In the second episode of DSMG’s brand new season, Laura chats with Nicola Salmon, a fat-positive fertility coach and author of ‘Fat and Fertile’. This is such an important conversation to have to support people in relearning how to trust their own bodies and ability to get pregnant. Some of the topics we touch on in this episdode include;
- Fat-positive fertility
- Why you don’t have to lose weight before starting a family
- The BS that are BMI cut-offs in assisted fertility
- Things you can do to support your fertility at any size
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Nicola’s Website
Check out Nicola’s IG post on the research behind fertility and BMI
Check out Nicola’s book ‘Fat and Fertile’Buy a copy of Just Eat It | How to Just Eat It
Sign up for a Learn with LCIE Course
Buy an Intuitive Eating friendly guide to managing different health concerns
Edited by Joeli Kelly
Transcript:
Nicola Salmon
There are so many studies that are coming out now that show that actually dieting before you get pregnant, so kind of in that preconception phase, actually really negative has a really negative impact on your fertility. And it shows that it doesn’t increase your chances of getting pregnant. Surprise, surprise, like it just, it’s not great. You do not want to go into the conception phase, like signalling to your body that there’s either a famine, or there’s the stresses going on, or you know that it’s unsafe to be in your body because that’s what it feels like when you’re going through those processes.
Laura Thomas
Hey friends, welcome to Don’t Salt My Game. I’m Laura Thomas. I’m a Registered Nutritionist specialising in intuitive eating, and I’m also the author of two books, Just Eat It and How to Just Eat It. And we are here having conversations with game-changers. I am so excited to introduce you to today’s guest Nicola Salmon. She is just such a delight. And this conversation feels really nurturing. Alright, so if you don’t already know Nicola, she is a fat-positive fertility coach and author of Fat and Fertile. She helps fat folks navigate getting pregnant in a weight-obsessed world and advocates for changes and how fat people are treated whilst accessing help with their fertility. Nicola uses her unique fat positive framework to support people in finding their own version of health without diets advocate for their bodies, relearn how to trust their bodies and believe in their ability to get pregnant. So in this episode, we are talking about fat positive fertility, we discuss why you don’t have to lose weight before trying to start a family and how that might actually even be counterproductive. We talk about the weird predatory fatty fertility diets that are out there, we discuss BMI cut-offs around assisted fertility and why they’re complete bullshit, and why the term high risk is harmful. And lastly, we talk about some practical things that you can do to support your fertility at any size. I’m really excited to let you listen to this episode. But first, I just wanted to flag that we mentioned a couple of the Learn with LCIE weight inclusive guides to things like fertility, gestational diabetes, PCOS, and we have loads more. If you’re interested in learning more about those or if you want to access them, then I’ve linked to our Gumroad page in the show notes. And if you’re a healthcare professional who wants to use them with your clients, then I invite you to look at the full training that we’ve developed to go alongside these guides. They help you advocate for your clients to get the best care and are aligned with intuitive eating so can be a really helpful resource to navigate health concerns. All of that is on our teachable page for professionals which I’ve linked to in the show notes. All right, before we get started, I want to say that I’d love to hear your thoughts about this conversation. So if you want to find me I’m @bub.appetit on Instagram, or @dontsaltmygame if you want to tag the podcast and Nicola is @fatpositivefertility. Alright team, here’s Nicola.
Laura Thomas
All right, Nicola, we are going to start with a quick fire round. So I’m going to ask a question, and I want to hear the first thing that comes to mind. Are you ready?
Nicola Salmon
No, but yes.
Laura Thomas
All right. What subjects did you like best at school?
Nicola Salmon
Maths, I know, bleuh, geek.
Laura Thomas
Most refreshing beverage?
Nicola Salmon
Oh, you know that Fanta that’s lemony, like the lemonade stands that you always get on holiday? I think that is definitely the one.
Laura Thomas
I feel like if you want thirst quenching, you have to go lemon.
Nicola Salmon
Yes, it’s so like, [lip smacking noises], gives you that little in your mouth.
Laura Thomas
If you could live anywhere in the world, where would it be? I already know what you’re gonna say.
Nicola Salmon
If I could live anywhere in the world?
Laura Thomas
Yeah.
Nicola Salmon
Oh, I love where I live now.
Laura Thomas
I knew gonna say that!
Nicola Salmon
I live in the forest but if I could choose anywhere in the world, that would be Canada because they have bigger forests and big lakes where you can go swimming and they’ve got mountains. Yeah, it’s blessed, but I love my little place in the woods right now.
Laura Thomas
Yeah, for context. Nicola has this very cute little garden shed situation. And I can see the trees in the background, it all looks very green and lovely.
Nicola Salmon
We get lambs. We’ve got lambs trotting up and down the road. It’s just the most adorable thing ever.
Laura Thomas
Like just outside your house?
Nicola Salmon
Yeah, they just wander around in the village. You know? It’s very funny, but they’re brilliant.
Laura Thomas
Oh, well, we definitely don’t have that in London. But we have a shit tonne of foxes also, so this city farm like 20 minutes from our flat. They just had a whole load of piglets and they are just ridiculously adorable. Like It’s indecent how cute these little piggies are.
Nicola Salmon
We have wild boars in the forest. I haven’t seen any baby piggies yet, but they’re called humbugs because they’re stripy. It’s adorable.
Laura Thomas
Okay, Nikki was like, I see your baby pigs in the city farm and I raise you some wild boar. All right, cool. All right, do you have a hidden talent?
Nicola Salmon
I can wiggle one ear, but don’t ask me to do it now.
Laura Thomas
No? I feel like, I need to see this.
Nicola Salmon
Maybe afterwards. I spent probably the first year of my uni degree, concentrating on how to figure this out rather than on like, anything I should be studying. So yeah, I spent a stupid amount of time just practising in the mirror.
Laura Thomas
I did not know this was a skill that one could sort of acquire.
Nicola Salmon
Yeah, I think I stumbled upon it once when I was very drunk and then just decided it was a you know, like a hyperfocus.
Laura Thomas
What is your favourite flavour of cake?
Nicola Salmon
I love — so I hate coffee, but I really love coffee cake. So like when they do the really good coffee icing? As long as it doesn’t have walnuts in because I hate nuts. But coffee cake is like, love it.
Laura Thomas
Is it like all nuts. Is that like a blanket ban or?
Nicola Salmon
Yeah, and yeah, I kind of can get on board with almonds. As long as they’re like ground up. So like if you do them in a curry or in a cake or something. But yeah, I think it’s just the texture of nuts. It’s just that weird thing. I don’t know what it is. It’s that hard. But yeah, I normally I really like crunchy stuff, but it’s just nuts, but I dislike.
Laura Thomas
They’re like they’re like hard but also soft at the same time.
Nicola Salmon
Yeah, they’re their own like unique texture. Yeah, not for me.
Laura Thomas
I know what you mean about walnut. I’m not super pro walnuts. Okay, sorry. This is meant to be a quickfire. last question, what is your favourite kitchen utensil?
Nicola Salmon
Oh my goodness, I don’t think I’ve ever thought about what my favourite kitchen utensil is. But I really love a spatula, you know where you can like, if you’re baking cakes, and you can get all the mixture out. It’s just really satisfying to like, get it all out the bowl.
Laura Thomas
So satisfying. And it’s so weird that you said it because I had spatual in my head when you were saying that. And I’m also, so on The New York Times cooking YouTube channel, they do these like kitchen tours. And there’s this like really awesome baker that I was watching and she had this like tiny spatula, like it was on like a normal length handle. But like it’s really small. So you can get like right into the corners of stuff. And I’m like, I need one of these in my life for like getting to the bottom of things. Anyway, spatula is our gift in the kitchen.
Nicola Salmon
And I never knew that it was my favourite until you just asked me.
Laura Thomas
Alright, Nicola, so you specialise in helping support fat folks to get pregnant and to advocate for themselves around fertility. And a common narrative that I hear is that if you’re fat, you have to lose weight before you can conceive. So let’s unpack that a little bit. What are your thoughts on this? Is this a smart move? For trying to get pregnant? It’s a very loaded question, let’s just put it out there.
Nicola Salmon
I think it’s one that so many people believe because that is like the main narrative in the fertility world, that fat people are unhealthy, therefore fat people can’t get pregnant. And it’s just such a load of…can we swear? Are we swearing?
Laura Thomas
Nicola, have you met me?
Nicola Salmon
It’s such a load of bullshit that it’s just cannot you know, every time I you know, talk about this stuff, and I do it every single day of my life now, it just blows my mind how ridiculous this idea is because fat people have been getting pregnant for millennia. Like, we know that there has been diversity in bodies for the entire populate, you know, like, lifetime of our species. And we’ve been having babies. We’ve been doing the thing the whole time. And yeah, all of a sudden now, you know, and it’s been in what the past 50 years. All of a sudden, our bodies have been demonised and been told that no, this is something that’s difficult for us. And actually, I think I looked when I started, like really looking into the research around okay, like, you say, it’s more difficult for fat folks. Look at what actually the research says, I found one paper that said it took longer for fat folks to get pregnant. And that was by a month, one month. And I’m like, dudes, like you cannot count this as like a thing that you’re gonna go around saying and you know, sensationalise in the media because A, one month is like, it’s not really a long time and B, it’s not, you know, as with every research paper ever written, it doesn’t take into account the lived experience of fat people. I’ve been, you know, dieting, weight cycling, you know, the weight going up and down the stigma that we face when navigating the fertility world. So, yeah, we’re calling bullshit on that one.
Laura Thomas
I think they’re like, so just for context, a while back, you contributed to a guide that we produce at LCIE which is a guide to fertility. And I was just reading over that the other day. And one of the things that like never tweaked for me before, but it’s really obvious when you say it, so we know for sure, for sure, for sure, I think, unless you’re gonna tell me otherwise, that age is sort of correlated to our ability to, to, to fall pregnant. So not that, you know, like, there’s like this cut off line of, you know, after this point, you can’t get pregnant, but that just, it can be more challenging for folks.
Nicola Salmon
Yeah, absolutely.
Laura Thomas
And so what we’re talking about in the guide, is that if you go on, if you’re told you have to go on a diet to go and go lose weight before you can see, or before you’re offered fertility treatment, or whatever it is, you’re getting older. And just kind of was this like, like, the kind of mind blowing moment for me that I was like, oh, yeah, so we’re actually, you know, by like, if people, you know, hold off, not that they’re necessarily holding off the whole time that they’re trying to lose weight. But I was, there’s, there’s also kind of like a few other things that, that play into this as well, because we know that dieting is stressful, both psychologically and physically. And that that can have have a role in terms of our ability to fall pregnant, right? So it’s not only that, like, the science is rubbish. The science is shit and kind of is weaponized against people’s lived experience. But it’s that there’s this piece that that I think might actually be unhelpful, and potentially harmful. Like, what what are your thoughts on that?
Nicola Salmon
Yeah, I mean, there are so many layers to it, you are so right, like the age thing like, yes, it’s absolutely not a cliff that you drop off when you’re like, in your late 30s or early 40s. But it absolutely we know it does play a role. We know that folks will go through perimenopause and menopause, at different stages in their lives. And that’s not something we can predict. It’s not something we can go, this is gonna happen then. But absolutely, it plays a role. And we know that people can lose weight in the short term. But it often takes a long time, it often then will be regained. And there are so many negative impacts with it, like weight loss isn’t this thing that just stands on its own and it’s fine and it doesn’t have any impact on your life. So absolutely. It’s not a great idea from that perspective. But also, there are so many studies that are coming out now that show that actually dieting before you get pregnant, so kind of in that preconception phase, it’s actually really negative, has a really negative impact on your fertility. And it shows that it doesn’t increase your chances of getting pregnant. Surprise, surprise. Like it just, it’s not great. You do not want to go into the conception phase, like, signalling to your body that there’s either a famine, or there’s these stressors going on, or you know that it’s unsafe to be in your body because that’s what it feels like when you’re going through those processes.
Laura Thomas
Yeah, yeah, I hadn’t really considered it from from that perspective of like, well, we know that being in a famine state as it were, being in a state of deprivation, can affect epigenetic signalling and then have an impact on the child’s health as well. And I’m sorry, I just want to say I don’t, that is not to sound blaming or point fingers at anyone who has dieted prior to becoming pregnant. Like that just, we are all swimming in the same soup of diet culture bullshit, and anti fatness. So yeah, I just I didn’t want anyone to hear me, misinterpret what I was saying there. And the other thing that I was just thinking about something that I see in folks of all body shapes and sizes, is that when we’re in a relative energy deficiency that can affect ovulation, right?
Nicola Salmon
Absolutely.
Laura Thomas
People can become [trips over saying amenorrheic]
Nicola Salmon
I can’t say them either.
Laura Thomas
Can you say the word?
Nicola Salmon
Amenorrhea
Laura Thomas
Ammenorrheic, god my brain this morning. You’d think we were recording it like 10 o’clock at night, it is 930 in the morning for context.
Nicola Salmon
You haven’t been drinking. [Laughs]
Laura Thomas
I just have a toddler, okay? So yeah, like, so basically, you can, what can end up happening is that again, your body perceives that you’re in a food shortage and there’s a famine. So it starts shutting down non essential systems in the body, including fertility, fertility is basically one of the first ones to go, right.
Nicola Salmon
Absolutely. Because if it’s not safe for you to be able to access food, for you to be able to, you know, feel safe in, you know, in your environment, then it’s not a time to be, you know, creating offspring and bringing new life into the world, like, if you cannot, you know, in our old in there, when we were hunter gatherers, if you weren’t able to find food enough for you, it was not, you know, your body was not going to risk the extra resources, that it would need to grow another human being and then bring that human into the world. So it makes a lot of sense when you think about it from that perspective. But also, it’s, you know, like, it’s really important that people understand that the evidence behind this is just not there. Like, the scientists that are doing this research are biassed, like you say, we’re all living in this soup. And when you kind of start to look at the information that they’re using to make these decisions, it’s so bias, and it’s so anti fat. And yeah, it just blows my mind that people actually come to these conclusions and can say, this is the fact when actually we know that there are no good reasons for that. And, and you were saying about the periods and like people losing their periods when they are dieting, like, there is a whole condition called hypothalamic amenorrhea, which, you know, it happens to so many folks, you know, high level athletes who put their bodies under intense stress to go through kind of really extreme forms of movement. We know that for folks who experience eating disorders, often their periods will go because of again that deficiency. But it’s so common for so many people and for fat folks in particular, we don’t often get diagnosed with eating disorders. You know, we know that the eating disorder world is very anti fat. So I know that there are going to be so many people out there who’ve been misdiagnosed with something like PCOS, for example, because that is the classic kind of fat person’s disease in quotes, and they’re not getting the help they need. They’re often given medications that aren’t useful or could be potentially harmful. Because doctors aren’t doing their due diligence, and they’re just seeing that and going “you’ve got this” when actually there’s so much more to unpack.
Laura Thomas
Absolutely. And I’ve seen it I’ve seen it happen. The PCOS misdiagnosis, when actually what we’re looking at is HA but it got, you know, it got labelled as PCOS because, I feel like I’ve interchanging PCOS, PCOS, whatever, it’s the same thing. People are getting misdiagnosed with this, because just purely because they’re in a bigger body. And like, you know, doctors are kind of just looking at or asking cursory questions rather than asking deeper questions or doing the appropriate lab tests and ordering those, like clear, get a clearer picture of what’s going on. And so yeah, it’s just a lot of assumption, a lot of bias, a lot of stigma coming into it. Yeah, so also, just so folks know we have the guide for both HA and PCOS and in that there’s kind of a table that helps you differentiate between the two and Nicola helped us put together the PCOS one as well. All right, so something like, upsets me. And I don’t know, like, maybe I’m being just like, very sensitive. I’d really like to hear your thoughts on it. But I hear I see a lot of people kind of selling a lot of dieticians, nutritionists selling these like fertility specific diets. So like, they might be about weight loss, they might not necessarily be about weight loss, but they are still very, like prescriptive and restrictive. And they obviously come with this like huge promise attached to them, right. I just feel that their predatory, like I’m just gonna say it.
Nicola Salmon
Oh yeah
Laura Thomas
What do you think about it, are you seeing this? Like, I think maybe it’s always been there. It’s only that I’ve just kind of become aware of it since having Avery, like, I don’t know what, tell me everything.
Nicola Salmon
It’s everywhere. Like, of all the healthcare sectors. So like in western medicine, like all the different health care functions seem to be separated out into their own like specialty, of all the specialties fertility is the one that is rife with diet culture and diets. Like I know, doctors who run fertility clinics and have books about keto, like they seem to go hand in hand, it is wild. And the thing is like, we know that the evidence isn’t there to support it yet doctors have seem to really cling on to this idea that by controlling what we eat, we’re going to impact the outcome of you know, fertility treatments, getting pregnant, but it is so predatory, like you say, like folks who are going through fertility treatment, folks who are navigating this often feel so out of control, because they cannot determine when this is going to happen. Like when you’re navigating, getting pregnant as your goal like there’s no halfway you don’t know, when you’re halfway pregnant, like it’s just this goal that feels so out of your control. And food is obviously something we can control. So often folks will really grab on to that and, and use it as a way of finding that control in a really uncontrollable situation. But clinics really, really, and doctors and nutritionists, and anybody in this sector really, really take advantage of that desire for control and use it to sell things and use it to sell products and diets and really harmful practices to people because and especially for fat folks who, who feel that they should be doing these things anyway, because that’s what they’ve been told their whole lives. It really, really makes them feel like they aren’t worthy of getting support to get pregnant until they’ve lost weight or, you know, being quote unquote good around their food. And it really just pokes that insecurity that they have that maybe they haven’t been eating right, or that it’s somehow their fault. It’s putting all the responsibility on them to say, you’ve not been doing it right up until now, here’s the magic pill, which is going to make everything better. But again, it’s just making them feel more like they haven’t been doing enough. And that it’s their fault, which it absolutely is not. And so yeah, hate it, hate it hate it.
Laura Thomas
It feels like such a double bind for people. Because on the one hand, I can see how if you’re not conceiving, like on the timeline that you’d hoped for, or if you were experiencing recurrent miscarriage or you know, some of these horrible, awful things that that happen to people, that you feel so vulnerable, you feel so desperate, that you’re willing to give everything a go. And at the same time then the narrative that if you just control what you eat, if you just eat the right foods, if things do end up going wrong, even though you’re kind of doing the right things, or if they go wrong, and you’re not doing the right things in inverted commas, you end up with so much blame put on yourself. And, like all the judgement and everything that goes along with that, and I don’t know, it just it feels like it’s a lose lose.
Nicola Salmon
Yeah, you’re never gonna blame the quote unquote good food for things going wrong. Or you’re always gonna find another way to blame yourself if things don’t work out the way you’d hoped them to. But we know that by focusing on food that that just brings more stress, because you can never do it perfectly. That’s not life. And it’s just that hyper focus, isn’t it, of concentrating on something that’s so detrimental for your health,
Laura Thomas
And then that can end up being stressful as well. And then another thing that I sort of see is like the vilification of certain foods as well or like, caffeine seems to be something that at the moment is like, getting shafted.
Nicola Salmon
It’s wild, it’s like you really think that drinking like a few cups of coffee is really going to have like a huge…it’s just like, we know that people in all situations in all scenarios all over the world get pregnant, and we are vilifying a cup of coffee and saying that this is the thing that’s gonna make or break it. Like, we know from the social determinants of health, when we zoom out on our health that there is so much more to play than the things that we’re putting in our body right now. There are so many other things that are going to impact that. And by being fat, what you’re doing is you’re living in a world that doesn’t, you know, that absolutely hates your body. And that is the thing, if anything that is going to impact it the most, not what you’re putting in your mouth, not how you’re moving your body. And obviously some of those, a lot of those things we can’t control, which again, is frustrating. But you know, a lot of the work that I do is around trying to help people get back some of that control and being able to access care and find support so they feel safer in this path.
Laura Thomas
So I want to come back to you know, what are practical, tangible things that people can do kind of towards the end. I don’t want to like leave it on a bum note but I just want, I wanted to kind I think a little bit more about that piece that you just mentioned around like navigating the system and advocacy and all of those kinds of things. And so we know that if folks aren’t conceiving, they might go to their doctor and be referred on to fertility support. That’s not the right word is it?
Nicola Salmon
There are specialists, there are yeah, clinics and all kinds of people that you might get referred onto, depending on which system that you’re in. So in the UK, you’d normally get referred to a fertility clinic, if, if you’re able to, which is not very often for folks in the UK, or in the US, you might go and see a reproductive endocrinologist, you might have a clinic that you’ll go and see or your OBGYN, like there’s a lot of different ways and different people that you might access. And hopefully there’ll be fat friendly, but you know, chances aren’t great in most healthcare systems.
Laura Thomas
Yeah, so what I was, I was thinking of, the word that I was thinking of was assisted fertility. Sorry, I was just having a little brain fart there. And so I put, I put a question box up on stories yesterday on Instagram, and a question that I got from a follower was around this topic, so I’m just gonna read that out. So this person says, I’ve been told to get my BMI under 30 to help with fertility, what evidence supports this? And you literally just wrote a post, which I can share in the show notes, but you explain what the evidence is, and what your experiences working with clients around this. So can we unpack this like BMI 30 cutoff point for accessing fertility treatments.
Nicola Thomas
So we know that BMI has been massively, massively. I can’t remember the word now. But it’s hugely flawed. We know that it has been brought down, is no clinical relevance, is not useful at all. And a BMI barrier of 30 is just an arbitrary number. Completely made up, pie in the sky. Like, it doesn’t mean anything. There’s no research to support that this number is the magical number, it’s just because it’s got zero at the end of it that folks have decided that this is the number we’re going to use. And in the UK, it’s for financial reasons. The reason that they do it is to restrict how many people can access NHS funding. And they have determined that folks in bigger bodies are the ones that they are going to restrict funding for which is unethical, eugenics, immoral, take your pick. But the research is kind of multi level. So for IVF treatments and Clomid and all the different kinds of fertility treatments you can access there are almost like two different like sets of data. Like there’s, there’s also, there’s some research that shows that if you’re in a bigger body, you won’t, it won’t be as effective for you. So it will be you’ll get more cycle cancellations, you’ll get fewer eggs if you’re going through like an IVF process. And that is when everything is the same for everybody. So you get the same doses of medications, you get the same treatment protocol, which makes sense in a scientific study, because you want to like reduce the variables, you want to make sure that you’re comparing like for like, but the problem with that is that we’re all human beings, and we’re all different. And the second set of data, what they do is they personalised doses for people so they give you the medication that you need in order to stimulate your body. And for fat folks, sometimes that’s more, like that tends to be the trend, like folks in bigger bodies tend to need more medication. And that doesn’t mean that everybody in a fat body will, like people have variable sensitivities to medications. But when you personalise the dose for you, then the outcomes are the same. Pregnancy rates the same, cycle cancellations are the same, the outcomes are the same. So it’s not that it works less effectively for fat people. Often we just need bigger doses and we need to be treated like individuals.
Laura Thomas
It’s just it’s like, it’s so wild to me. I mean, like I understand why it like shakes out like this, but like it just seems so obvious. Like different you know, sized humans need different amounts of food, like why wouldn’t they need different doses of like supplementation or medication and like just it’s another one of those things that you’re like, really science like this is what we can do?
Nicola Salmon
Yeah, common sense right? There was a veterinary nurse who commented on that post and they said we do this for animals, like we dose treat on animals depending on their weight.
Laura Thomas
Well you do for anethestic and, everything else like…
Nicola Salmon
And children’s medicine!
Laura Thomas
Yeah!
Nicola Salmon
It’s just like, come on. Like guys like this is basic. Like, let’s, let’s get the basics right.
Laura Thomas
But it is, it’s just like another layer of, well, as you say, it seems like gatekeeping. And, and just a way of like cutting costs and but like there is a cost to that, there’s a very human cost to all of this. And yeah, that’s the devastating part. So sorry, I feel like, have you finished talking about the evidence? Or was there something more that you wanted add to that?
Nicola Salmon
There’s another piece to it around this idea that, you know, like, so often doctors will say, if you just lose 5 to 10% of your body weight, and this will increase your fertility. And when I look into the research around that, sure, there is some research that exists, that shows that but what that research never shows is when you separate out the weight loss from the health promoting behaviour changes that you make. So I think it’s really important to recognise that whilst doctors may say this, and some research may show it, actually what’s going on, isn’t as simple as just lose this percentage of your weight, because that doesn’t really make sense. And, you know, like, if you’re saying that fat people are unhealthy, surely somebody who loses 5% of their body weight in a much higher weight body, you’ll still deem them unhealthy, even though you’ve now decided that because they’ve lost that weight, they’re then going to be more fertile. So I think it’s really important to acknowledge that actually, when people start to make changes in, you know, like behaviours that they make, the things that you can control, because weight loss is absolutely not one of those things, then that’s what really the doctors are talking about when they’re talking about this, you know, like there are small things that you can absolutely do to support yourself, if you choose to, because absolutely, it should not be something that should be a prerequisite for accessing care. But yeah, when your doctor says that, you need to kind of read between the lines and go actually what they mean is that if I take part in these different health promoting behaviours that will support my health, those are the things that are going to, that are going to make the difference.
Laura Thomas
Yeah, thank you for kind of clarifying the difference between those. And we see that like across the board in all areas of weight related and health related research. Again, it’s like science come on, can we just do the thing and try to tease these apart?
Nicola Salmon
Make it make sense.
Laura Thomas
Another kind of, something else that folks run into whether it’s along their fertility journey, or during pregnancy is the label high risk. And it just, it just feels horrible. Just to say it, so and again, I’m just wondering, like, what your thoughts and experiences around this are and what it really means and, you know, is it a helpful term basically.
Nicola Salmon
So people might run into this term really early on. So for folks in bigger bodies, especially, it is almost again, used as like a gatekeeper. So for folks who want to go to clinics, who want to access care, often they will be said, well, we can’t help you get pregnant because you’ll be too high risk. So even before you get pregnant, you’re given this label of high risk. And, for me, I was labelled high risk in both my pregnancy. So I’ve got two kids. And I was duly given this label. And it was not helpful in the slightest. It didn’t make me feel empowered to make healthcare decisions. It didn’t make me feel reassured that I was getting a different type of treatment. It made me feel like again, it was my responsibility that I was this ticking time bomb as it were. And I spent my whole first pregnancy very anxious that something was gonna go wrong. Every single thing that I thought could possibly go wrong, I thought would happen. And that meant that I didn’t enjoy my pregnancy very much. It just meant that I was waiting for the other shoe to drop. I was waiting for something to go wrong. And nothing did. It was a very unremarkable pregnancy. Nothing happened. But it just it meant that yeah, that my mental health suffered because that label and I understand it, you know, it’s really important for folks who are wanting to get pregnant and navigating pregnancy to understand that there are an increased incidences of things happening. And again, like the research, there’s so many layers to that research. The first layer is like when you look at the research, it’s not black and white. It doesn’t all say you’re at an increased risk of getting gestational diabetes or pregnancy loss. It’s about third that says you do, a third that says you don’t, and the third that says it’s possible, but it’s not conclusive. So there’s that layer, then there’s the layer that says, Okay, well, if we assume that the risk does exist, we’re going to say that it’s really, you know, you’re definitely going to get it. You know, we really sensationalise that risk when actually, for, you know, for example, for gestational diabetes, I think the percentage is around 2% for folks who are in a quote, unquote, normal BMI. And then for folks in the highest BMI category, it goes up to 10%. So whilst is a five times increase, actually, there’s 90% of folks who don’t get it at the highest BMI rate. So it’s really important that we understand the risks so that we can make those informed decisions. But fat folks are often really infantilized, and what often makes sure that we can’t make those decisions for ourselves. So I think it’s really important that people have all that information of knowing that, actually, we don’t know if this risk exists, we don’t know why it exists, if it does exist, and if it does exist, this is the you know, this is what the incidences look like. And then, you know, like this top layer of people like being able to make informed consent around their body, and having that body autonomy to make that decision. So yeah, so high risk is a really problematic label, it’s not helpful, it is really harmful to folks’ mental health. And actually, what folks need is a complete picture of what the research really says, so that they can make that informed consent and have body autonomy and make those decisions with all the information.
Laura Thomas
Yeah. Wow, it’s yeah, just I think, I mean, first of all, thank you for, for sharing your experiences. And I was thinking like, you know, I, I related to a lot of what you were saying in terms of like, just feeling really anxious that something was gonna go wrong at any possible moment. And I feel like, for a lot of I don’t know, everyone’s experienced that, like, that’s a lot of folks baseline. So then having this label slapped on top of it, it’s almost kind of like co-signing your anxiety, right? It’s like, oh, no, you know, that’s, no, you should be anxious, you should be worried, you should be concerned, because you’re high risk. And like, that is so counterproductive. And so unhelpful. And then I think it’s really important what you were saying about kind of teasing apart the, the, the relative risk versus the absolute risk, as you were talking about there. So I think, you know, oftentimes, if you go and see a doctor, or a midwife, or whoever it is, and they’re like, Okay, you’re five times more likely to get gestational diabetes, just to illustrate your point, that is the relative risk. Okay, so you’re five times more likely than a straight sized person. However, in the grand scheme of things, your absolute risk, your like, there’s only a 1 in 10 chance. And that’s still really, really low.
Nicola Salmon
Yeah. And it’s really, really manageable. Like folks of all bodies get GED, folks of all bodies manage it well. It doesn’t mean that you’ve made bad choices, doesn’t mean anything about you. It’s just something that happens to some folks, and we can control it.
Laura Thomas
I think I’m going to do a whole episode on on gestational diabetes because, like, I think what a lot of people don’t understand is that everyone becomes insulin resistant during pregnancy. It is literally your body’s way of prioritising the foetus’s, the foetus God Jesus sorry, like that sounds so horrible. The baby The baby’s nutrients over the person carrying the baby. So like, we all become insulin resistant in pregnancy, and but it’s just that, like,
Nicola Salmon It’s the level right?
Laura Thomas
And what I was even gonna say is like, it’s only people in bigger bodies that get like, stigmatised for that, right?
Nicola Salmon
Yeah, and it is a real stigma.
Laura Thomas
It’s such a huge stigma. Right. I’m doing an episode on gestational diabetes, it’s coming. I already know who I want to talk to about it. So, okay, we’ll put that back in, back in the in the can for now. Is there anything else you wanted to say on like that, that label around high risk? And we talked about, you know, maybe asking your doctor, what is the absolute risk versus relative risk? Is there any other piece around advocating for yourself? I mean, I know that this like, this is a lot of what you talk about, but maybe just a few kind of pointers or things for people to consider,
Nicola Salmon
Yeah, so I think the other point that I really wanted to make is that labelling somebody as high risk is really ableist as well. Like this idea of health, of what a healthy pregnancy look like, is really damaging for folks with chronic conditions, for folks that are navigating other health concerns. So I think it’s really important to just flag that as saying like this is can be really damaging for a lot of people who are navigating other you know, being in bodies that are not, you know, maybe not fat, but navigating with a health concerns or fat and have other chronic health concerns and labelling someone high risk, because of their, you know, other because their health doesn’t look like what your health looks like, or what you deem healthy to be, I think, is really dangerous. And again, like just really reiterating that it’s not your fault if something goes wrong. It’s not that you’ve done something wrong. But labelling someone high risk automatically kind of puts that blame on them saying, you know, like, because of your BMI, you’re high risk, and therefore, if anything does go wrong, it’s because of that. I think it’s a really damaging path to go down. But yeah, so back to advocacy. It’s, advocacy is a really, I think it’s really important to remember that we’re not taught these skills at school, like our whole society is set up so that people who identify as women or people who are women, or have been assigned female at birth, are oppressed. And advocacy is not a skill that we want to teach people who we’re trying to oppress. So it’s really important…
Laura Thomas
That’s such a great point.
Nicola Salmon
It’s really important to remember that these skills we’re not taught, we don’t learn them we’re never like, we don’t have like a, here’s how to advocate for yourself module in school. So it’s something that takes a lot of practice, it takes a lot of time, it takes a lot of energy. It is exhausting. And it’s not work that you should have to do. Like, I really want to acknowledge that this work is something that people should not have to do.
Laura Thomas
It should just be a given, it should be the baseline of care.
Nicola Salmon
Yeah, to every human being.
Laura Thomas
Yeah, yeah.
Nicola Salmon
And it’s really, really sad that we’re not, we don’t have a society where it deems everybody human and equal to be able to access that care. But that’s not your fault. So you can only do your best in any given situation. So the way that I kind of talk to people about advocacy is something I call prepare and care. So we do our best to prepare for whatever scenario you’re going into to advocate for yourself. So that could look like making it as easy as possible for you to navigate that appointment time. So whether knowing you know, do you talk to people best in the mornings, are you better in the afternoons, maybe some point in your cycle you’re better at kind of expressing how you feel. Maybe it’s taking someone with you so you have someone to support you, you know, setting up those conditions to give you the best possible shot if you’re able to, of navigating that conversation. You know, do you have people on your team and that’s your healthcare team, it could be a therapist, dietician, coach, nutritionist, who can do some of the work on your behalf. So often I’ll send emails to clinics for folks asking, you know, setting boundaries for people, asking them to not weigh them, talk about weight loss, talk about dieting, setting those kinds of boundaries for folks, it’s just about kind of preparing as much as you can. And often I’ll help folks by giving them research resources and summaries, so that they feel more confident in their bodies by reading that information. But they’ve also got this stuff to talk to their doctor about or hand to their doctor, or, you know, ask them about the research. So it’s just another tool in their belt. And then, you know, the second part of that is the care part. So really making sure that they take as much care as they’re able to for themselves afterwards, because it’s such an exhausting process and you know, mentally, emotionally, physically, doing everything in your power to be able to support yourself.
Laura Thomas
And I think that there’s, as I was just thinking about that after care piece that you mentioned, like it’s I just wanted to acknowledge as well that you can go in really well armed to your doctor or whoever it is. And you know, have prepared, know all the research, you know, have like someone like you or I advocate on your behalf, like do all of the things, and still be shut down and still be dismissed, still be invalidated. All of those things. And that is, like, that’s just devastating. That’s so difficult. And again, it just speaks to the point that you were making earlier that like, we shouldn’t have to do this stuff anyway. This should be, that person-centred care should be the default. People should be like, held with care and just and that’s just not something that I think, and this is not blaming any individual human in the NHS, but it’s just not something that our system itself and most medical systems around the world. There, you know, I was actually had this exact conversation with Nicola Haggett yesterday, and we were talking about how health care in this country is not health care. It’s like first aid, right? It’s it’s like disease management or something like that. It’s like, I forget what she actually called it, but like, it was something along those lines where we’re just, it’s dehumanising a lot of the time. So yeah, I just wanted to acknowledge that. You know, you can have, you can put in all the groundwork and like it can still, sorry, that’s like a really depressing thought, but I just feel like it’s important to acknowledge that.
Nicola Salmon
It’s really important to acknowledge that reality because your doctor could still be a dickhead, your doctor could still be something that you cannot control and you cannot change their mind. And, you know, you can go into that appointment and still not be able to say all the things you want to say because your nervous system is triggered by, you know, a previous traumatic experience of a doctor. And you just go in and you just nod your head. And that is a completely valid reaction to that experience, because doctors, it can feel really traumatising. And it can really send you into like an you know, a kind of fight or flight or fawn or freeze response. So it’s really important to acknowledge that, it is not your fault, you’re doing the very best that you can. And you just yeah, unfortunately, it’s just the situation that it is. And it’s okay, that that’s happened.
Laura Thomas
And I think this is where it can be so helpful and so healing to have people like yourself, and like communities, like the one that you’ve developed to go and be like, this is what happened and just get that care that you deserve, like, care in this, not in the like literal sense, but like, be held emotionally. And just kind of have your experiences validated and vent and like scream at other people that understand exactly what you’re going through.
Nicola Salmon
Yeah, I think the power of community when you’re navigating something like this is so healing because for fertility alone, like it can feel very isolating because you feel like not many people talk about it. But when you add a layer of fatness on to that you are terrified of talking to people in your life about that, because you’re worried that they will be like, Oh, well, have you tried this diet? Or have you thought about losing weight because that’s what will help like, you get all those stigmatising messages from everybody in your life if you don’t have a circle of people that you can trust with regards to your body. So it’s got those, you know, like that double layer of isolation. So realising that you’re not alone and that other people are navigating this too can be really, really affirming.
Laura Thomas
Yeah. All right. So I feel like we’ve bummed everyone out now. I think I know, I think it would be helpful if we just spent the last little bit of time together thinking about some things, some practical steps that people can take, if that’s okay. And again, I got a question from a listener, follower, I don’t know what to call someone, someone who’s interested in getting pregnant. And they said, I just started dieting against my better judgement so I can have fertility treatment for a second baby. And then they explained that they lost X amount of weight for the first one, and then have like, a bigger amount of weight to lose now, and then they’ve just asked, is there another way? Okay, so we’ve said that diets aren’t useful. We’ve explained why they’re not. Can we talk about some things that are helpful? That maybe will offer some reassurance?
Nicola Salmon
Yeah, so first of all, I think it’s really helpful to acknowledge that that is a real reality for a lot of people, like so many folks who are navigating this experience, especially in the UK, where we have the NHS, the free point, you know, access healthcare, it can feel like you’re stuck between a rock and a hard place, like, you’ve got to either jump through the hoops that the NHS provides you or you have to pay out of pocket. And for people who aren’t in a position to be able to do that with the financial means, then sometimes the only option that they have is to diet to be able to access that care, and that is a shitty place to be. And that is not something that I would, you know, ever ask somebody to do, but unfortunately, is the reality of our system. And I think it’s really important to acknowledge that if you have to do that, like that is understandable. That is absolutely your decision to make like there is no judgement is now this this path that you’re taking because of the system that we have in this place. I mean, you know, I just want to send people so much love who feel that they have to go through that process to navigate that care, you know, what I try and do is give people the full picture of, yes, losing weight will allow you to access this care, and you’ll feel less stigmatised. It will come with all these risks. But as long as you’re informed about that, when you’re making that decision, then it’s absolutely your choice to make. There are other clinics out there that will support folks, if you have the financial means, in the UK, or if you’re living in another country where you need to access that care, there are clinics out there that will support you, if you need tests, if you need treatments. I’ve got a list on my website, that’s kind of, like I’m trying to crowdsource lots of people’s recommendations of different clinics all over the world. So it’s a good starting point to be able to access that care if the reason you’re dieting is because you can’t access care. But in terms of like practical things to do, there’s kind of three things that I often advise to folks, as like a general starting point. I ask them, are they eating enough? So that bit, eating enough, there’s no eating enough protein, it’s just are you getting enough food in your body to be able help you feel safe and sustain a pregnancy,
Laura Thomas
I could kiss you Nicola, honestly, the number like of times, I have to have this conversation with people like, you’re not eating enough food.
Nicola Salmon
If you’re not eating enough, your body’s gonna know you can’t trick it with drinking more water or sniffing an apple. Your body needs enough food to be able to grow a human being. So you need to give it enough food so it knows that it’s safe to do that. I ask people if they’re resting enough, because often that, you know, rest is not inherently valued within our culture. And especially for folks who are navigating PCOS, you know, hormonal issues, rest is a huge factor, whether that’s, you know, like making sure your quality of sleep is supported, making sure that you rest throughout the day, that your work life balance boundaries, especially with folks who are working from home, like making sure that you’re actually switching off rather than scrolling through your emails when you’re supposed to be not at work. And then I’m also you know, asking people, how they’re supporting their movement. And in finding intentional movement, whether that looks like a five minute walk around the garden, whether that looks like you know, 15 minutes, it all counts, doing the washing up counts, doing some gardening counts. It’s just helping people rebuild their relationship with movement from maybe a place where it’s felt punishing and harmful, and finding ways to support them if they choose to. So that’s kind of the places where I start with folks. And also just meeting people where they’re at and saying, you know, it’s okay, where you’re at exactly right now, and helping folks figure out what they want things to look like, how they want their lives to look, without this idea of weight loss, or dieting, being like this healthy thing that we should aspire to.
Laura Thomas
I love all of those kind of recommendations. And I will link to that list of providers that you have crowdsourced. That’s such an amazing resource. Thank you for sharing that. I wanted to, if it’s okay, maybe add like one easy especially, well, two points that I want to make, because I feel like we’ve really focused on folks who are the owners of the uterus. And it’s just to just to remind people that like sperm quality has a role to play in all this, as well. So it’s not just like, on the yeah, the the uterus owner. So and then the other thing that I feel like it’s just not out there enough that is something that I always remind my clients about, which is around folic acid supplementation. So in the UK, at least, and I think probably a lot of places around the world, if you’re trying to conceive, you’re suggested that you take 400 micrograms, I think, yeah, trying to look at my notes here, 400 micrograms of folic acid supplementation a day. However, there is a recommendation, that if you have a BMI over 30, that you should be taking five milligrammes a day which is only available on prescription. And I just, that just feels like such a simple thing that people can do. I’m like a big advocate of like, let’s just have a supplement as a safety net here. And it’s just such it’s such an easy thing that people could do but like if you, if, that information, I feel like it’s just not out there.
Nicola Salmon
It’s an interesting one. So going back to the sperm owners thing, I absolutely, like about a third of, so when you look when they talk about fertility or subfertility, it’s about a third of folks, a third of the problems are with the sperm owner, a third of it is the folks that with the uterus owner, and then a third of it is with like, combined or unknown. So I always recommend folks who are in a partnership, where they have their sperm in the partnership, that they go and get checked first, because all they have to do is jizz in a cup like that’s not invasive.
They don’t have to do any tests, any you know, anything really, that’s, you know, that takes a long time. So that I always recommend folks go and do that first, because that’s a really very easy, yeah. And with the folic acid, that’s really interesting. I did quite a deep dive into the research around that. And you’ll be surprised or not surprised to know that it’s actually quite a lot of anti fat bias within that recommendation. So the it’s linked in the NICE guidelines, which is the guidelines in the UK, but it’s really low quality evidence that they use to make that recommendation.
Laura Thomas
That’s not surprising. The most, pretty much the foundation of the NICE guidelines in like across every….
Nicola Salmon
Is it low evidence? But yeah, so actually, when you look at the research, most of the time, the nought point four is enough. And there’s one study that said that maybe another 350 micrograms would be helpful to folks in larger bodies. So that takes it to about point eight. But yeah, 80 times is quite a lot. And for most folks, it’s quite benign. So it’s not a big deal if you’re taking too much. But for some folks, it can, if you’re sensitive to medications, it can be it can, upset your digestive system. So I tend to recommend to folks try it, if you get on well with it, that’s fine. It’s not going to do you any harm. But if you have any side effects, you’re probably okay with a smaller dose.
Laura Thomas
I had that same suspicion as well, even as I was saying it, and I could see your face. It was like, okay, we’re gonna talk about this. And again, I suppose, where I kind of lie with like, supplements, and…even if it has like, a bit of a placebo effect,
Nicola Salmon
Oh, yeah, I’m all for placebo.
Laura Thomas
Yeah, or like, I’m totally, or if it like offers like, a little bit of reassurance or like, feel supportive, then like, like you said, as long as you don’t have a negative reaction to it, then like, it feels like something really easy and supportive that you can do. Or you could just get like a prenatal supplement. And that would, you know, like,
Nicola Salmon
That covers your bases, yeah.
Laura Thomas
It’s like, it’s something little that you can do that you can feel like, okay, like you said, covering my bases, it’s a bit of a safety net, you know, because especially, this is more like, you know, post fertility, I suppose, or like once you’ve conceived like, in that first trimester when all you can eat is carbs like just knowing that you’ve got that supplement that’s kind of got your back? That can be really, really reassuring. So, yeah, okay. Like so it’s complicated basically,
Nicola Salmon
It’s not a simple thing. And it seems quite wild that the, the differences are so much and there’s no, they’ve actually not use that number, again, from any evidence that I could find. It was just, let’s pick a number out of thin air and see what happens. So yes, so see how you get on with it, it’s definitely something to be aware of, and definitely getting a folic acid or folate, which is the kind of natural version of it. Some people do have a gene that makes it more difficult for them to synthesise folic acid, folate can be an alternative. But yeah, if you’ve got a supplement that’s got it in, that’s probably covering your bases. And if that’s all you’ve been taken so far, you’ve been doing a great job.
Laura Thomas
Yeah, and if you’ve got like a generally, really, like, you know, you’re getting a bit of everything in your diet, then it’s going to make up that difference anyway.
Nicola Salmon
It’s in loads of stuff. It’s in eggs, it’s in dark green leafy veg, it’s like, there’s loads of ways you can get it in your diet. So do not worry.
Laura Thomas
It’s fortified in carbs as well. Okay. So, I feel like we’ve covered so much in this. So I just like I’m really grateful that you have come and shared your wealth of information with us. And well, we’ll talk about where to find you in just a second, but is there anything else that you wanted to like, leave people with or any just like, final thoughts that you have? Not final final thoughts, but like, closing thoughts.
Nicola Salmon
I think one of the most helpful things for a lot of folks is that permission that you can start trying now. For so many people, they’re like, well, I can’t really start trying yet because until I’ve done this or got more healthy or lost the weight or blah, blah, blah. I want to give folks permission to go yes, if you want to get pregnant now, if you want to start trying to grow your family now, you absolutely can in your body. There is no reason to believe that being in a bigger body is gonna cause any problems at all. So if you are ready to get started, then get started. And if there are problems, if it’s not going in the timeline that you want, then you are still absolutely worthy of navigating and accessing that care that you need, no matter what that is, in order to grow your family. So yeah, there’s no reason to believe anything’s wrong. And if it’s not going well, you are totally worthy of getting that care.
Laura Thomas
That’s such a lovely, hopeful thought to leave it on. Alright, so at the end of every episode, my guests and I share something that they have been really into. So Nicola, would you like to go first?
Nicola Salmon
Yes. So I have been really into trying to find different ways of moving my body because for so long, I have stopped myself from doing fun things because I didn’t see people who had my body doing them. But now I’m like, fuck that shit. I’m gonna go and move my body in whatever way I want. So, for example, this week, I have been doing aerial yoga. So I’ve been going upside down and doing like acrobatics things off the floor, which has felt awesome. I’ve been doing Morris dancing.
Laura Thomas
What? I didn’t even know people still did that.
Nicola Salmon
Now that I’m living in the Forest of Dean, you know, this is a tradition. So I have joined the crazy people who do it and started waving hankies and smashing sticks around.
Laura Thomas
Are you gonna do like a, are they the folks that like, go around the maypole?
Nicola Salmon
Yeah, yeah.
Laura Thomas
Are you gonna do that?
Nicola Salmon
Well, I don’t know if we’ll have a may pole. But on the first of May, what they all do is, there’s a hill close by called May Hill. And they like everybody who does it go up this hill, and then does dancing at the sunrise, which I thought was pretty fun. I’m gonna give that a whirl. But you get bells, I love bells, who doesn’t love a good bell. You get little jinglely bells to go on your legs. And outdoor swimming, I have been going wild swimming and wild swimming has been one of the most affirming things because it’s just filled with people who are in bodies like mine. And I love it. And the community is fantastic. And my body is really good at going cold water swimming, because I have what they call biopreen, which is like the layer of fat that keeps you warm in the cold water. So I’m actually really good at it. So yeah, finding ways to move my body that feel different, exciting. And yeah, trying not to give a shit about what other people think about me, hand in my jam.
Laura Thomas
So much joy in that, okay, I feel like I’m like really struggling. And this is so ridiculous after your amazing, joyful experiences that you’ve just shared but, okay. So something that I am, maybe not like, really into, but like, I’m grateful that it exists. Alright, so context. I have been vegan for like, a long time, like, since way before, it was cool. Way before. Since I was like, 18, and like, vegan food has come a long way in this time. And what I’m particularly excited about with this, like round of veganuary that we just had a couple of months ago, they released vegan Babybel. And, it’s just, it’s like such a small little thing but it feels like, I don’t know. It’s just like nostalgia. And like, it’s just fun to pack for Avery. Like, it’s just a good, like a cool snack to like, just throw in a bag and I don’t have to think about it. Right.
Nicola Salmon
Easy.
Laura Thomas
So easy, and he, like, loves peeling the little wax off of it. And like it’s still got that, like, you know, that feeling? Yeah, yeah, that you like, we’re both like, opening our hands into like little v shapes, you know, but it’s when you just like pop the Babybel out. And I don’t know, there’s just something really satisfying.
Nicola Salmon
That is amazing. My boys love opening them, but I refuse to eat them. So we’ve only had them a few times because it’s just a waste. But I get what you mean.
Laura Thomas
It’s so interesting. Sometimes Avery will just like have a bite and then hand it to me and other times he’s like, more more.
Nicola Salmon
Does it taste the same? Does it taste how you remember it?
Laura Thomas
I think it’s pretty good. Like, I have no real recollection of what it tastes like to be honest, but it has like a cheesy flavour. And I was, I gave my friend some the other day and she said yeah, it’s pretty similar. But I just like in general, I’m quite impressed by like, how supermarkets and stuff are upping their like vegan cheese related product game. So like M&S have vegan cheese straws. And they’re so good. They’re really, really good. And there’s like vegan Philadelphia, vegan Boursin, like all these like, just like, you know, like brand names that you know and love.
Nicola Salmon
Cheese would be one of those things that would be the real barrier to me becoming a vegan, it would be definitely cheese.
Laura Thomas
Like I, like I totally get it and it is one of the things that I like, lament is that the right word? I don’t know. But I also live in like, bougie hipster East London, where there’s like, lots of…
Nicola Salmon
Everything’s vegan now.
Laura Thomas
Everything’s vegan but also there’s like lots of vegan cheese available. And some like really interesting. Like, there’s what you know, what like miso in it and like, yeah, some really cool flavours anyway, I’m going to stop going on about vegan cheese because I realise how freaky this sounds.
Nicola Salmon
It’s quite niche, but just as important.
Laura Thomas
I just yeah, something to get like, I think this also just like speaks to how exciting my life is. It’s been a long year, okay, it’s only March.
Nicola Salmon
I’ll be honest, when my kids were in the toddler phase my world was very small. And it’s only really now that I’m starting to like, be able to let go and talk people and go out and do things again.
Laura Thomas
I shouldn’t be allowed to talk to people if the best I’m coming up with is vegan cheese straws. I’ll have something better for the next episode. Nicola, am I right in thinking you have a new version of your book coming out?
Nicola Salmon
Soon, yes! So hopefully in about three or four months. I’m doing a new edition. Because obviously, when you write something three or four years ago, you’re like, Oh, now I wish had done it a million times differently. So I get to do that. Because I’m self published. I can be like, Yeah, I’m just gonna write a new one. So that’s what I’m doing. And I’m getting an editor this time, which will be awesome. Hopefully less typos. But yeah.
Laura Thomas
Oh my god, do people like email you and be like, you’ve got this, this typo in your book? And you’re like, fuck you.
Nicola Salmon
Oh, yeah, I’ve got my my share of good reviews on Amazon that are like I’m giving it three stars. It was a good book, but it has this typo and this typo, and this is grammatically incorrect. And just like,
Laura Thomas
Can we just talk, wait, whatever, it’s a whole other podcast about like the ableism in..
Nicola Salmon
Oh clasist, yeah.
Laura Thomas
Yeah. Anyway. Okay, so new book, that’s something to watch out for. And do you want to tell people about like your other offerings and where to find you?
Nicola Salmon
Yeah, so I am normally on Instagram @fatpositivefertility. All my work is on my website, nicolasalmon.co.uk. And, yes, I have a few different ways folks can access information and work with me. I’ve got workshops and stuff all around like IVF for fat folks, evidence based fertility, fat fertility 101. Those are the kinds of things that I’ve got. And then I’ve also got a really low cost group community. So people can access and find other folks who are navigating this with them, where I answer questions, off Facebook now, hurray. It’s called The Fat and Fertile Alliance. And then I don’t know when this will air, but in mid-April, I am launching a new version of my kind of one-to-one / group programme called the fat and fertile, no, Fat Positive Fertility Family, which is how I work with folks over six months to really support them and be their own personal cheerleader and advocate for them with clinics. And yeah, we work together really intensely so that you can feel like you’ve got someone in your corner as you’re navigating this.
Laura Thomas
That all sounds incredible. And this will come out, like sort of around that time, I think. So hopefully, we’ve got some time.
Nicola Salmon
Awesome, so if you’re listening, and it’s yeah, just give me a bell. And if you’re interested in working together like that, I’m sure I’ll be able to squeeze you in.
Laura Thomas
Before you go, when I put up on my stories, like I got some questions. But I just wanted to share some of the responses that I got that weren’t necessarily questions. Okay. So someone said, Not a question, but bloody love Nicola’s work. So keen to hear more of what she has to say. Another person said Yes! Heart emoji, clapping emoji. Her book made me know it was possible, conceived naturally, high BMI.
Nicola Salmon
Oh, that’s amazing.
Laura Thomas
And then another person. No questions just thank you for having her on this. I’m anxious that I can’t get pregnant. And so just wanted to share with you like how valuable and important your work is, and you know how much people appreciate you in this space. So yes, you’re, you are so valued and so needed. So thank you for being here and for sharing everything with us. And I will link to all the places to find you in the show notes and like your courses and your book and everything else as well.
Nicola Salmon
Oh, I really appreciate that. And yeah, I just, I’m here for any thing, if anybody has anything they’re struggling with, I am so happy to help because I know how, how hard this place of, you know, can be to navigate so thank you for sharing that with me. And yeah, thank you for having me. This has been such a joy.
Laura Thomas
Thank you, Nicola.
Laura Thomas
All right, team. That’s this week’s show. If you’d like to learn more about today’s guest, then check out the show notes in your podcast player, or head to laurathomasphd.co.uk for more details or the full transcript from today’s episode. Big thanks to Joeli Kelly for editorial and transcription support. And if you need to get in touch with me then you can email hello@laurathomasphd.co.uk or find me on Instagram @bub.appetit. And if you enjoyed today’s episode, then you can help the show reach more people by subscribing on your podcast player and sharing it with a friend. Alright, team. I will catch you next Friday with a brand new episode. See you there.
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