You're Not In Charge of the Scale

Stephanie Walsh, MD
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You're Not in Charge of the Scale - Hosted by Stephanie Walsh, MD, a pediatrician board certified in obesity medicine with over 20 years of experience caring for kids and families struggling with weight. This podcast is here to normalize conversations about pediatric health — and to say the quiet parts out loud. Each episode digs into the evidence behind weight, hunger, and health, and works to dismantle the shame and stigma that families carry every single day. If weight were as simple as calories in and calories out, this wouldn't be a podcast. Every family who walks into Dr. Walsh's clinic has already tried the diets, the exercise, and all the things they were told they should be doing. Weight is not a measure of health. Fear and blame don't create change. And you are not in charge of the scale. Expect honest, evidence-based conversations about GLP-1 medications for kids, food noise, weight bias, the mental health toll of bullying, what actually counts as research, and why obesity is a disease that deserves real treatment — not judgment. For parents, patients, pediatricians, and anyone who's ever been made to feel like their body is a personal failing. Stephanie Walsh, MD, is a pediatrician This podcast shares medical information, not medical advice.

  1. 11h ago

    That's their own business | Natasha D'Arcangelo, part 3 of 3

    I'm Stephanie Walsh, MD, Founder of Bright Path Family Health. This is the last part of my conversation with Natasha D'Arcangelo. In part one we talked about the messages we inherited, and in part two about what to say out loud instead. This time: what to do when someone comments on a body in front of your child, and what to make of eating for comfort. I started with the small stuff so many of us grew up with — "minute on the lips, forever on the hips," the grandparents with something to say about everybody's body. Natasha works with adults living with trauma, and her point is that those comments don't stay in childhood. They go on living in your nervous system, present day. A lot of the people who come to her are asking "what's wrong with me?" Her answer is that "that's just not true." A nervous system that had to over-adapt to an unsafe childhood did what it needed to do to keep you alive, "not because there's something wrong with you." From there, she talks about choosing. "We will do things for our children that we will not do for ourselves." Natasha has made a conscious choice not to comment on anyone's weight when she sees them, however long it's been. As she puts it, "that's their own business." So what about when someone else does it, with your child standing right there? Natasha's suggestion is to say it out loud: "that's actually a really mean thing to do." Not everyone wants to take on a stranger in the moment, and I talk about the quieter version — saying something to your child afterwards, even hours later, because that's where the impact is. There is no perfection. We're working on progress, one step at a time. Then eating for comfort, which I asked about because I do think eating makes you feel better. Natasha's answer is that if you're eating for comfort, "that's fine, unless afterwards there's guilt and there's shame around it." A rough day, some ice cream, and you feel better? In her words, "Eat your ice cream." It's what comes after that tells her something, which is why the first question she asks a new client is "tell me about your relationship with food." Where we both land is that it "doesn't make you a bad person," and that "there's no moral value around the food." Natasha's last answer is patience: "give yourself some grace," because "this is not going to be an overnight process." It shows up in small things, like a client who wore her favorite pair of earrings, or a pair of heels, and felt better about the whole outfit. One of my favorite parts of a first visit at Bright Path comes before we talk about anything medical: I ask the kids what brought them in. Most of them can name five or ten things they like about their body. They haven't had all the messages yet. Thank you, Natasha. If these three conversations come down to one thing, it's kindness towards ourselves. Find Natasha: natashalmhc.com This podcast shares medical information, not medical advice. For questions about your child, talk to your own pediatrician. Chapters: 01:10 — The comments we grew up with 01:59 — Not because there's something wrong with you 03:41 — Choosing to do things differently 04:35 — Talking about people's bodies 06:48 — Eating for comfort 09:17 — Give yourself some grace

  2. Oct 14

    Saying more positive things about myself out loud | Natasha D'Arcangelo, part 2

    Most of us don't say kind things about ourselves out loud. Something like "oh, my hair looks great today" can come across as bragging, so we just don't. In part one, Natasha D'Arcangelo and I talked about where the voices in our heads come from. In part two, we talk about what to say out loud instead. I'm Stephanie Walsh, MD, Founder of Bright Path Family Health. My guest Natasha is a licensed mental health counselor and licensed professional counselor, licensed in eight states. She does this at home with her own daughter. At night, they do affirmations together: "I am smart, I am resilient, I am brave, I am confident." Her point is that it wouldn't hurt for kids of any age to hear it: "they can be four, they can be 14." For older kids, she talks about inviting them in: "I need your help. Can you and I work together to try to turn this ship around?" She's honest that it won't feel natural at first. "Is it gonna be really, really uncomfortable and awkward the first time? Yes. Will it feel better by the hundredth time? Yes." She compares it to learning a new language. Nobody expects to be fluent in Mandarin a week after they start. We also talk about the other places kids pick up messages about bodies. The books Natasha reads with her daughter have "characters of all different colors and sizes and shapes." And she makes the point that if social media is the only place kids hear about bodies, "that becomes their truth." There's a phrase I love: don't believe everything your brain tells you. If your mind goes straight to what you don't like about yourself, that's what so many of us were taught to do. Changing it can start with something as small as "these earrings look great on me." And it does work. Being a helper is one of the affirmations Natasha does with her daughter, and now, when something spills, her daughter gets her little broom out: "Mama, I'm a helper." If saying something kind about yourself out loud feels silly, that's normal, and it does get easier. As Natasha puts it, "give yourself some grace." Find Natasha: natashalmhc.com This podcast shares medical information, not medical advice. For questions about your child, talk to your own pediatrician.

  3. Oct 7

    I heard my mother's voice come out of my mouth | Natasha D'Arcangelo - Part 1

    "I heard my mother's voice come out of my mouth." Natasha D'Arcangelo has heard that from her clients, and I suspect most parents have felt it at least once. I'm Stephanie Walsh, MD, Founder of Bright Path Family Health. My guest Natasha is a licensed mental health counselor and licensed professional counselor, licensed in eight states. She works with adults living with trauma and anxiety, and with professional caregivers dealing with compassion fatigue. She's also an adoptive mom, and she told me the part of motherhood she never saw coming was re-parenting herself. We talk about the messages so many of us absorbed growing up, about food and about bodies. Natasha grew up hearing "you better clear every last grain of rice off your plate before you get up from the table," and the idea that dessert was something you earned. For over 40 years, her grandmother has greeted people with a comment about their weight. None of it felt unusual. As she puts it, "that is just what I grew up listening to." Then we get practical. Natasha shares the words she's chosen to use with her own daughter, at the dinner table and in front of the mirror. She's decided that "makeup doesn't make me look pretty. I'm pretty with or without makeup." It makes her look fancy, and her daughter has picked that up: "mama, you fancy today?" Natasha also shares the question she works through with her clients: "is this a thing that I would want my child repeating to themselves about their bodies?" We talk a lot on this podcast about role modeling, and I know that I say that out loud, but it's not the easiest thing to do. Natasha is doing this work herself, and she's honest that it's "really, really hard." If you've ever heard your own parent's voice come out of your mouth, that isn't a failing. It's what you grew up hearing. This is part one of my conversation with Natasha. In part two, she explains why changing these patterns is a lot like learning a new language. Find Natasha: natashalmhc.com This podcast shares medical information, not medical advice. For questions about your child, talk to your own pediatrician.

  4. Sep 30

    What the families who got it right actually did | Dr Sheethal Reddy, part 4 of 4

    I'm Stephanie Walsh, MD, Founder of Bright Path Family Health. This week I'm joined for the final time in this little series by Dr Sheethal Reddy, a psychologist I've known for nearly twenty years — we worked together at Children's Healthcare of Atlanta's Strong for Life programme. She's been practising in weight management and eating disorders since 2010, and there's nobody I'd rather ask about this. I asked her the question I'd been saving. Of all the families we saw together at Strong for Life, what did the ones who got it right actually do? Her answer isn't a diet. It's that they did it together — the whole family, not the one kid who'd been identified as the problem — and they got, usually within a visit or two, that it was never about the weight. The scale often didn't look different. The family was happier. The kids were happier. Sometimes the labs were better. You're not in charge of the scale. Then we get into the thing that shows up alongside weight more than anything else: anxiety. Not depression, which is what most people assume — both of us did. Sheethal explains why eating is such an effective way to soothe it, why that's usually learned and can be unlearned, and the signs to watch for in a child who can't yet say "I'm anxious." Nail biting. Tummy aches. Avoiding things. Getting loud. And a lot of practical, mostly free things: the apps and resources that mean you don't have to break the bank or wait six months for an appointment, what to say at dinner when you show your kids your own coping, why nobody at Strong for Life ever wanted a screen-time goal, and why it's okay to let your kids see that you're working on this too. That's the series. Thank you, Sheethal. The full conversation is on YouTube in one piece. Chapters 0:00 — Intro 1:07 — What the families who got it right did 2:43 — Anxiety, not depression 4:10 — The warning signs — and why eating to cope is learned 6:18 — Free things, and doing it together 7:33 — It's okay to be imperfect

  5. Sep 23

    Will talking about it cause an eating disorder? | Dr Sheethal Reddy

    If your child is on a weight medication, or you're thinking about it, you've probably already run into the judgment. Other kids. Other parents. The comments online about people taking it to fit into a prom dress. And underneath all of that, the fear I hear from parents more than any other: if I say anything about my kid's weight, am I going to give them an eating disorder? This is part three of my conversation with Dr Sheethal Reddy, a psychologist who has worked with families around weight and eating disorders since 2010. We talk about why weight carries a stigma that diabetes, cancer and rheumatoid arthritis don't, how to help your child figure out who's on their team and who doesn't need to know, and what actually drives eating disorders — because it isn't a parent raising a concern with care. Sheethal walks through exactly how she'd frame the conversation about coming in for a visit — "yes, you're the patient, but the visit is for all of us" — and says the thing I wish every family heard before a first appointment: you don't have to do anything after you leave. You can go home and do absolutely nothing they recommend. I also talk about what the first visit at Bright Path actually looks like. Nobody leaves with a lecture. Part three of four. The full conversation is also on YouTube in one piece if you'd rather not wait. Chapters 0:00 — Intro 1:13 — Medication, stigma, and who's on your team 4:29 — Will talking about it cause an eating disorder? 7:08 — How to set up the appointment 8:37 — Take a deep breath — take two 9:48 — There are options now

  6. Sep 16

    Sneaking Isn't About The Food | Dr Sheethal Reddy

    This is part two of my conversation with psychologist Dr. Sheethal Reddy. Last time we talked about what to say. This time we talked about what happens at home, which is harder. We started with control — how much of it you actually have, and for how long. You can decide what a toddler eats. You cannot follow a twelve-year-old to a sleepover, and the episode is fairly blunt that trying to is its own kind of problem. What comes up in adult clinical work is that heavily controlled childhoods don't tend to produce adults who are relaxed about food. They tend to produce adults who still sneak it. So we spent most of the episode on sneaking, because it's the thing parents find and then don't know what to do with. Sneaking is usually about shame rather than about food. Punishing it makes a child feel worse without making the behavior stop. And kids are terrible at hiding it, which is worth remembering — the wrappers are always somewhere findable, and that's an opening for a conversation rather than a confrontation. We also got into the part that's uncomfortable for grown-ups: that a sigh, an eye-roll or a look does the same work as a comment, and that children are extremely good at reading all three. Shital's suggestion isn't to become a person who has no reaction. It's to say the reaction out loud. The last few minutes are about what kids hear us say about ourselves — the almond mom thing, what boys are now hearing about their own faces, and one line near the end of this episode that I keep thinking about: "I don't have to do anything to deserve a cookie."

  7. Sep 9

    "Do you think I'm fat?" What to say when your child asks | Dr Sheethal Reddy

    Your child comes to you and asks if they're fat. Or tells you someone at school said it. It's one of the moments parents tell me they most dread, and most of us react before we think. I'm Stephanie Walsh, MD, Founder of Bright Path Family Health. This week I'm joined by Dr Sheethal Reddy, a psychologist I've known for nearly twenty years — we worked together at Children's Healthcare of Atlanta's Strong for Life programme. She's been practising in weight management and eating disorders since 2010, and there's nobody I'd rather ask about this. We talk about what to do in the first ten seconds, why your child coming to you at all is a good sign, and why you don't have to solve anything in that moment. We get into what happens when your child's question drags up your own childhood, how to tell whether your child is actually bothered or whether it's you who's worried, and why the answer to "do we all have to change how we eat?" is usually yes — and has nothing to do with anyone's weight. This is the first of four conversations with Sheethal. The full conversation is also on YouTube in one piece if you'd rather not wait. Chapters 0:00 — Meet Dr Sheethal Reddy 2:16 — "Do you think I'm fat?" — what to say first 5:33 — When it brings up your own childhood 6:45 — Is it actually a problem for them, or for you? 8:15 — Health, not weight

  8. Sep 2

    GLP-1: It's NOT The 'Easy Way Out'

    There's a lot of information out there about GLP-1 medications and whether they should be used, and I don't think everybody knows where these medications actually came from. So this episode goes back to the beginning. GLP-1 is a hormone your own intestines release after you eat. It tells your brain you're full, it slows down your digestion, and it improves your glucose control. That last part is where the medications started — they were diabetes medications first, and it was only with further study that it turned out that at higher doses they also improved weight loss. I also want to take apart the myth that all these medications do is switch off hunger. They work on the brain, turning on the places that let you know you're satisfied. They work on the digestive tract. They work on the pancreas and on insulin. There's a great deal more to them than a smaller appetite. And I want to say something to anyone who hears about a family using them and reacts badly. People with overweight or obesity get told they're lazy, or that they haven't done enough. Then they start a medication and get accused of taking the easy way out. That is a very hard place to be, and I think we should be applauding people who are working on being healthy. The last part of this episode is for the parent who has already asked and already been told no. Obesity medicine is a young specialty and there are now physicians board certified in it. You wouldn't think twice about calling a cardiologist or a gastroenterologist, and this is the same thing. Chapters 01:08 — Treating food noise, not just weight 01:52 — Weight bias and the "easy way out" 02:45 — What a GLP-1 is, and where it came from 05:18 — When a doctor says no, and how to find a specialist

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You're Not in Charge of the Scale - Hosted by Stephanie Walsh, MD, a pediatrician board certified in obesity medicine with over 20 years of experience caring for kids and families struggling with weight. This podcast is here to normalize conversations about pediatric health — and to say the quiet parts out loud. Each episode digs into the evidence behind weight, hunger, and health, and works to dismantle the shame and stigma that families carry every single day. If weight were as simple as calories in and calories out, this wouldn't be a podcast. Every family who walks into Dr. Walsh's clinic has already tried the diets, the exercise, and all the things they were told they should be doing. Weight is not a measure of health. Fear and blame don't create change. And you are not in charge of the scale. Expect honest, evidence-based conversations about GLP-1 medications for kids, food noise, weight bias, the mental health toll of bullying, what actually counts as research, and why obesity is a disease that deserves real treatment — not judgment. For parents, patients, pediatricians, and anyone who's ever been made to feel like their body is a personal failing. Stephanie Walsh, MD, is a pediatrician This podcast shares medical information, not medical advice.

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