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Breaking Up is Hard to Do

“The irony is that we attempt to disown our difficult stories to appear more whole or more acceptable, but our wholeness – even our wholeheartedness – actually depends on the integration of all our experiences, including the falls.” —Brené Brown, Rising Strong

As of last Friday, I no longer work at a bariatric clinic.

Many of you are cheering, and I am so grateful for your support as I’ve been feeling my way toward my truth over the past year and a half.

Some of you are left wondering why I left a steady source of income after five years. (Don’t worry, I moved laterally to another position.)

Some of you might feel betrayed – how could I claim to be a Health At Every Size® dietitian if I worked at a weight loss surgery clinic? I hear your pain and I apologize. I promise to do better, and I also understand if you feel that it is too little, too late.

The Story Up to This Point (Abridged)

I’d been working at the bariatric clinic for about four years when I first discovered body positivity. It wasn’t long before I saw the ways that the surgeries were described by many in the body positive community: “stomach amputation”, “bariatric butchery”, “barbaric”, “mutilation”. Because of this, I hesitated to call myself a HAES dietitian, or join ASDAH, the de facto HAES organization.

As I dove deeper into the body positive movement, I knew that I wanted to adopt a non-diet, weight-inclusive approach in my practice. My work at the clinic reinforced the fact that weight loss is often fleeting and doesn’t bring health and happiness. It also exposed me to the trauma that led my patients to the clinic… and the trauma that my coworkers and I were inflicting.

I tried to practice from a weight-neutral place as much as possible – I viewed my role as helping people meet their nutritional needs, not promoting or maximizing weight loss. Instead of “portion control”, I taught people how to tune in to their hunger and fullness cues. Instead of “no cookies in the house”, I talked about how physical and mental restriction promoted binge eating.

Outside the clinic, I already didn’t talk much about my work because of conflict of interest rules from my employer, but I doubled down on this “secret”. On the rare occasion that I shared my conflict, I am grateful that I was met with support, and told that my perspective was needed and welcome.

Still, the cognitive dissonance and vicarious trauma got harder to bear. It would make sense that leaving would be easy, wouldn’t it?

Feeling it All

When I got the call that I’d got the job, I couldn’t believe it was real. I’d just been rejected for another position weeks before – where I work is unionized, so hiring is seniority-based. I thought for sure someone with more seniority than me applied for this position too. When my new manager told me that she had good news, it was exciting, but it wasn’t the feeling of pure elation that I’d expected.

The bariatric clinic was where I learned to normalize fat bodies. I saw resilience, commitment and beauty in my patients every day.

It was where I honed my counselling skills. I experimented with motivational interviewing, learned to hold space, and learned to sit with discomfort.

It was where I saw changes in my patients, beyond the scale. More importantly, it was where I saw my patients change.

It was where I had the support of a close-knit team, whom I consider friends.

I sometimes wonder whether I would’ve embraced the non-diet approach in the way that I did if it weren’t for my experiences, positive and negative, at that clinic.

Of course, I am glad to no longer work at a place that is now so incompatible with my nutrition philosophy, and I’m relieved to no longer be contributing to the oppression of fat/larger bodies (at least not in that way).

It was the right thing, but surprisingly, not the easy thing.

“I did then what I knew how to do. Now that I know better, I do better.” —Maya Angelou

10 Comments

  • Danna on Jan 11, 2018 Reply

    Congrats on the new position!!! I too was a patient at the clinic that ultimately decided that bariatric surgery wasn’t for me.

    Unfortunately you weren’t my dietician however, the one I had did completely understand my decision to give up dieting. I love your posts and all your advice. Thank you so much for all you do!

    • Vincci Tsui on Jan 11, 2018 Reply

      Thank you so much for your comment, Danna!

  • Beva Dudiak on Jan 11, 2018 Reply

    Let me start by saying congratulations on the new position. Somehow I knew you were working in a bariatric clinic but I never thought of it as a conflict with your HAES philosophy as I just assumed, I guess, that you were doing those things you mentioned….like hunger fullness cues and working against binging etc. And you are a registered dietitian. Where are you supposed to work? I didn’t think anything of it. But glad to hear you have moved on to an area that fits in better with your HAES mentality. It just makes sense. You will be more comfortable but I hear you are feeling a loss. It was part of your journey. It helped you grow. Take what you can from the experience. And move on.

    • Vincci Tsui on Jan 11, 2018 Reply

      Thank you so much for your encouragement and words of support, Beva!

  • Rebecca on Jan 11, 2018 Reply

    Absolutely beautiful. I feel the same internal struggles as you do, and am wondering how I’ll find the resolve. Thank you so much for sharing. Love your content!

    • Vincci Tsui on Jan 11, 2018 Reply

      Thanks, Rebecca!

  • Tammy LeClair-Davies on Jan 11, 2018 Reply

    Vincci, I was a patient of yours at the bariatric clinic and though I did go through with the surgery I felt it was the best option for me because my health was suffering so much from it and I needed the tool that bariatric surgery gave me. I have had dieticians, nutritionists for over 10 years and none of them committed to me the way I feel you did during our 2+ years together. You taught me that all food is good food and you slowly helped me erase the shame I felt when I would eat something that may not have been the best choice and this shift in eating helped guide me to moderation and it was so much *easier* to make the better food choices while still enjoying the not so better. Your fullness scale is another technique that helps and I try to use it daily. I cannot tell you how much you have helped me by giving me skills that I will use for the rest of my life. I will always be a bigger woman, and I am ok about that but with your guidance you have helped me be accepting of it and to be healthy. Congratulations on this next step in your journey.

    • Vincci Tsui on Jan 11, 2018 Reply

      Thanks so much for your support, Tammy! I’m so grateful to hear that you found our work together helpful.

  • Lori on Jan 11, 2018 Reply

    It was in the program where I first met you and your advice really helped me. After participating in the program for several months I decided for sure that bariatric surgery is not for me. And in fact, it was something you said to me that confirmed my decision to leave the program and break up with dieting.
    While I understand the conflict you must have been feeling in that position, please don’t underestimate the value that you brought to your clients. Vincci, I can’t be the only one. There are others who were encouraged by your warm generous spirit and found their own truth. I just know it.
    All the best to you in the next chapter of your career.

    • Vincci Tsui on Jan 11, 2018 Reply

      Thank you so much for your support, Lori! I think you’ve told me that story about what I said to you before – I’m so grateful to hear that my words resonated with you on your own personal journey.

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