My byline on my blog posts for Sequence reads like this: “Summer Kessel, RD, LDN, CSO is a Registered Dietitian Nutritionist and mom of two who comes to Sequence as a member and with 8+ years of experience in clinical and bariatric nutrition in Tampa, Florida. She is a champion for individualized, sustainable, realistic and evidence-based nutrition and fitness interventions that improve quality of life. In addition to her professional skills, Summer has lost and maintained more than 145lbs—of course, not without challenges—over the past 14 years, sharing her personal journey along the way to encourage and support others.”
But it's hard to fit your entire life story—especially one fraught with challenges around living with obesity and food noise (more on that later)—into one paragraph, so, I hope to share more with you here. I’m beyond grateful to work for and be a member at Sequence because I finally feel seen and heard—an experience many of our members share.
Before we get started, I want to acknowledge that weight is not a behavior. It is important to be clear that there are several measures of health independent of weight. Weight is also not a reflection of any moral value of a person. Body diversity is beautiful, and body autonomy is at the forefront of my worldview. Obesity is not a character flaw. Weight is also not solely the reflection of personal choice —our genetics, environments, and socio-economic political landscape all play a role. I hope your takeaway is that weight management is a complex endeavor, and that a little understanding of what it’s like to live with obesity can go a long way towards acceptance of obesity as a chronic disease.
My history with weight, dieting, and food noise
I struggled with my weight my entire life, and I initially decided to become a dietitian to help myself. I thought if only I could learn the secrets to nutrition (to be clear, there are none), I would find that missing piece to solve all my problems, including but not limited to my weight. And well, I learned a lot. More balanced and decidedly less restrictive, I developed a healthier—but not perfect—relationship with food. I learned the science of metabolism and calories and the magic of lean protein. I began to appreciate and consider how social determinants of health and the systematic, institutionalized exclusion of marginalized people from equitable healthcare impacted weight for a lot of people. I fell in love with strength training. And, better yet, I learned how to counsel other people to eat well and, in a way, counsel myself at the same time towards a more realistic and sustainable approach. I finally learned that being too restrictive backfires. I became a person who managed my weight and exercised as a core pillar of my personal brand. I implemented tools that helped, like counting macros and meal prepping, that seemed to be the flexible yet portion controlled strategy that clicked for me. “The best diet is the one you can actually stick to” was my motto. It was admittedly frustrating at times, and it took a lot of intentionality. I, annoyingly, made my weight management a non-negotiable aspect of my life. It was, without a doubt, absolutely exhausting.
I was *fine*. Still, if a package of Oreos made their way into my home, I would eat the entire thing in short order! I could white knuckle it. I could meal plan and meal prep like a professional! I knew exactly what I needed to do! And yet, it was HARD WORK and I still had a lot of excess adiposity, despite all these efforts. For years, I worked as a clinical dietitian in a hospital—including a bariatric surgery program—and I was always the biggest dietitian in any room of dietitians. People always thought they were being nice when they told me “I carried my weight well.” But I always felt like I had to really prove myself and my skills as a dietitian to be seen as competent in my job—because, unfortunately, fellow members of the healthcare team equated my size to my abilities and knowledge. I became more critical of and began to advocate for my patients against weight stigma and bias in the hospital.
To be honest, I really didn’t realize how hard it all was for me until now that I have started a GLP-1 medication and can think differently about my relationship with food and weight.
I told myself I was just larger-framed and athletic, so maybe the BMI didn’t apply to me because I had muscles. For a while there I had almost resigned myself to the idea that I would always be “plus size.” But, as I was getting older, I was developing hypertension. The GERD from a hiatal hernia I had made me miserable. Heart disease and chronic obesity runs in my family. My father’s recent open heart surgery was difficult to witness. The pandemic had me terrified that my larger body put me at risk. And yet, additional efforts to lose more weight—above and beyond the attention it took to maintain without unrealistic restrictions—were short-lived and unsustainable.
You see, the thing is, I have the chronic disease of obesity. No amount of knowledge or good intentions can treat my biology. I have an insatiable appetite. I am a bottomless pit. Fill me up with all the lean proteins, vegetables, and fiber you can, and I’m *still* hungry. My chronic, relentless, and progressive disease clouds my best intentions to diet and exercise. Food calls to me. I could never have “just one” of anything. I would eat in secret. I would eat past the point of physical comfort. I could eat when I was happy or sad, stressed, or relaxed. I ate when I was bored. I ate when I was busy. I could eat mindlessly and also intentionally depending on the amount of mental effort I was willing to expend to fight my own biology.
I had a voice in my head—the food noise—that never stopped reminding me that I could go get some food. Sometimes I would fight myself about it; shame myself; beat myself up. Sometimes it would win. Sometimes I’d have to decide to just brush my teeth and go to bed early to stop thinking about food. Sometimes I would pull a half eaten treat out of the trash. Sometimes the food noise would control my entire day and take away any enjoyment from any activity that involved food. And if food wasn’t immediately available, I’d anxiously await the next opportunity to eat — hello, purse snacks.
I had the motivation. I had all the education and resources, the gym memberships and personal trainers, and the privilege to access and afford all the foods. I had the time. I had social support. I would say, “Summer, you are a smart, funny, and amazing person; why the hell can’t you just stop eating?” Well, you see, eventually you have to eat something. It's not like alcohol where you can attempt to just avoid it altogether (which, of course, is a challenge in its own right).
Call it internalized fatphobia or implicit bias or societal conditioning that to be healthy meant you had to be thin—whatever it is, I had that too and continue to work through it. I would repeatedly attempt to “eat the right things” by whatever diet I thought at the time might be the solution, and yet, couldn’t always stop myself from overeating even those “right things.” You can only fight hunger for so long. And it’s not just regular hunger that’s satisfied by eating, because even eating more than enough wouldn’t make it go away. We white knuckle against it. We try to strategize around it. We try to distract ourselves from it. And then, as if that isn’t hard enough, we even face the shame that comes with wanting to diet at all. We try the complete opposite approach and give ourselves permission to stop dieting and restricting, accept our bodies as they are, get in touch with our intuition about food, and escape the diet culture as best we can—only to feel worse about ourselves as our weight creeps up. Hunger—moreover, that chronic disease of obesity and the food noise—would always win. Maybe not every day, but enough.
My journey with Sequence
Enter Dr. Spencer Nadolsky, tweeting about GLP-1s. When I first became a dietitian, I remember really appreciating his approach to nutrition on Twitter. He was funny yet empathetic and always SPOT ON. His memes made people laugh and mad as hell. He was especially critical of nutrition extremes and the “all or nothing” approach to food. He constantly reinforced the power of strength training. We would find ourselves arguing with the same people online. He would laugh at my jokes! It was fun to fight misinformation with him on your side!
I trusted him. So, when Spencer started talking about these anti-obesity medicines and Sequence, I was all ears. He would share stories from his patients’ experiences, and I would find myself saying, “Oh my Gosh, THAT’S ME!” He would say, “Obesity is a chronic progressive recurrent relapsing disease,” “Obesity is not due to a lack of willpower,” and that “GLP-1s help people stick to the lifestyle skills and tools they already have”. I read the clinical studies. I found people online on these medications. And I eventually, Joined Sequence. My only regret is that I didn’t join sooner. With a BMI of 31, a comorbidity of hypertension, and some luck with a manufacturer coupon, I started my medication. Then, my entire world changed.
I started sharing my experiences online, as I do with everything in my life. It was scary, but by this point, I was really good at ignoring the trolls, and I knew my community would respect me for sharing (and probably disown me if I suddenly lost the weight and lied about how). Of course, there was the backlash associated with the stigma of taking medication and the false belief that all I needed to do was diet and exercise “harder”—as if that were even possible. My friends really thought I was making it all up! And then they, too, started their GLP-1s. Our experiences have been nearly universal.
Suddenly, that food noise that consumed my entire brain at all hours of the day was gone. I can drive past a Starbucks, still satisfied from my nourishing breakfast, without the mental gymnastics of “should I, could I, will I, maybe, tomorrow.” I tweeted Spencer, “Ok, this is wild, my entire brain is different.” Suddenly, I could eat foods that I love and know are nutritious—I am a dietitian after all—and for the first time in my life, I could stop when I am full. I had no more interest in stealing chicken nuggets from my kids. After the first week, I thought, damn, even if I don’t lose a single pound on the scale, the incredible benefit to my mental health and relationship with food will be worth it!
I didn’t realize how much mental space was consumed by thoughts about food until it was gone. I’m happier. I’m less anxious. I’m a more patient mother. I’m more productive at work. I’m nicer to my husband. Now I am the type of person who can stop after one cookie and not even think about the candy jar at work. I hardly drink alcohol anymore—those two margs on vacation were tasty, sure, but I had no desire to get intoxicated. I’ve never felt so safe around food. This must be what “normal people” feel like with food.
I never thought this new life with food was possible for someone like me. I no longer track, measure or weigh anything I eat (although, to be fair, when you do some variation of that for 10+ years, it's like you have a tracker in your brain). Now my guesstimates are good enough! I still love delicious, interesting, flavorful food, but I can eat a reasonable amount and move on with my life.
After a few months as a patient, I tweeted Spencer again, “Hey man, y’all hiring dietitians?” And well, here we are. I am part of an incredible team of highly skilled, compassionate, empathetic dietitians delivering life-changing 1:1 nutrition counseling and developing groundbreaking nutrition content alongside obesity-informed clinicians. I’m filming podcasts, sharing my story, counseling members, creating useful Lessons, writing blogs, working from home, enjoying a healthy body weight, and absolutely loving my life.
For the first time in my entire life, my weight is finally just a number. When I started my medication, the Weight Noise in my brain left, along with its best friend, the Food Noise. Let's be really honest here, it is a whole lot easier to work on your relationship with food and your body and unpack the ways you were impacted by diet culture when you aren’t hungry all of the time. Hindsight, man.
If you’re frustrated with diets, I hear you. But I need you to know, just because the diets didn’t work for you doesn’t mean that the problem was you. I truly believe that obesity is a chronic disease— not a lack of willpower or skill or education—and that there is not a one-size-fits-all approach. At Sequence, our members feel like they have finally found a place where they feel seen, heard, and understood. They have found peace with their food noise and their biology.
Lastly, I want to say thank you to each and every person living with obesity that has engaged in this conversation around weight management and GLP-1 medications. I so appreciate your time and your emotional vulnerability. We are not alone. Your feelings are valid, and I hear you. If you would like to share more, I am always willing to listen. You can email me here: Summer@joinsequence.com or connect with me on most major social media @summerthedietitian. Be well.
To learn more about GLP-1 medication and see if you qualify for our comprehensive weight management program, please take our quiz.
