S6E23: Health at Every Size®

Mariam: Okay. When do we start? Oh, you already started. To our listeners, this is going to be an interesting episode for a lot of reasons. Me and Margaux are currently sharing a mic sitting on my living room floor just making the best of what we've got with our virtual studio.

Margaux: I love it. And I'm actually excited to be sharing a mic with you, Mariam, because historically when I've had to share a mic, it's with Harjit, and I had to be pretty defensive about it. But I'm really enjoying these sharing vibes that we've got going on right now. Love you, Harjit.

Mariam: Shout out to Harjit. Yeah, she's wonderful. But I feel like I'm going to be a better mic sharer than . . . No, I'm just kidding. Anyway, let's just jump into the episode. So welcome back everybody to "Bundle of Hers." I am in the virtual studio with Margaux. Say hi, Margaux.

Margaux: Hey.

Mariam: The title of this episode is "Health at Every Size." This might be something that many of you guys have heard of. It's kind of been a topic I think that's . . . I wouldn't call it a hot topic just yet in the medical world, but I think it's been a topic that's been talked about a little bit more.

Before I kind of jump into what health at every size is, I'm actually curious, Margaux, had you heard about this movement before?

Margaux: Only recently, I'd say, in the last few years have I learned about health at every size. And I would also say it's a hot-take topic because I think, as we're going to talk about and as we have talked about with BMI in the past on this podcast, talking about weight and fatphobia and implicit weight bias in medicine is always a hot-take topic. So I'm very excited to talk about health at every size. But I do think it is not very well known and not taught in medical education. So let's dive in.

Mariam: And that actually reminds me. For you listeners who didn't know, Margaux, and I think Harjit, and I can't remember who else did an episode on BMI and fatphobia and medicine. So if you haven't listened to that episode, definitely check it out. I cannot tell you what season it was. But it's there wherever you listen to the podcast.

But that's a really great episode. I actually did listen to that episode a while back and I feel like it's a really good conversation. We're going to be talking about kind of some similar things regarding fatphobia and medicine, but more specifically, we're going to dive into this framework of health at every size and kind of why it's a hot topic in medicine.

Before I kind of jump in, I wanted to just explain why I decided on this topic, and my positionality, how I want to approach this topic, and things I want to be mindful of during this discussion.

Essentially, I wanted to explore this topic because more recently when I started my clinical rotations in this past year, and I've been on an elective more recently too, I've noticed just a lot of blatant and unapologetic, horrible discrimination towards patients based on weight that are really just rooted in fatphobia. And I just think it's an incredibly irresponsible and horrible way to practice medicine.

It got to the point where I would just go home and vent to my friends and my community about just kind of some of the horrible ways that a lot of my patients had been treated in clinical setting. And because we're on a podcast, I decided to do an episode talking about it.

So I essentially maybe about a year ago was on social media and follow a lot of people who are in the dietitian world or in the healthcare world. And there's this movement called Health at Every Size. I was just very curious about this framework because I didn't see it taught a lot or even talked about enough in the clinical setting or in our training. So we're going to jump into it a little bit.

I do want to say that this episode is going to explore kind of my perspectives based on my experiences as a medical trainee. But I do want to acknowledge that I am a smaller-bodied person and I've never been discriminated against based on my size. And I think that positionality is really important to disclose before I jump into this topic as well.

I also want to put out there, just like with all my other episodes, but I really want to emphasize with this episode, I am not the expert. I'm just somebody who wants to practice medicine in a responsible way. And I want to be really intentional about not introducing weight bias or fatphobia into my practice and really learn how to resist it throughout my training as well.

Did you want to add anything?

Margaux: Yeah. I second everything that Mariam just said. But also that episode she was referring to was two seasons ago and the third person was a guest, Isis Cruz. She's a nurse at Primary Children's and we're so grateful she came on to talk about her experience and being very vulnerable with us.

It also is a great foundation and groundwork for this podcast episode about learning about the history of BMI and sort of how fatphobia became intertwined in medical practice and the medical institutions. So definitely check that one out too.

Back to you, Mariam.

Mariam: Amazing. Switching out mics is a fun time. It's like we're on the news.

Anyway, what is health at every size? So I did a little bit of digging and found a website that was created by the Association for Size Diversity and Health. They're a great resource, by the way, for anybody who wants to learn a little bit more about this topic. And towards the end of this podcast, we'll recommend some other resources as well for anybody who's interested.

But their approach to health at every size and kind of this topic in general, I think, is one that I vibe really well with and I really like. So I'm going to go ahead and jump into how they define health and health at every size specifically.

The Association for Size Diversity and Health affirms a holistic definition of health, which cannot be characterized as the absence of physical or mental illness, limitation, or disease. Rather, health exists on a continuum that varies with time and circumstance for each individual.

Health should be conceived as a resource or capacity available to all regardless of health condition or ability level and not as an outcome or objective of living.

Pursuing health is neither a moral imperative nor an individual obligation and health status should never be used to judge, oppress, or determine the value of an individual.

So centering on this definition of health, the health at every size principles and framework are a continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes.

The health at every size principles promote health equity, support ending weight discrimination, and improve access to quality health care regardless of size.

It's a lot. But Margaux, I'm kind of curious, what are your thoughts just hearing that?

Margaux: I definitely believe that this is a principle in their definition of health that should be more taught and more on the forefront of medicine.

Again, historically, there is so much pressure and training rooted against bigger bodies and fat people, right? This comes back to the history of BMI.

And another thing that really makes it difficult is that it's a visual thing, right? You can't look at someone and tell that they have hypertension. You can't look at someone and tell that they have diabetes. But you can look at someone and see what the shape of their body is and the size of their body. And so we have learned to judge people based on that in our training.

And so I love that this is working to unlearn and untrain that from us and just really associate that you can be a healthy person at every size. That's not something that we are trained in medical school. And so I really like this and I think it should become more prominent in medicine, especially medical education.

Mariam: Yeah. I think it's a really just different approach to health than we're taught. I think health in general . . . I mean, people assume that being in medical training, we are the experts on health, including our own health, which let me tell you is not necessarily true. We have all this wonderful training, we do learn a lot in medical school, but at the same time, the way that I think we as a society broadly think about health could be challenged in a lot of ways, especially as it pertains to weight discrimination.

When I was reading this earlier, as I was doing my research, it was kind of like a breath of fresh air. I was like, "I feel very excited to practice medicine in a way where it almost feels like you're bringing power back to your patients." I think it's a really cool way to practice medicine.

Margaux: I think it's also, on the flip side, really refreshing for patients to come to a healthcare provider who has been trained or has this lens of health at every size when they know and trust that they're not going to be questioned or berated or told that they need to lose weight at every single visit they go to, no matter what their complaint is.

And that's historically part of the problem of implicit weight bias in medical training, is that so often we are willing to chalk every problem they have up to their weight. "Oh, lose weight, come back, and then we'll decide." And that's how a lot of diagnoses go missed or take a long time to get diagnosed for these patients. And that's just not okay.

Mariam: Yeah, for sure. So diving into the health at every size key principles, the first one is weight inclusivity. So accepting and respecting the inherent diversity of body shapes and sizes and rejecting the idealizing or pathologizing of specific weights.

Then there's also health enhancement. So supporting health policies that improve and equalize access to information and services.

Eating for well-being. I think this one is a really big one and we'll get into this a little bit more throughout the episode. But promoting flexible and individualized eating based on hunger, satiety, nutritional needs, and pleasure rather than any externally regulated eating plan focused on weight control. Love that.

Respectful care. So going into this acknowledging biases that we're taught in our training and working to actively end weight discrimination, weight stigma, and weight bias.

And then life-enhancing movement. So this is the last principle. Just supporting physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement to the degree that they choose.

So those are kind of the big key principles of health at every size.

I kind of alluded to this a little bit, but I became more curious about this topic because I have recently been on an elective through OB. It's the maternal-fetal medicine elective where we take care of a lot of "higher-risk pregnancies."

So as somebody who wants to go into OB, I noticed that there was just a lot of blatant fatphobia in this space. One of the things that we do is we see patients who have gestational diabetes, or diabetes that patients will develop while they're pregnant.

Pregnancy creates a little bit of insulin resistance in everybody. Some people end up developing gestational diabetes. Sometimes it's managed with just diet and exercise, and sometimes it's managed a little bit more aggressively with insulin. And there are goal ranges of blood sugars that we monitor.

And throughout my time in clinic, throughout my time on my OB rotation and in my electives for OB, just noticing how a lot of these patients who have gestational diabetes or high blood sugars were counseled in the clinical setting was actually kind of a discouraging way to experience healthcare.

A lot of counseling that goes into this patient population is really focused on numbers, right? Because the goal from the OB perspective is to get below a specific number or within a specific range for blood sugars. But there wasn't a lot of holistic counseling.

And in fact, there was a lot of, dare I say, shaming when it came to a lot of the counseling that was happening in that space, a lot of, "You know that you should be exercising. You know you shouldn't be picking up the carbs. You know you should be carb counting. You know you should be doing this, this, and this," without any real acknowledgment of the person as a whole, what they do, what their everyday life looks like, what their goals are, how they feel about their body, and what feels comfortable to them.

And I think every single time I bring this up with a provider, or if I ever tease the idea of, "Maybe there are other ways we could counsel patients," it's always like, "Mariam, you don't know this, but you're not going to have the time in the clinical environment. So you just have to say the goals and trust that your patients listen to this and take this advice." I thought it was a really interesting perspective because I don't think a shame-based approach to counseling ever really works.

Margaux: I absolutely agree with that. Personally, as a parent myself and then in child psychiatry, been learning about parenting styles and just attachment styles for children, what you're describing and how doctors . . . Basically, "You don't have time. Just give them the information," is a very authoritarian style, which is using fear to create change. And we know from psychology that that just doesn't work in patients.

The other problem that I have with this take is that the implicit weight bias is coming up strong in this case because we also, on the ped side, whenever we see a person who has had a history of gestational diabetes, we get worried. We think about all the medical problems and we start pathologizing just on that. And we do know there's some pathophysiological basis to gestational hypertension and things that can happen to the baby, so that all is very appropriate to be worried about.

What's problematic is automatically associating it with the size of the patient and then attaching your own fears and phobias and implicit bias onto that patient to shame them away from that.

The reality is, regardless of your size, pregnancy causes gestational hypertension. Sometimes people in bigger bodies maybe have a higher predilection for it, but that isn't always the case. There are people in smaller bodies that will also get gestational hypertension.

And so the fact of the matter is we are not looking at gestational hypertension as a disease caused by pregnancy. We are looking at it as a disease caused by the person's moral or work productivity, and how we've been socialized in our society to think about that.

And I'm using the term "fat" because the fat liberation is choosing to reclaim this word fat, not as a bad thing or a negative thing. We go more into that in that earlier episode two seasons ago.

But this is a prime example of where implicit weight bias comes up, because part of the word fatphobia is that fear that we also get in ourselves, and that's where the shaming comes from.

The authoritarian parenting style is like, "I'm going to tell you what to do because I'm afraid for you and I'm afraid for myself because I have fatphobia." And that's how we've all been socialized.

But the reality is if you take a health at every size approach in this case, you look to understand, "Okay, this person is pregnant. We know that pregnancy increases your risk for gestational hypertension, just as you could get hyperemesis gravidarum," or however you say it.

Mariam: Hyperemesis gravidarum. I think that's . . . I should know how to pronounce that.

Margaux: Doctor words, right? Whatever. Just as you could get that from pregnancy, but that's not something that we've been trained to associate with weight, and so there's no stigma around it, right?

So we need to really shift the frame to be like, "This is a process that happens because of the pregnancy, not because of the person's size."

Having a health at every size perspective really thinks about objectively the process, the symptoms of what is happening with the person, and working with them to support them in the symptoms that they're having as a manifestation of what's going on in their body, rather than looking at their body size and being like, "Well, your size is the reason you're having this problem."

So I think it's really important in OB, in peds, in psychiatry, and every other medical specialty.

Mariam: Internal medicine, we're looking at you. One of the most fatphobic rotations I've been on. That was my personal experience. That might not be everybody's experience. And there are wonderful attendings and residents and healthcare providers who don't adopt these fatphobic ideals, but it's an important conversation to talk about.

Something that I was thinking about, Margaux, as you were talking was just kind of going back to those key principles. It's just funny with counseling patients . . . I'm going to stick to OB patients because I've seen a lot more obstetric patients recently. But this whole idea of eating for well-being and life-enhancing movement, which goes back to those key principles of health at every size, just feels so healing to me.

When we're talking to patients who are pregnant, in patients especially who are very excited about growing another human inside of them . . . which LOL, can't relate at this point in my life, but awesome. Instead of being like, "Wow. You need to restrict this and do this and only gain a certain amount of weight during pregnancy," what I think is actually so beautiful is encouraging patients to not only just nourish their bodies during this time when their bodies are changing, but what does that nourishment look like for you?

What are the foods that you like that keep you satiated, that make you feel connected to your community, to your culture, to your body? I think that those are kind of really powerful things.

And again, we don't really get taught about our relationships with food in our medical training, but I think that's kind of a shame because we do a heck of a lot of dietary counseling as providers. It's just kind of an interesting different take looking back at these principles for health at every size that honestly to me feels very intuitive and very, very healing.

If I think about the ways that I would want to be counseled in my diet or in terms of how much I move and exercise, one of the principles being life-enhancing movement, that sounds so great. What would enhance my life?

Instead of somebody being like, "You need to walk 7,000 steps a day," does walking enhance your life? If it doesn't, why don't you go cycle or something?

I don't know. I love that a lot of these principles are kind of just rooted in nourishment, life-enhancing. Those are the terms that you just don't hear in a clinical setting.

Margaux: Personally, when I was pregnant, I definitely resonate with this enhancement idea of "if it doesn't make you happy." First of all, in first trimester for me, when I had morning sickness, I couldn't eat anything. And so the few things that really actually enhanced my life made it that much better.

But also, I think there's something so powerful and beautiful to be said for the cravings that we have or that exist during pregnancy, because I think it really is your body communicating a deeper need. It knows what you truly need to help support the growth in you or your own enhancement.

And so I would love to hear more of encouraging patients to indulge in those cravings, because what we know from psychology and from health at every size and intuitive eating research is that the more we restrict and avoid those internal cravings, those internal messages we're getting from our bodies, the stronger the signal is going to be and the less satisfactory the rest of our life, the rest of the food is going to be that you try to fill that gap in.

So, for example, lemonade was my craving that I had during pregnancy. I loved lemonade. I wanted it every day all the time. Ice cold. Don't forget the ice. Lemonade is not something I usually used to drink, and I think I had been socialized that lemonade has a lot of sugar, you shouldn't drink it, it's bad for you, all that implicit socialization.

And then one day, I started researching what restaurants have the best lemonade and really going for the fresh. And that really truly was life-enhancing, just giving in to that one . . . "Giving in" also has a negative connotation, right? We need to unlearn that sort of rhetoric around it.

Indulging in that craving that my body . . . having that lemonade, just the pure satisfaction. And then it wasn't like I went out of control and needed it the rest of the day.

So there's a lot of power in listening to our bodies and I think that's what health at every size also brings to the table. That's so important.

But I just overall would love to hear more people talking about enhancing our lives rather than what you said, the authoritarian, "No, you should not do this."

Mariam: I also just like how these key principles also highlight kind of having a level of love for your body too, because that's another important thing in terms of maintaining health.

I get a lot of people don't necessarily feel like this, especially as it pertains to . . . People feel complicated things about their bodies and I want to make space for that. But just feeling more at home with their body and finding different exercise practices or spiritual practices or dietary practices that make them feel more at home in their body.

That doesn't always translate to the clinical setting, but I think it's worth having a conversation about this framework because not enough clinicians . . . I mean, what clinicians are doing right now I honestly think is not serving our patients.

Margaux: And psychiatry is a really great example to bring in now, my experience in psychiatry. So, historically, we know that almost every mental health medication, what we call psychotropic medication, has a side effect of weight gain, some more than others.

Specifically, the antipsychotics are known to be huge "weight gainers," whereas your SSRIs maybe not as much. But across the board, it's something very interesting that medications used to treat mental health disorders caused weight gain.

We do not fully understand the mechanisms or why that is. There are some theories that for people who have severe depression, all of a sudden their depression symptoms are better, they're feeling better, and now they're out more, social, and eating more. So that could be one reason of it, but we know the antipsychotics specifically just tend to make people gain weight.

So patients that I've treated will feel much better from their depressive symptoms, but then start to notice the weight changes. And I've tried actually to have the health at every size conversation with some people, because they also then will come to me, "My mood is so much better, but now that I'm gaining weight, my anxiety is so high. So I almost would rather be depressed because then I'm in a smaller body."

That, to me, is such a complex thing, and I think we have to, like you said, Mariam, give space to the fact that this is how our society in the U.S. really socialized us to be, to have a lot of fatphobia, a lot of implicit weight bias, to want to try to fit into this model body, one-size-fits-all, which is not how human bodies are.

So I try to talk to patients about the fact that there's some connection between our state of wellbeing and our life-enhancing stuff that makes our bodies go back to this set point where we're supposed to be.

And there's so little research on that, on how our metabolisms truly work and what determines where our bodies want to be in terms of weight. We do know from a lot of research that restrictive dieting through a person's life, the more you do it, the more weight you actually end up gaining in the long run.

And not to say that weight gain is bad in the long run, but the fact that by intervening or trying to do things to make your body not what it wants to be can actually counteract itself.

So coming back to this sense of radical self-acceptance and self-love I think is a huge first step. I try to talk to my patients about that. But also, the fact that now your mood is better, you're feeling better, you can maybe engage in more of these life-enhancing things. Especially the eating for well-being, I think, is so important, especially for mental health too.

So that's something we've been acutely navigating and it has encouraged me to try to talk about health at every size more in my clinical practice. But everything is a learning . . . Like you said, learning about it first for myself is really hard, not being an expert on it. And then having patients who are also socialized very deeply in implicit weight bias mentality, it's been really difficult, I would say, to try to connect with people on that level.

But I just hope that the more I can learn about health at every size and the more conversations I can have, the more I will learn and hopefully shift, even in my colleagues, to change the conversations around weight gain and everything.

Mariam: And it's interesting too . . . We talk about how there's a lot of weight bias in healthcare, within healthcare providers and how we're trained, but also there's a lot of weight bias in society. And yeah, a lot of our patients have internalized a lot of that and sometimes don't feel comfortable in their body or have specific goals.

As a provider, you want to honor those goals and you want to validate how somebody feels about their body and their experiences while also wanting to promote health in a way that isn't so biased against heavier weights.

And so I think it is a difficult balance. There is no right way to do it. But I think, again, going back to, like you said, Margaux, emphasizing, "Yeah, some of these medications may have a side effect where you gain a little bit of weight. But if you're feeling better, if some of those depressive symptoms are resolved, let's talk about ways to kind of enhance your mood through how you feel about your food and through movement," and things like that that kind of go back to that health at every size piece.

And sometimes people don't feel comfortable in their body and there are a lot of feelings that go into that. But I think acknowledging that as a healthcare provider and not necessarily pushing, "Okay, then we need to have you lose this amount of weight," and going back to, "How can we make you feel good?" I think is a really powerful approach.

I want to kind of jump into, just to tie out the episode, how this framework of care is an important part of seeking justice within the healthcare system, and more specifically addressing symptoms . . . Oh, sorry. And addressing . . . Why can't I speak today?

As we're tying up this episode, I want to actually talk about how this framework of care is an important part of seeking justice within the healthcare system and addressing systems of oppression within medicine.

And so we're talking about a lot of the things that we talk about on "Bundles," racism in medicine, ableism in medicine, classism, all these isms or systems of oppression that we're constantly having conversations about.

I think health at every size is a really important framework to kind of seek out justice in these spaces to actively battle these systems of oppression. And one big thing that I've noticed a lot is racism in medicine is very alive and well, and I think fatphobia specifically in medicine is very heavily targeted against a lot of communities of color.

More specifically, what I've noticed in the clinical setting is a lot of communities of color, people who are refugees, or have recently immigrated here will come in, seek out some type of primary care, and then be essentially shamed for how they're eating or shamed for how they take care of themselves.

I would say patients of color specifically I've noticed in the healthcare setting are presumed to not have an understanding of their own health, which is a very kind of messed up and super racist assumption on the side of healthcare providers.

So I have a funny . . . It's not a funny story. It's kind of a messed up story, but I can say it's funny because I'm Afghan. It was targeted towards my community.

But I did a family medicine rotation and I was looking through one of my attending's trainings. At the site that I did my rotation, they saw a lot of refugees, especially a lot of Afghan refugees. And so they did this kind of cultural orientation on Afghan refugees. And the title of the presentation, I still laugh, was called "Afghanistani Healthcare." I just started identifying as a half-Afghanistani.

Anyway, obviously, I was going to click on that and go through that training. And it was so interesting. I mean, bless this attending. I think he meant well. But they get to the part of promoting this concept of health literacy in Afghan patients. And essentially, the PowerPoint was saying Afghans generally have a cultural diet that's heavy in oils and fats, and they eat really unhealthy.

And I just think that's so funny because, first of all, Afghan food is bomb. And yes, we do use a lot of oil in a lot of our cooking. But that doesn't necessarily mean that it's extremely unhealthy.

I mean, you're telling a community of people who have been surviving and thriving on this type of cuisine for centuries that what they're doing is wrong when they move to this country. And then you're telling them to eat freaking kale and broccoli because that's apparently what's considered healthy in the West.

And I'm just going to be honest with you. Nobody in my family is going to pick up any kale, because that's not what they grew up with, right?

So what I'm trying to say is when you're implementing this approach of health at every size, and thinking more specifically about those principles of eating for nourishment and life-enhancing foods, a lot of that ties back to somebody's cultural background and how they relate to their food.

Margaux: I think that is so important to recognize the racism that is inherently tied into implicit weight bias and fatphobia and how we practice medicine. And your point about thinking about other cultures and foods practices and labeling them as unhealthy is a huge part of that.

And like you so eloquently outlined earlier, I think it is so important to walk the path with the patient and not talk at the patient or sort of scold them. At the end of the day, when you partner with your patient to understand their background, their needs, their goals, their wants, their hopes, their dreams, your therapeutic outcomes and your medical practice with them is going to be so much better, because that's what they want. I will feel better about a patient interaction that they are in control of, right?

I think historically medicine was very rooted in this patriarchy hierarchical model of, "We tell you what to do, and you are obedient." A good patient is an obedient patient. But that's not how medicine is practiced or historically practiced across in many cultures across the world.

It's very much an understanding of what this health at every size is coming back to: life enhancement. What makes you happy as a person? What is good for your body? I mean, maybe Afghan food is good for Afghan people, and maybe white people too.

Mariam: It's good for everybody. Everybody go get Afghan food. By the way, if you like kale and broccoli, this is not a dig on you. I like broccoli. It's good. Kale sucks.

So as we're closing out this episode, I do, again, want to emphasize this was a topic that I was curious about, not something that I have put into a lot of practice because I just started my medical training. But it's something I definitely want to learn a little bit more about so that I can put it into my practice and my training.

But if you, our audience, are very interested in this topic, there are a lot of podcasts, Instagram pages that are amazing that I follow, that I've listened to, and Margaux as well. I actually have gotten some of these recommendations from Margaux.

But one podcast that I will recommend is called "Maintenance Phase." It's a podcast series that kind of dives into this topic. Not specifically health at every size, although they do talk about that. They talk a lot about fatphobia in different systems. And so definitely check that podcast out.

Margaux, do you have any recommendations?

Margaux: I absolutely love @nalgonapositivitypride, which is an eating disorder harm reduction that is run by and for black, indigenous, and people of color. It's an absolutely amazing resource. Definitely check that out.

And I will say I love and appreciate your growth and wanting to learn more about this, Mariam. As someone who's been trying to implement it in my practice as a resident, I will say the first and easiest step that anyone can take is just whenever you have a patient who even mentions or brings up any concerns for their weight or their body size is just acknowledging that we've been socialized to victimize our bodies at any size.

And that acknowledgment that that exists and that it is not just that person that feels that way can go a really long way. And then hold space for them to vent and feel the way that they feel. Walking that path with them is just a really simple thing that you can do to start.

So I hope that we can all start in taking away this fatphobia from medicine. We are the powerful next generations.

Mariam: Be that change. Yeah, I really think it's hard to implement that change when you're in the system, but just remember how powerful it is and how much better off your patients will be.

And that's the whole point of medicine, right? Why else would we be in medicine? Did we go into medicine to shame our patients and to be fatphobic? No, we did not. We went into medicine to take care of people who are really sick and we want to provide the best care that we can, and so that's how we do that.

All right. On that note, we finished the episode. So thank you, guys, for tuning in. Shoot, I hate closing because I don't know what to say. So if you want to tune into more of our episodes, then follow us wherever you podcast. And if you're not already following us on Instagram, what are you doing? @bundleofhers. Come on, follow us. We are amazing.

Margaux: I honestly wish we had a TikTok, but I can't do it. I have no capacity.

Mariam: I might have capacity. I love TikTok. Should we do it? We're going to talk to Chloe about doing a TikTok. DM us if you think we should do a TikTok. @bundleofhers.

Anyway, this I believe is the second to last episode of the season. So please tune into our next episode, which is going to be our season finale. It's so exciting.

Margaux: And sad, bittersweet, but amazing. Tune in. Listen. We're going to be authoritarian on this one. You better listen. And follow Timmie Joon on Instagram if you're not.

Mariam: Oh my god. So I've been pushing for this for so long. Timmie Joon, @timmiejoon. He is the official "Bundle of Hers" mascot. He's a cat. He's my cat, in case y'all don't know. No, Timmie doesn't do TikTok. Should I start a TikTok? All right. Thanks for listening. We love you guys. Bye.