it's really great at controlling blood sugars. So I started on a one milligram dose and it worked. Three months later my A1Cs were in a great range. And today, I can't remember my number but it's not in a diabetic range. So it's done a really great job at managing my blood sugars. That's how I started taking Ozempic.
Christy Harrison: And this was before it was a whole thing, before all the hype, before it was being used for weight loss and spotlighted for that. This was when it was just sort of a diabetes drug that hadn't morphed into a weight loss drug. And what happened when it did? How did that affect your relationship with it, with your body, with fat liberation?
Amanda Martinez Beck: I had a hard time getting it when it exploded as a weight loss drug. My pharmacy couldn't keep it in stock. People were paying out of pocket for off label use and I had to go three months without it, which thankfully I didn't suffer some of the more potential side effects of not being on it.
Christy Harrison: Did you switch to something else or did you just take nothing?
Amanda Martinez Beck: I just took nothing. I'm also on metformin and because I don't check my blood sugars, I don't know what my A1C did in that time, but the next time I got my blood work done, I was still in a good range. That is what it is.
Christy Harrison: Yeah.
Amanda Martinez Beck: So when I started taking Ozempic again, and the first time I had taken it, I noticed, oh, my body is changing. I'm also on, for post Covid syndrome, it acts a lot like ADHD, so I'm on Adderall. It's a miracle for my brain but it also reduces hunger cues. And so I wasn't eating very much. And I knew between Ozempic and Adderall, I had to be disciplined in making myself eat because otherwise I would have just given into my eating disorder, which said I didn't need to eat at all.
Christy Harrison: Are you and were you in treatment with an eating disorder treatment team that was helping support you with this?
Amanda Martinez Beck: Sort of. One of my best friends is an eating disorder therapist. She did not provide therapeutic services, but I had someone to point me to, "Remember when you were in treatment, this is what you did." Because I was in treatment for eating disorders with a nutritionist and a therapist prior to the pandemic, so I had a regular schedule. I used an app that reminded me to eat so that I was still getting nutrition. So my body did not change as much as it has for other people. Maybe because of the way the drug worked on me, maybe because I was reminding myself to nourish myself during the day.
And at the end of the day, I was still fat. Even if my body had shifted downward, I still fit in a fat category. And I define fatness as an accessibility issue and it's a range. So this is Fat Liberation 101. Not everyone is fat. Even though we "feel" fat. I judge fatness based on accessibility. Like, do you have access to clothing and healthcare and seating? Those are kind of a good test. And there is a range. So small fats, medium fats, and super fats have different access to those three things. And when I started taking Ozempic, I was in the super fat range, which meant I couldn't buy clothes in a store and sometimes not even online and I couldn't sit in a chair with arms. Ozempic changed my body to the mid fat size so that I can sit in some chairs with arms and I am able to buy clothing online.
And so in a way, I was struggling with my feelings about Ozempic because the results of taking Ozempic made my life easier. I shifted downwards. I don't weigh myself, so I don't know what exactly happened. I could take an airplane flight and not have to buy two seats. That's a big deal. And I have to keep reminding myself that's not a problem with my body, that's a problem with the system that excludes fat people. And my body was becoming more compliant, more fitting in because of my response to Ozempic.
So I had a lot of guilt at my ease because as a fat liberationist, I wasn't supposed to want to be smaller or that's what I thought. I wasn't supposed to feel good about losing weight. And I was feeling something. And so I wasn't telling anybody that I was on Ozempic because I feared judgment.
Christy Harrison: What was it like to keep that secret? And what made you finally decide to reveal it?
Amanda Martinez Beck: Keeping the secret was a really challenging thing. I am a truth teller.
