400. GLP-1s and parenting: Body image, food noise, and talking to your child about changes to your body with Dr. Rachel Goldman

Dr. Rachel Goldman (00:00):

Yes, your food matters. Yes, your movement matters, but guess what? It matters for everything. Yes, we should quote should, because I hate the word should, but we should be eating healthy-ish. We should be trying to move our body a little bit more, but for some people, no matter how much you do of that, it is not going to change your health and your weight.

Dr. Sarah Bren (00:30):

GLP-1 medications like Ozempic and Wegovy are everywhere right now, but behind all of the headlines are real people navigating complicated questions about health, identity, and body image. And for parents, there’s often another layer to consider. What happens when your body changes and your kids start to notice? How do you talk to them about weight loss or body changes without reinforcing shame or diet culture? How do you model body acceptance while also making choices to care for your health? Hi, I’m Dr. Sarah Bren, a clinical psychologist, mom of two, and the host of Securely Attached. Each week, I sit down with leading experts in psychology, neuroscience, medicine, and child development to translate complex research into practical, grounded insights that help you parent with more clarity and confidence. Today, I am joined by Dr. Rachel Goldman. Rachel is a clinical psychologist, clinical assistant professor in the Department of Psychiatry at NYU Grossman School of Medicine, and a nationally recognized expert in women’s mental health, body image, obesity, and eating behaviors.

(01:37):

She specializes in cognitive behavioral therapy and works with individuals navigating everything from disordered eating to long-term weight management and the emotional impact of body changes. She’s also the author of the new book, When Life Happens, which explores how we navigate unexpected changes in our lives and bodies with resilience, flexibility, and self-compassion. In this conversation, we talk about the psychology behind GLP-1 medications, the concept of “food noise,” and why obesity is now understood as a complex chronic disease rather than a simple issue of willpower. We also explore how significant body changes can impact our identity and self-image, why the shift from body positivity to body neutrality may be more realistic for many people, and how parents can talk to their kids about weight loss or changes to their own bodies in ways that support health, self-respect, and emotional safety.

(02:33):

Hello, Dr. Rachel. I am so excited to have you on the podcast. Thanks for being here.

Dr. Rachel Goldman (02:45):

Thank you so much. I’m super excited to be here with you today. So thank you for having me.

Dr. Sarah Bren (02:50):

Oh, I’m very excited about this conversation. So for any listeners who may not be familiar with your work, and if you are not, you definitely should be. Can you share a little bit about your background and how you came to focus on eating disorders, body image, women’s mental health?

Dr. Rachel Goldman (03:11):

Sure. Yeah. So for anyone listening, first, I’m a clinical psychologist and I’m here out of New York City. I’m also a clinical assistant professor in the Department of Psychiatry at the NYU Grossman School of Medicine. And as of today, I can actually add the title author to my … Or add, I guess the name to the title or whatever it is. Author. Author that since my book comes out today of When Life Happens. But yes, so my area specialty is in cognitive behavioral therapy and more specifically with women’s mental health and body image, body acceptance, the treatment of obesity, disordered eating behaviors. And it’s kind of a long story, but I’m going to give you the short version, is that back in college actually, so I just became very interested in health and nutrition within myself. I danced when I was younger, but in a very small town, so I was never really exposed to all of the pressure, like the weight pressures, the body image pressures.

(04:16):

It was great, to be honest. Looking back, my dance teacher never commented on anybody’s body shape and size, and it is what it was. It was for fun. And then I went to college and I just became more interested in the connection between health, nutrition, and mental health and the mind-body connection. And I kind of just took it upon myself to take as many health education courses and nutrition courses as I could to understand kind of the mind-body connection. And then one day I was doing research on eating disorders, more bulimia, anorexia, and I was doing research with a mentor in college. And one day I realized, yeah, this is the area I want to go into, but I can help this small amount of people or I can help the majority of people get healthy and help them on their health journey. And I quickly shifted to really focusing more on the treatment of obesity and weight management.

(05:23):

And then I kind of say things just kind of fell into place, but yes, looking back, it’s the work that you put in, it’s the context that you make, things like that. And I found researchers doing the type of work that I wanted to do. And then in grad school, kind of convinced my mentor at the time to allow me to do my dissertation, looking at actually eating behaviors in children and family environment variables that impact children’s choices to eat healthier food versus less healthy food. And again, kind of one thing led to another. Before you knew it, I was on internship with a mentor that I really wanted to work with who was like, “You’re going to do bariatric surgery evals.” And I was like, “What is bariatric surgery?” And I kind of fell into this and was really amazed. I think I was probably like most people maybe years ago that would think about bariatric surgery and be like, “Why can’t they just move more and eat less?” And to be honest, that was also me years ago.

(06:30):

And then I remember sitting in the room with my first client, my first patient doing a bariatric surgery psychosocial evaluation and them telling me, “I can’t walk to the mailbox. What do you mean that I should walk to the mailbox every day as getting moving?” And I realized that not everybody is physically capable of doing the things that we’re recommending. And this was years ago. We know so much more now than we knew then, but I quickly learned that obesity is not a willpower issue. These individuals want to get healthy. They want to do the things that are recommended and biology, genetics, all of these things come into play and make it difficult. So that was a really long story. I wanted to make it shorter and I didn’t. And then I worked at the bariatric surgery obesity department at Bellevue Hospital for five and a half years as their psychologist doing all of that work and a little bit got burned out, to be honest, and decided to leave the hospital job. And then COVID happened and that happened and all these things happened and here we are today. Fast forward.

Dr. Sarah Bren (07:48):

Fast forward. But you’ve done a lot of … I mean, even just in the last, what you just fast forwarded over…

Dr. Rachel Goldman (07:53):

I skipped a lot.

Dr. Sarah Bren (07:55):

Has been what I think partly and what I think speaks to the fact that you’re writing this book and that you’re working with the kind of people that you’re working with and have the platform that you have is because you’re speaking to people in a way that helps them understand complicated things in an accessible way, in a shame-free way, and in a way that kind of pulls the veil back behind like, okay, this isn’t just, like you were saying, this isn’t just about willpower. There are some deeply internalized narratives that inform our behaviors, our conscious and unconscious behaviors. And I think you do a really nice job of helping people recognize that so that they don’t feel so confused as to why some things feel really a struggle for them. In hearing that validation of their struggle, I think it also gives them clear strategies to approach it differently and maybe have better success.

(08:59):

I mean, I think one of the reasons why the work you do resonates with people is because it’s helping people make changes. I think because you pull away some of the shame, you help people pull away some of their internalized shame.

Dr. Rachel Goldman (09:11):

Yeah. And I appreciate you saying that. And as you’re saying it, I’m actually thinking about one client in particular that had bariatric surgery years ago. I started working with them after bariatric surgery because they were concerned and didn’t want to have weight regain, weight recurrence. So we started working together and COVID happened and they did have weight recurrence because obesity is a chronic recurring disease. And for years, or for a long time, I’ll say, I actually was suggesting to him, even though you had bariatric surgery, this is normal, this is common. Unfortunately, this is a little bit expected, why don’t I refer you to an obesity medicine specialist and consider medication after bariatric surgery? And for the longest time, he was like, “No, I had bariatric surgery. Nope, I should be able to do this. I’m going to do more. I’m going to do better.

(10:08):

I’m going to log my food. I’m going to … ” And they were already going to the gym every day, doing all these things and I’ll never forget the day that it finally clicked for them and I said, “Obesity is a disease that you have to manage for the rest of your life. You can keep doing everything you’re doing and unfortunately, probably nothing is going to change in terms of your health status.” And again, they were doing all the health behaviors and something clicked one day in a session and I remember they came back the next session and they were like, “I think I’m ready. I want that referral.” And they kept thinking they just have to try harder. They’re not trying hard enough. And it clicked and they’re like, “Oh.” And I remember they wrote it down and they come back to it all the time and they say, “I will never forget you said whenever things are tough, I remind myself, obesity is a disease that I have to manage for the rest of my life.” And that allowed them to seek further treatment outside of what I could help them do.

(11:13):

Because I mean, yes, mindset is a lot. We know that cognitive work, behavioral work is a lot, but can only go so far. And it’s the combination of the treatments that typically work the best. So I’m still seeing them regularly and they’re on GLP-1 medication for their obesity and it feels different. It feels better. It’s not all about weight loss, but they’re losing weight, they’re getting healthier, and now they’re understanding that, wow, I’m putting the work in and it’s working.

Dr. Sarah Bren (11:49):

Right. And because I think at the end of the day, and you talk about this in your book, but at the end of the day, we aren’t just treating a body or a number on the scale, right? That’s not really the point. And that’s not really why people struggle with food or weight or body image. It’s a million things and it’s an experience. It’s a collection of experiences that we hold inside. And for example, this client you’re referencing, it sounds like there was a part of this person that had a story they’re telling themselves like, I’ve done X, in this case, bariatric surgery, therefore…

Dr. Rachel Goldman (12:34):

I should.

Dr. Sarah Bren (12:35):

I should be able to succeed now. And if I don’t, anything that’s not a success is a failure. And that sort of black and white thinking of like, I’m either succeeding or I’m failing and there’s no in between versus like … There’s a lot more to it than that. And I see this play out with a lot of things, a lot of stuff outside of like obese, because I don’t necessarily, that’s not my area of focus, but like I, for example, neurodiversity. I work with a ton of people who have ADHD or whose kid has ADHD and a lot of it is like this non-acceptance of this is just the way the brain is. And it’s not a choice, it’s not a deficit, it’s neither good nor bad. It simply is. And it means that we have to manage it. And it means we have to understand it.

(13:26):

And it means we have to look through things from a lens that gives that context like, “Oh, maybe there’s a reason why this is a little bit harder.” Does it mean that we say no change can be expected or we have to drop all expectations? No, it just means we recognize it’s going to be a harder stretch to do certain things, doable, but needing appropriate supports. And when I frame it that way, a lot of times people are like, “The shame goes away.” The shame at how … Oh, I think the shame is tied to it being a struggle and it’s like, “Oh no, but if the struggle makes sense, then it doesn’t feel shameful that there’s a struggle.”

Dr. Rachel Goldman (14:08):

Exactly.

Dr. Sarah Bren (14:08):

And I wonder if that plays out a lot with your clients in their journey with me.

Dr. Rachel Goldman (14:13):

Yeah. Yeah. I mean, absolutely. If when we say obesity is a disease and this isn’t your fault, I think that’s the light bulb that goes off, which is the same thing as there’s nothing wrong with your child. There’s this deficit and it’s not their fault though. And it’s the same actually, going to this idea of a failure, words matter. And I talk about this a lot, especially in the field of obesity, but what I like to tell people, and this is also, I think, really getting rid of the shame, is that they didn’t fail bariatric surgery, or if somebody’s on a GLP-1, you’re not failing the GLP-1. It’s the medication or the treatment that failed you. So bariatric surgery is not going to be the … First of all, it’s not the answer for everything anyways, but for that client, I’m like, “Okay, bariatric surgery worked for you for a certain amount of time, and now it’s no longer working for you.

(15:13):

” But then for that client, I do remind them that their starting point is different than somebody who maybe just started a GLP-1 today because they do have all of this other weight loss that they did have from the bariatric surgery ahead of time, but it’s important that we frame it that way. It’s the surgery that failed you. It’s the treatment that failed you because let’s look at hypertension, right? People are on hypertensive medications. One medication doesn’t work, you go to another one, cholesterol medication, CPAP machines. I mean, we could name any treatment for any illness or disorder that’s out there. If one doesn’t work, we’re not like, “What’s wrong with me that that cholesterol medicine didn’t lower my cholesterol?” It’s like, maybe that’s not the right treatment for you.

Dr. Sarah Bren (15:57):

Right. And I think it’s helpful to use those health metaphors because I do think when it comes to weight loss or it comes to mental health, those areas tend to be tied to self-worth and it’s just, they live in a more sensitive space within us than things like blood pressure or even diabetes. Even diabetes within the obesity world, I would imagine helps people on some level feel more or less shaped. If I can explain it on the diabetes, then it’s less about me being a failure versus … Do you get what I’m saying? I just think sometimes…

Dr. Rachel Goldman (16:40):

Absolutely. I mean, well, and it’s because obesity is complicated because we can, not everybody, but obesity is related to excess fat. That is not the whole story, but if we were to just define what obesity is, well, it is a metabolic chronic recurring disease, but if you look at the most basic definition years ago when they used only BMI, it had to do with weight. So because of that, it is probably one of the only diseases that you, again, might see, right? I don’t want to say it’s appearance focused because it’s not, and not every person in a larger body has the disease of obesity, which is why it gets even more complicated, but it does have to do with excess fat. So we see that a little bit more, which is why if you have diabetes or you have hypertension or you have high cholesterol, you’re not going to see that.

(17:40):

And that’s why I think a lot of people assume it’s a willpower issue. And again, for years, we used to say, “Eat less, move more.” We are finally getting to a place where I think people are starting to understand that it is more complicated than that. Yes, your food matters. Yes, your movement matters, but guess what? It matters for everything, right? Yes, we should quote should, because I hate the word should, but we should be eating healthy-ish. We should be trying to move our body a little bit more, but for some people, no matter how much you do of that, it is not going to change your health and your weight.

Dr. Sarah Bren (18:21):

And I also think, and we could get into this brain science of this, but I do also believe that we’re talking about neurological wiring and not necessarily neurological wiring that you’re born with like in ADHD, but neurological wiring that gets formed and crystallized over time. And it’s really, really, really hard to rewire the brain, especially in adulthood. It’s not impossible. And I do think GLP-1s create neuroplasticity that actually allows for…

Dr. Rachel Goldman (18:51):

Absolutely.

Dr. Sarah Bren (18:52):

… behaviors that you engage in during the time you’re using that medication to have a different impact on the rewiring of neural pathways, AKA habit structures, right? Behavioral structures change the neural wiring. And so when we’re able to shift that, to open up that plasticity, behaviors that previously you might engage in for a little bit, all of a sudden now you’re engaging in them a small amount, but they’re impacting the wiring and now they’re easier to maintain. So it’s not just about … I really don’t think it’s about willpower or…

Dr. Rachel Goldman (19:39):

Well, it’s not.

Dr. Sarah Bren (19:42):

Or biology as much as it’s about conditioned neurobiology.

Dr. Rachel Goldman (19:46):

Right. Well, there’s this messy image, and I would pull it up quickly, but I’m not going to waste time, so does I, but there’s this messy image. And I love to say it’s messy and complicated because I think it just explains how complicated and complex obesity is. But there’s this image that literally is like a circle with all of these lines going to all these different things that really impact and influence how obesity, like why obesity is what it is and how it’s involved in … It’s really just multifactorial. There are so many factors that come at play, and it’s not just biology, it’s not just psychology, it’s not just environment, it’s not just what you put in your body. It’s very, very complicated. And I do agree, and I think there’s so much research coming out now and every day more is coming out.

(20:40):

And I think just the simple fact of that since GLP-1s do decrease food noise and the majority of individuals that use them right there gives us so much knowledge in terms of that if the food noise is quieter, there is more space in the brain for other things, which then could be the cognitive work, the rewiring, the habit change, all of those things. But when somebody’s brain is so consumed with food and eating and that food noise, all that other stuff can’t be happening. There’s just no space for it.

Dr. Sarah Bren (21:16):

Right. Which also I think speaks to the point that this isn’t just a willpower issue. Exactly. It’s a neuro … If the brain is filled with food noise, and you take a medication and the food noise quiets, well, we know that there’s something it’s touching and it’s not willpower. It’s not self-worth. It’s not anything related to that. It’s something going on.

Dr. Rachel Goldman (21:43):

I mean, it’s incredible. I mean, my clients will be like, “I used to come home or in the evening, go straight to grab maybe the chocolate or the ice cream or whatever.” And like habit, maybe they still go to grab, like they go to that cabinet and they’re like, “I don’t want this. ” Whereas it used to be so automatic, it’s so automatic, the behavior, and then they realize, wait, why am I here? I don’t even want this. Or if they have a little bit because it’s so automatic, they’re like, “I’m done.” Whereas before, it was very hard to feel in control and right there we know that is something with the brain, right? Something is getting turned off, so to say, that will be like, “Oh, okay, I can eat a little bit and I can be done.” So what I like to say is that these GLP-1 medications are actually putting individuals on an even playing field with the individuals that don’t have obesity.

Dr. Sarah Bren (22:39):

Don’t have the intense food noise. Exactly. Absolutely. Because I’m also curious, and I don’t know, I got to look up the research on this, but I’ve been curious about if the GLP-1s, I know they’re being used sort of off-label for a lot of things. I know that ADHD is something that is being looked at. I’m curious if … I know addiction is definitely being looked at. Yes. I’m curious if OCD might be looked at, because to me, the food noise sounds a lot like the intrusive thoughts of OCD.

Dr. Rachel Goldman (23:16):

Absolutely. Yeah.

Dr. Sarah Bren (23:17):

And I just feel like we’re also starting to understand that these are all kind of manifestations of a similar neurological process. I don’t even pretend to know the intricacies of it, and I think the research is still bearing out because it’s so new, but it’s interesting and I think it’s very validating. And I haven’t talked about it on the podcast yet. I have mentioned a little bit about my relationship with food and body image and eating disorders on the podcast in previous episodes, but I actually have been on a GLP for like a year. And very selfishly, one of the things I wanted to ask you about, because I want to bring this back to parenting a little bit too, is like, okay, we could talk … I’m happy to talk about this, and maybe this is another episode of what my process was for getting from where I was to being ready to take those medications, to then the whole year’s journey of being on them. But very long story short, I lost almost 50 pounds and my body has changed a lot. And my kids who are eight and six.

Dr. Rachel Goldman (24:29):

Probably notice.

Dr. Sarah Bren (24:30):

Definitely notice.

Dr. Rachel Goldman (24:32):

Right. It’s kind of hard to hide that.

Dr. Sarah Bren (24:34):

Yeah. And I can imagine that parents who have taken these medications who have been through a transition, physical transition, because like you were saying, one of the things that makes obesity so challenging in our world is that it’s not invisible. And to the same respect on the flip side of that coin is weight loss is not invisible. And so everybody can see that it happened and nothing like a child to have no filter and say like, “What’s this difference I noticed?” And I was ready for that. I did a lot of work preparing for my own readiness for it.

Dr. Rachel Goldman (25:12):

That’s amazing that you did that, by the way.

Dr. Sarah Bren (25:15):

Well, thank you.

Dr. Rachel Goldman (25:15):

Because not a lot of people are prepared for that.

Dr. Sarah Bren (25:20):

Yeah. And maybe we could talk a little bit about that too, because I think maybe if parents are thinking about getting on it, maybe we want to give them some strategies for thinking how to be intentional, what questions to be asking themselves, but also once you’ve lost the weight … I made the choice, and again, this is just what I did. This was what made sense for me and my family and the way that I’ve sort of approached parenthood from the get- go with my kids is I normalized it. I said what I was doing, I told them what it was. They have seen me administer shots. It’s really neutral.

(25:58):

It took a long time for, I think, to be physically noticeable, but then it happened kind of after … It hit a threshold that was like, really my body looked different. And I’m very mindful of the fact that I want to … I have a son and a daughter. I really have always been very intentional about having body positivity around them. I’ve loved my body post-pregnancy, which took a while. I also did a lot of work to be able to do that, but I did. And my kids would like … When they were little, they’d grab my belly and they’d be like, “Why is your belly so big?” And I would say, “Well, because my body made you. ” And it grew to make you and still has a little bit of fat from when I made you, and this is my powerful body that made you, whatever.

(26:48):

I’ve said a bunch of stuff. They’ve asked it a million times, but I tried to just be super neutral about it and embrace it because I didn’t want to be imparting negative communication to them about my body, which then they might absorb and internalize and project onto their body changes at any point in their lives.

Dr. Rachel Goldman (27:07):

Exactly.

Dr. Sarah Bren (27:08):

But then I’m like, “Well, now I lost all this weight and I want to be able to also have a narrative around that with them that allows them to me to project that it’s okay to change your body too without it being inconsistent or incongruent with the messaging.” And I know that there are parents out there that are probably grappling with similar questions like, “Do I talk about it? Do I not? How do I talk about it without it becoming a negative implication about how my old body looked?” What do you see?

Dr. Rachel Goldman (27:45):

Yeah. So first, I want to thank you for sharing that because I think it’s not something that everybody is comfortable sharing and I don’t think there is a right or wrong. It is your choice to share it if you choose to, or if not, it’s your health, your body, your decision. But I do appreciate you sharing that because I think people listening can really … I think it’ll resonate with a lot of people that are kind of debating, “Do I tell my children? Do I not? Am I on it? Who do I talk to about it? ” Things like that. And just like I talk about in my book, life happens and we have to try, we can, not we have to, we can try to be prepared for what’s going to get thrown our way. So something like this, it’s like you’ve thought about it and you were like, “All right, when the time comes, this is what I’m going to do, ” which allowed you to feel more in control of the situation, right?

(28:45):

If you didn’t think about it before, which it’s also totally fine, and then your child one day was like, “Mommy, you look very different. What’s going on? ” It would maybe catch you off guard if you didn’t think about it. And maybe, I don’t know you personally, but in these situations, many of us as humans will react out of emotion like, “Oh my gosh, what do you mean?” Or not know what to say and kind of get all flustered. And so I think taking the time, so if anybody listening, taking the time to really think this through and be like, “Okay, they didn’t ask me yet, or I’m not on the medication yet, how am I going to address this with certain people at different times?” I think is first really important to think about. And again, there’s no wrong way to do it. I have clients that their friends and family and colleagues know, and I have clients that their friends and family and colleagues don’t know, and that’s okay.

(29:39):

I think what you have to think about is what’s important to you, and if you want to share it with people, kind of role play or think through what you want to share, and I love that you particularly are focusing on, I actually call it body neutrality, which you’re actually getting a little bit away from the body paths Positivity and what you’re describing, which I think is a good thing. And talking more about bodies in a neutral way, because we all have bodies and they all serve functions. And looking at how our body is serving us, the function into serving us, why is your belly a certain way? Because I grew to humans.

(30:21):

I love to say, “I love my arms because I can hug my children. I love my legs because it allows me to walk from point A to point B or to the run.” But really identifying the purpose and function of our body and getting away from appearance. And I think if we focus the conversation around that, I think we’re already decreasing the shame, the blame and all of that. Just as, I’m so glad you didn’t call GLP-1s a weight loss medication, but many people do. And I say, “No, let’s get rid of that. ” Because if we call it a weight loss medication, we’re just feeding in to the shame and blame. These are not weight loss medications. They are medications indicated for the treatment of obesity or diabetes, or we can call them GLP-1 medications. In the medical field, we call them anti-obesity medications as well. But if we’re going to call them weight loss drugs, then we’re only focusing on appearance and weight.

Dr. Sarah Bren (31:20):

Right. That’s actually interesting you say that because I had not thought about that.

Dr. Rachel Goldman (31:25):

And I love, I’m like here cheering you on that you didn’t say that because if you did, I’d be like, “So wait a minute, we got to change the way we’re going to think about this. ” So I love that you already are doing that.

Dr. Sarah Bren (31:37):

Yeah. It’s funny because I didn’t realize I was doing it. And one of the things I’ve all, because I also have ADHD and I take ADHD medication and I’m really sort of … When my kids ask me what it is, I say, “Oh, it’s medicine that helps my brain so that I can focus.”

Dr. Rachel Goldman (31:53):

Amazing.

Dr. Sarah Bren (31:53):

Because my brain has a hard time focusing. And I really try to be just things that I’m explaining to my kids because one, I think as grownups, we assume kids know what things mean because we’re just, or we don’t really take the time to think about the fact that our kids probably don’t actually know what those things mean and they need more descriptive language. And so I’ve always really tried to do that because I really want to normalize neurodiversity and I also want to normalize my relationship to my body because those are things I’m trying to just get ready for in the world as my kids grow up.

Dr. Rachel Goldman (32:30):

Right. And most people, I can’t speak to everybody, but most people who are on GLP-1s for the reason that they are indicated for are not on them to just lose weight. They are on them to improve their health. They are on them, like I’m just going to start listing things that my clients that I’ve heard, but they’re on them to improve their health. They’re on them to be able to sit on the floor and play with their children. They’re on them to be able to go on an airplane and not need a seatbelt extender. They’re on them to be able to go on the rollercoaster. They’re on them to be able to walk up the stairs and not feeling out of breath. They’re on them to get off the CPAP machine. And so again, if we’re only going to call them weight loss drugs and we’re only going to focus on weight, we’re missing the point of these medications.

(33:14):

And they are medications indicated for certain things to help improve health, to decrease risk of other health conditions, to increase longevity, all these other things. Again, it’s complicated. So again, I love that you’re not calling them that. And for anyone listening, if you want to share with your children, I wouldn’t say I’m on medicine to lose weight. No, you’re on medicine to improve your health or whatever resonates with you or whatever. It could even be, I’m on medication so I can be more active with you if it’s your children.You notice mommy gets really out of breath. I want to be able to have more energy and be able to live longer to be with you. It can be things like that. So it really starts in the house is what I say. And in the home, we can start shifting the way that we talk about things, about bodies, about shape, about food, and we can really also not just start talking about things differently. We can also be mindful of our own personal behaviors and the way that we talk about it to ourselves and others because our children see everything. And you said it before, they internalize it all. They absorb it, they internalize it. So I gave this example before, but if my son sees a scale at the swimming pool, gym or locker room, and he’s like, “Oh, I want to see what my weight is. ” I’m like, “Sure, hop on. ” And no matter what it says, I’m like, “Wow, you’re so strong.”That’s it over conversations done. We don’t talk about weight. You are so strong.

(34:52):

And I think that we can start doing things like that in the household to start neutralizing it and start focusing again on the function and less on the weight. So I talk about protein with my children in order to build muscle and be strong and have energy and be focused and concentrate. It’s not about the calories. It’s not about eating less. It is literally about, let’s make sure we’re getting the energy that we need today.

Dr. Sarah Bren (35:27):

Hi, jumping in quickly to share a resource I want you to know about. So many parents today are trying to be more intentional about raising kids who have healthier relationships to food, body image, and self-worth than many of us were raised with. But that can be tricky to navigate in real life. Kids notice everything. They notice changes in our bodies. They hear the language we use about food and health, and they are constantly forming ideas about what it all means. And a lot of parents want to be thoughtful about those moments, but aren’t always sure what to say or how to handle them. At Upshur Bren Psychology Group, we help parents think through exactly these kinds of questions and develop a clear plan for navigating them with more clarity and confidence. Through therapy and parent coaching, our clinicians work with families to build emotionally healthy home environments, helping parents develop language, strategies, and parenting approaches that support their child’s confidence, emotional regulation, self-esteem, and long-term wellbeing.

(36:26):

While they’re navigating body image conversations, supporting a sensitive or anxious child, dealing with power struggles or defiance, or something wanting to parent in a more intentional way, we are here to help. With offices in Westchester, New York, we offer in- person therapy as well as virtual services worldwide. You can schedule a free 30-minute consultation call by clicking the link in the episode description wherever you’re streaming this podcast, or visit upshurbren.com to learn more. That’s U-P-S-H-U-R-B-R-E-N.com. All right, now let’s get back to my conversation with Dr. Rachel Goldman.

(37:08):

I really do love this idea of pivoting away from body positivity to body neutrality. And I’m just curious if you have some closing thoughts on how parents can feel like, okay, if I haven’t been as neutral, how do I pivot and do I want to maybe name that some ways like, “Hmm, I realize I’ve been using this kind of language and I don’t actually think that totally describes how I feel about my body and I’m going to change that. Or you might notice that I’ve been doing this and I want to change it. ” How do you pivot and then what does being more body neutral or practicing body acceptance in whatever form, because especially if you’re going through a transition in the way that your body’s going to show up to your kids. How do we talk about that in a way that helps model this neutrality and acceptance for the past, the current, and the future?

Dr. Rachel Goldman (38:14):

Yeah. So first, it’s never too late to pivot and to shift, right? If somebody’s listening and they’re like, “Oh, that makes sense. I maybe should think about doing this differently.” I think being vulnerable, being honest and being transparent with communication is so important. I’ve said to my son before, “Hey, mommy got it wrong. I got it wrong and I’m going to shift it and we’re going to try this instead.” And I think we can say something like that kind of like, “You know what? I’ve realized I’ve been saying this and actually that’s not true. When I think about it, it doesn’t feel good when I say that. ” So in a way, we’re teaching CBT how thoughts, emotions and behaviors are linked. I teach my kids this all the time like, “Wow, I realize that I’ve been saying this and when I say it, it doesn’t feel good to me.

(39:03):

So I’m going to change the way that I say it. I’m going to shift. I’m going to pivot.” So I think first we could totally be vulnerable and own that. And I think that also helps our children, again, realize bigger picture wise, wow, mommy is shifting the way she does things. If I kind of screw up or mess up or make a mistake one day, I can fix it too, or I can shift or pivot also. So it doesn’t even need to be related to this, but they absorb that and they remember those things. I also want to acknowledge with body positivity, body acceptance and body neutrality, we can love our body and powerful word and want to change it. Two truths can be held at the same time, right? You don’t have to hate your body in order to want to make changes. You can love your body.

(39:57):

And actually, I actually say to my clients all the time, “I’m so proud of you. This tells me that you love your body and that you care about your health and that you’ve came to me or that you want this referral.” That is very telling. And I think to remember that, that if you want to seek treatment, and it’s not right for everybody, and again, not everybody in a larger body needs it, wants it. It is literally a personal health medical decision that you make with your medical team. But if you or somebody listening and you’re like, “Well, I feel weird that I love my body and I want to change it, ” there’s nothing wrong with that. And to be honest, so I live in a normal sized body, whatever normal is, and I do things regularly to maintain my health. It’s actually how the title of my book When Life Happens, kind of how it came to be. It’s actually about running and me maintaining a certain level of physical, emotional health and fitness in order to be prepared for when life happens.

(41:06):

So I think it’s not necessarily that I’m trying to change my body, but I’m doing things to make sure that I am in the best shape health, mental health, physical health, everything that I can be for when life happens. But I think there’s nothing wrong with … It’s completely natural for some other bodies change and it’s okay to want to change things. It’s also completely normal to wake up and not love every inch of our body every day. And that’s where I think body positivity gets it wrong in a way. And this is why I think it’s a bit unrealistic because I think overall, maybe body positivity is … The way it started, it has evolved and it isn’t really the same as it was years ago,

(41:55):

The movement. But what I do think is the idea that we should love our bodies all the time and not want to change them is just unrealistic. I mean, even if we think of the different phases of life that we go through, right? You and I are both moms, pregnancy, getting pregnant, having a growing belly, having a growing body, postpartum, perimenopause, menopause, all these things, our bodies are going to be changing. That doesn’t mean we failed. That means that we’re evolving. That means that we’re growing. And sometimes there’s things like taking hormone replacement therapy, for instance. Nobody’s shaming people for going on HRTs if they need it when they’re going through menopause. And those treatments are going to, in a way, shake things up, kind of manage what’s going on hormonally, and people might lose weight, that their bodies may kind of return to where they were beforehand.

(42:50):

Everybody’s different. But I think accepting that fact that two truths can be held at the same time, you don’t have to hate your body to want to make healthier choices, and you don’t have to expect to wake up loving your body every day either. I don’t love every engine of my body every day. That is just not normal. I mean, if you do amazing. I mean, if you do amazing.

Dr. Sarah Bren (43:16):

Also, not pathological.

Dr. Rachel Goldman (43:17):

Exactly. Right. We have bad days, and so much is influencing. I do have a lot of this in the book about body image, but so much influences the way that we feel about our body. What were you doing right before you looked in the mirror? What were you doing right before you slept on the scale? What were you thinking about? Did you have a good night’s sleep? All of that’s going to impact how you think about your body in this very moment. So it’s not like we live in a bubble and it’s like, oh, I love my body every day. No, but we can love what our bodies do for us every day or on most days. That’s a little more realistic.

Dr. Sarah Bren (43:51):

And I think that’s the best way to message to our kids too. To your point about when we talk about our body’s functionality with our kids versus our body’s appearance exclusively, I think that helps kind of highlight that it’s multifaceted. We are so many things and the more we can hold that multiplicity, I think the more room there is to like some things, to want to change some things, to be frustrated by some things, and it’s still all okay because there’s many layers.

Dr. Rachel Goldman (44:30):

Right. I was just going to say that and it’s okay. Right.

Dr. Sarah Bren (44:33):

Yeah.

Dr. Rachel Goldman (44:33):

I mean, even you saying that I was thinking about kids with like, “Well, why do we go to an eye doctor?” “Well, because we want our eyes to be healthy. Why do we brush our teeth? Because we want our teeth to be healthy. “So we can go back to that with every aspect of our body and be like, ” Why do we try to eat healthy-ish? Because what we put in our bodies actually matter, right? Does that mean that you can’t have sweets or desserts or sugar? “No, that’s not what that means, but you just want to be mindful of it. That’s all.

Dr. Sarah Bren (45:00):

Right.

Dr. Rachel Goldman (45:00):

I mean, I wouldn’t necessarily say that to you.

Dr. Sarah Bren (45:02):

We care for ourselves so we take care of ourselves.

Dr. Rachel Goldman (45:05):

Exactly. Right. Because we love ourselves. Right.

Dr. Sarah Bren (45:09):

I love that.

Dr. Rachel Goldman (45:09):

And because you love yourself is why you might decide to seek treatment.

Dr. Sarah Bren (45:14):

Yeah. For anything.

Dr. Rachel Goldman (45:16):

Right. Right. Exactly. And treatment could be, it doesn’t have to be medication. It doesn’t have to be surgery. It could be seeing a therapist. It could be seeing a dietician or a nutritionist. It could be seeing a trainer. It could be any of that, but because we love ourselves is why we then take the next step.

Dr. Sarah Bren (45:35):

That’s so amazing. I’m super excited that your book is coming out today. If people want to get your book, if they haven’t already, when life happens, if people want to follow along on all the amazing work that you’re doing, what’s the best way for them? Where should we send them? Where can they find you?

Dr. Rachel Goldman (45:54):

Thank you so much. So pretty much across all social media platforms, I’m @drrachelnyc and my book can be found at whenlifehappensbook.com. And from there, there’s all of the links of the different places you can buy your book, but you can really buy it wherever you like to buy books.

Dr. Sarah Bren (46:12):

Amazing. Well, thank you so much for coming on. Thank you for the work you’re doing. Thank you for giving me just some personal reassurance on my own journey. And I am excited. I’m very excited for your book.

Dr. Rachel Goldman (46:26):

Amazing. Thank you so much. And yes, we all as humans sometimes need a little validation, right?

Dr. Sarah Bren (46:32):

Right. Yeah. Even people who are supposed to quote, know what to do. Sometimes we just need someone else to be like, “Okay, you’re doing an okay job, mom.”

Dr. Rachel Goldman (46:41):

Exactly. Yes. And that’s enough.

Dr. Sarah Bren (46:46):

Yeah. Thank you.

(46:47):

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