This episode of the Princess in the Pea podcast, features a conversation with Nicola Salmon, a UK-based fat-positive fertility coach, who talks about her work supporting fat individuals seeking fertility support and challenging weight bias in the healthcare system. Annie and Nicola delve into topics like the stigmatisation of larger bodies, navigating the healthcare system, the importance of bodily autonomy, and the intersection of neurodivergence and health. The episode emphasises that everyone deserves appropriate, respectful, and evidence-based care regardless of their size or neurotype.

00:28 Welcome

02:05 Introducing Nicola Salmon

04:46 Nicola's Journey with PCOS and Fat Activism

05:35 The Impact of Diet Culture on Fertility

06:41 Transition to Fertility Coaching

07:40 Embracing Fat Acceptance

09:28 Challenges in Healthcare for Larger Bodies

12:35 Personal Experiences with Diet Culture

20:30 The Reality of Thin Privilege

28:10 Nicola's ADHD Journey

29:22 Exploring ADHD and Self-Diagnosis

30:17 Mental Health Challenges Post-Pregnancy

30:47 Life Transitions and Executive Functioning

32:07 PTSD and ADHD Overlap

33:52 Eating Disorders and Neurodivergence

36:12 Navigating Medical Bias and Advocacy

40:14 Fertility Treatment and Systemic Bias

53:10 The Importance of Self-Advocacy

56:30 Final Thoughts

Nicola Salmon

https://nicolasalmon.co.uk/

https://nicolasalmon.co.uk/fat-and-fertile-book/

https://nicolasalmon.co.uk/fat-and-fertile-podcast/

https://www.instagram.com/fatpositivefertility/

https://www.facebook.com/Fatpositivefertility/

https://www.linkedin.com/in/nicola-salmon-98683216/?originalSubdomain=uk

Don't question that you deserve that care because you absolutely do.

Like, whatever you have or haven't done in your life, like, you're born

worthy of receiving appropriate, respectful, and evidence based care.

It's bloody hard to get sometimes, especially if you're

marginalised in one way or another.

But never question that you're worthy of that care.

Welcome to Princess in the Pea podcast, where we deep dive into

the world of neurodiversity, accessibility, and advocacy.

I'm your host, Annie Crowe, a lawyer turned advocacy coach and the founder

of NeuroAccess, A consulting firm dedicated to breaking down barriers

and empowering neurodivergent people.

Before we begin, I would like to acknowledge the traditional custodians

of the land on which we record this podcast, the Ngunnawal and Ngambri people.

I pay my respects to their elders, past, present, and emerging, and extend that

respect to all Aboriginal and Torres Strait Islander peoples listening today.

The podcast is called Princess and the Pea, which holds a

very special meaning to me.

It comes from my childhood nickname, which I earned for being a highly

sensitive, unidentified autistic ADHD kid.

Much like the princess in Hans Christian Andersen's famous fairy tale.

In the story, the princess's sensitivity to a tiny pea hidden

beneath many layers of mattresses is what reveals her true identity.

Similarly, as neurodivergent individuals, our unique sensitivities and perceptions

often reveal our authentic selves and the unique ways we experience the world.

This podcast is dedicated to celebrating these differences,

shedding light on the challenges and sharing strategies to help us thrive.

Join me as we explore the latest insights, thought leadership, and stories that

will help you understand and navigate the complexities of being autistic,

ADHD, twice exceptional, or another neurotype in a neurotypical world.

Whether you're neurodivergent yourself or an ally supporting neurodivergent people,

this podcast is your go to resource for fostering equity inclusion and belonging.

Let's get started.

Our guest today is the wonderful Nicola Salmon based in the UK.

Nicola is a leading global voice for fat folks seeking fertility support, bringing

a unique fat positive perspective to her work as a fertility coach and author of

the groundbreaking book, fat and fertile.

She's a prominent figure in the world of fat activism, using her platform

and expertise to challenge the weight bias and stigmas that exist within the

fertility industry and empower those who are often marginalized to take control

of their reproductive rights and health with confidence and self assurance.

Through Nicola's innovative approach.

She helps clients find their own path to wellness free from diets and body shaming

and encourages them to trust and believe in their ability to conceive with her

expert guidance and compassionate support.

Nicola is changing the way people approach fertility for the better.

Join us as we break down barriers and discuss how everyone deserves appropriate,

respectful, and evidence based care./

Hi, Nicola.

Thank you so much for being here today and coming on the show.

So great to have you.

It's so good to meet you.

I've been looking forward to this so much.

Oh, I've been looking forward to it well before I asked you to even come on.

Oh my goodness, what an honour.

Any excuse, right?

Yeah, exactly.

So for some background, uh, I found your work thankfully a few months before

my partner and I started to try having a baby and I also have PCOS and was

very much aware of the medical advice to lose weight in order to increase

your chances of fertility that we constantly get told and yet, being

an active eating disorder recovery, weight loss was completely off the table

for me and really actively avoided.

Your work has really given me the confidence, in my own, you know,

health and bodily autonomy and empowered me to advocate for myself to medical

professionals who definitely have a bit of a power dynamic situation going on.

And help me ditch those harmful messages thrown at us constantly by doctors and

society around us of the benefits of weight loss that aren't what they seem.

Thank you for sharing that, Annie.

I appreciate that so much.

I'm so excited to have you here.

Yeah, it means such a lot to me that it's impacted your life that way.

I'm a long time fan and I know your story inside out, but for the sake

of our listeners, can you please tell us how you came to be the

brilliant fat activist that you are?

Well, like you said already, I was diagnosed with PCOS, so for

those of you who don't know PCOS, it's polycystic ovarian syndrome.

It's a hormonal and metabolic condition which shows up in loads of different

ways for loads of different people.

I think it affects like a third of folks who are born with uteruses.

Like, it is quite prevalent.

And, yeah, for me, growing up, that meant that I had super irregular periods.

I had acne, hair, in all the places that we don't want hair.

And that's actually got worse as I've aged, so.

You know, I have a lovely little beard going on and my tummy

is very furry, um, beautiful.

Yeah.

So it's, yeah, it's been interesting embracing those things whilst being

fat, but yeah, so diagnosed with PCOS.

Really struggled with my own stuff around that, like went on a lot

of diets because I was told that was their quote unquote cure.

Yes.

Struggled with my hormonal stuff as well because I was put on the oral

contraceptive pill as I was told that that would regulate my cycles, um, which

it basically just masks everything.

So yeah, I spent a long time in my like teens and twenties navigating

body issues and weight stuff.

I did the uni thing.

I met my now husband and somewhere in my twenties ended up training

as an acupuncturist because I had a trauma, which was not really

related to fertility or anything.

Um, and acupuncture really helped, like I got PTSD from it, and I couldn't

find a way of supporting myself.

Hmm.

And I randomly tried acupuncture and it really helped.

And before this point, I'd never tried any kind of alternative medicine.

So I was like, what's this?

What's it worth?

Like, what does it work?

Um, so I tried it as an acupuncturist.

And so then I started specialising in fertility because there's lots of

research that supports, the use of acupuncture with fertility issues.

And, once I'd done that, I realised that, I wanted to help people more.

I wanted to like support them with the emotional aspects of it

because it's such a vulnerable and emotive journey with folks go on

when they're navigating this stuff.

Oh true

So I ended up training as a coach as well like a fertility coach.

Which gave me a lot more tools in my tool belt.

Was this before you had kids or afterwards?

So this was before and What happened was that then I got pregnant super easily.

I was pregnant gobsmacked, panicked.

Yeah.

Um, all the things, all the things, but then realised like when my first was

a littlee that I could work from home being a coach, I had to do stuff online.

Yeah.

This was like another world.

Right.

So yeah, when he was a baby, I was Like trying to set up an online business.

I had no clue what I was doing.

But I did it anyway.

And then when my eldest, so he's eight now, when he was about

six months old, that was when I

first, really realised that I wanted to divest away from diet culture, so this

idea that you need to be smaller, that you need to lose weight, and that you need

to go on a diet if you're in a fat body.

Purely because I was so hyper aware of the impact that my words and my actions

and the way I talked about myself could have on him, like I knew that he was

absorbing stuff, even at that young age.

It's scary to

think that's influencing

them after we've had such a lifelong battle with our body image.

I know, and I was so desperate to not want that for him.

So that's when I was like, I'm never going to weigh myself again.

I'm never going to diet again.

I was just like, Gotta be all in on this, and I did, and I haven't done since.

Um, I know, you know, this is definitely not a linear journey, like, they've

definitely had thoughts of, like, wanting to be smaller, and wanting to

restrict, like, this is a all the way around, up and down, roundabout, you

know, like, mishmash of a journey, but, you know, That was really the beginning.

it gets easier.

Um, that was the very beginning of my like, fat acceptance journey.

And luckily around that time, I stumbled upon some other

incredible fat folks on Instagram.

Just, you know, living their fabulous lives, being fat, not giving a

shit, and I was just like yes!

I was like, holy crap, this is what I want!

I don't want my happiness and my health and my joy to be directly

correlated to my body size.

So that is when I started to like dip my toe in and start to like think about

maybe how it would feel to not diet again and to just be fat and that be okay.

And then it must have been about five years ago that I

kind of flipped my business.

So before then I was like doing just general fertility coaching um whilst I

was still doing my acupuncture and then I just had this like moment of like oh my

god there's so much diet culture stuff in the fertility world like there's so much

restriction and you've got to cut this out and do this and it's so harmful and

it's so harmful to fat folks because they cannot access treatment, care, support.

And I was like, why is nobody talking about this?

Like, why, why is this okay?

Why are we letting folks navigate this?

And I was like, you know, if this was me, in a parallel universe, where I

would have struggled to get pregnant, like, because that's what the doctor

told me, I wouldn't be able to access care, I wouldn't be able to get the

support I need to grow my family.

So I'm like, My family's complete like I had the capacity to do this work and

if nobody else is talking about it Then I guess I'm just gonna have to do it.

Yeah, you have no choice Yeah, I just really felt like I didn't Um,

so I didn't really know enough.

I didn't really Know, you know at the beginning what I was talking about really?

I just knew like really really new on a like a really cellular level

that It was not acceptable the way that fat folks were being treated,

and that dieting does not help.

Like, the years of experience I had in dieting, I knew that dieting

did not help me with my PCOS.

If anything, I had a feeling that it was contributing back to the reason that I

have hormonal issues in the first place.

Um, you know, being on a low fat diet from the age of nine is not going to

be helpful for hormone regulation.

Absolutely not.

So yeah, so I just started talking about it.

Luckily, I, um, did quite a lot of research and stuff when I was doing

my degrees and things so I was able to like navigate looking at the research

into it and really figuring out why doctors are so horrible to fat people

and like what does the research say like why do people talk about it um and the

more work I do in this field the more

angry I get, because the research is not there to support it.

It's purely based on this bias that we have in society that fat people are

unhealthy and should be responsible for all the health things that happen to them.

It doesn't take into account the lived experience of fat people, so, yes.

I'm just very angry at this point in my career.

Yes.

All the rage.

I definitely can feel your, oh, I'm the same.

It's, it's horrific.

It's interesting because I have very similar feelings towards both how fat

people and especially autistic people are treated by the health profession.

Yeah,

I can't even begin to unpack all of that because it was

just full of amazing content.

I totally, I totally agree with you around what did the pill and what

did restricting cause your body harm?

You know, people are constantly talking about how being in a large body is such

a problem, but what about everything they do to people in large bodies?

I think one of the reasons that I did get pregnant immediately, and

obviously I'm only speculating because I think some of it's luck, whatever.

But I truly believe that, and I thought this at the time, that the reason

that it happened so easily for me is because it was the first time in my

life where I wasn't actively pursuing any sort of diet or restriction.

And it was the first time I was implementing health behaviours

that had absolutely nothing to do with weight in, in like a, A

sort of F you to, to diet culture.

Yeah.

Where, you know, I wasn't restricting my eating.

I was practicing joyful movement that had nothing to do with

fitness or calories or anything.

It was just about getting fresh air and mental health and, and yeah, and both of

these concepts were very new to me after a lifetime of dieting and disordered

eating, I got put on my first diet at age, I think, 11, when I started to gain some

weight, like most girls do prepubescent.

Have a bit of a weight gain before a growth spurt.

And that's usually when society freaks out because women are supposed to be sticks.

And, you know, I was distressed because I was getting treated different at school.

And that was also the time when boys and girls became aware of each other.

And my parents saw my distress and like any loving parent did wanted to help.

And the only thing the world told them that could help was a diet.

And so begins a lifetime of dieting and developing a full blown eating

disorder, which many of us do, sadly, it's a slippery slope.

Hey, on top of that, I had, you know, you've got the PCOS and I got a few

other chronic health conditions and yeah, so I spent many years in and

out of doctor's offices and the weight would fluctuate as did the dieting.

It's interesting because I love the saying diets don't work and

I truly believe diets don't work.

But when you say that to people who are really entrenched in diet

culture, they're like, yeah, they do.

My cousin Stan lost 50 kilos and kept it off and he's loving life.

It's like, cool.

Good for Stan.

He's yeah.

Yeah.

He's one of the less than 5 percent of people in the world that successfully

have kept it off and I guarantee within two years of that almost completely

guarantee that it'll come back

Oh, he'll be really suffering with like an eating disorder

and really restrictive life.

Yeah Yeah, that's a very

good point for those who are so successful quote unquote successful Like

what cost is it right?

Exactly.

What cost is it?

And, and the thing that I love about what you talk about and that really hit home

to me in, in helping me really pursue anti restriction was the biology of it.

Right.

You know, caveman times and our ancestors, when we didn't eat and we're

fasting, we stopped getting our periods.

We stopped being able to procreate and make babies because we were surviving.

So it literally makes no sense.

To restrict food in order to get better fertility, which is what

majority of science tells us, even though, you know, the, the science

that's heavily drenched in weight bias, you know, unconscious bias.

And this is what really, really honestly hurts my soul because everyone is, you

know, evidence based, evidence based, and I'm very pro evidence based, but

I think the problem is, is that people

talk about evidence based without caveating it with the fact that

all science is biased and the fact that scientists almost claim,

and I'm not hating on scientists here, no, no one come at me.

The scientific field claims that they're unbiased and they check their biases

at the door and they're very, but they're not like you, you, we're humans.

You can't not be biased.

You just can't.

And this is my thing with doctors is doctor's arrogance.

If I meet a doctor that acts like they know everything,

I immediately distrust them.

My favorite doctors I've ever seen have been the ones that have said, have

admitted to where their limitations are and known when to refer me on.

I just can't stand it when anyone claims to know everything,

because you just can't possibly.

We don't live long enough.

And

things change all the time, right?

No human can keep up with, you know, every area of medicine that's

evolving and changing, you know, and it's so arrogant to think that

you could and that you should.

You know, I did a lot of research before I even went to my gynecologist

OB for a preconception consult.

And I was so armed at the ready for any kind of weight talk or anything like that.

And, and she did briefly bring it up, but I was quite cold about it.

So she, I think she got the hint that I didn't want to talk about it.

A lot of the research that I did look up, especially around PCOS.

Was promoting weight loss was basically saying that if you have PCOS and

you're in a big body, you're going to really struggle to get pregnant.

And then even if you get pregnant, you're going to struggle to, you

know, keep the baby, have a healthy baby, have a healthy delivery.

I remember a statistic that I saw everywhere and, and it was the one

thing that really, truly freaked me out.

And as someone with clinical anxiety, this is something I did not need to read.

It was that larger bodied people have twice the likelihood of a stillbirth.

And then I looked into what that research stems from, and it literally

goes from 1 percent of a chance for the general population to 2 percent chance

if you're in a larger weight category.

I get that that technically is twice.

But the way that language is produced, it's scaremongering.

It's, it's like, Oh my God, you're, you're basically going to kill your

own child before you even have a chance because you let yourself get fat.

Like we had a choice.

It's so manipulative.

It's so, so manipulative.

And it's just so ignorant to mental health awareness and like trauma informed care.

Absolutely.

They just clearly have no clue what it's like to live in a larger body.

And, and it's something that, I mean, we, you know, cause you're in this space

and shout it loudly to the world, but it's something that we face in every

aspect of healthcare, which is getting our needs and care put aside for weight.

I just blows my mind when I got into this stuff a few years ago and was

hearing about people getting turned away.

presenting with some generic symptoms and told, I'll come back in six

months when you've lost weight.

And then they've like come back and they've got stage three cancer

because the doctor didn't take them seriously because of their weight.

The biggest problem with being fat is how we're treated.

It's not the fatness.

Absolutely.

And that's, you know, the way that we're treated is often.

You know, why we get iller and why we're a higher risk of things because

of that delay and because of that, you know, reticence to get treatment

and care, and both externally and internally, like, through no fault of

our own, we will put off going to the doctor because of the trauma we've

experienced in the past from healthcare professionals, and that is not true.

It's not our fault, but it does delay our care and our treatment, and it's just, you

know, abhorrent, and it's not acceptable.

It's so bad, and my husband and I are starting to think about when

we want to try for our next child.

In thinking about going for round two, I'm already full of anxiety about having

to navigate that system again, and having to come into contact with, you know,

So many different health professionals and, and not knowing which ones are

going to treat me with the respect and dignity that I deserve with more of a

health at every size angle and which one of them I'm going to have to deal

with their unconscious bias and their fat phobia and, you know, I had it

like, I still have a little bit of it.

Like, I don't think anyone doesn't.

Yeah,

yeah, exactly.

But you know, in the, in the heat of dieting and an eating

disorder, it was so prevalent.

It, it almost convinces you that being fat is the worst.

That's what that message tells you.

And it is so toxic.

I find it interesting that a lot of people haven't heard of thin privilege.

And I mean, I hadn't until I dived into the world of anti diet and, and, you

know, fat positivity health at every size.

So I get it.

But I remember telling a friend of mine who has a daughter with an eating

disorder and I was explaining thin privilege to her and she got so defensive.

I don't have that.

And again, we all have it, right?

Yeah.

Yeah.

We all have different level layers of privilege in every way.

Yeah, it's not that life was easier for you.

It was just that life didn't have these extra hurdles.

Yeah,

like you've never had to ask for a seatbelt extender on a plane.

Or paid for an extra, you know, chair.

Yeah.

Or not fit in a doctor's surgery chair because they're not made for,

to support your weight and size.

Like, I mean, I even have a level of thin privilege, right?

Because I still can access most of society, even if

it's slightly uncomfortable.

Yeah, that's it.

Yeah, and I mean, I, I'm so limited to buying clothes.

I can still buy clothes.

Yes,

you can still order them online at the shops.

Yeah.

Um, I can't order them in the high street, but I can go online and buy clothes.

So absolutely.

Yeah.

And yeah, I just found it really interesting and she

didn't mean anything of it.

And once she understood thin privilege, she's like, Oh, okay, now I understand.

I think that's a really important thing to bring up because I think

until you experience any form of discrimination or marginalisation in

any way, whether it's racial or gender or sexual or neurodivergence or body

size, whatever, until you experience those things, you're It's very hard to

imagine what those people go through.

And so, you know, I, I constantly try and talk to neurotypicals and explain what

it's like to be an autistic ADHD woman in the world and the quite invisible barriers

that I face on a daily basis that they just never have even put their mind to.

And that's similar with weight, you know, my husband's six foot seven,

he's a giant and he, he, he likes to occasionally complain about the fact

that, you know, it's hard for him to buy clothes cause he's so tall and you

know, his head literally hits doorways.

Yeah, there's a lot of issues and, and, and yet, you know, really short people,

especially women quite openly talk about their shortness and the disadvantages of

that, which I'm not saying one's worse or the other, they both have hardships,

but what I'm kind of, I guess, saying in a roundabout way is that the more

petite short women can openly comment about their bodies and they're mostly

going to get people saying things like, Oh no, you're fine and lovely things.

And yeah.

Whereas larger people, it's more of a, let's avoid it, let's not talk about it.

Well, yeah, with height, like we're very confident as a society

that height is genetic and we can do nothing to impact it, right?

We're not going to be taking things to make ourselves shorter or taller, like,

unless obviously, you know, extreme circumstances for folks who've got genetic

disability, you know, things like that.

But with weight, it's like, it's your responsibility.

You're the one that, you know, quote unquote, got yourself in your, in

this position, then you can change it, which we know isn't true.

We know weight is non modifiable.

We know there's over a hundred factors that impact what our weight is at any

one time, but yeah, we're still fed this message by lots of people who make lots of

money from people trying to lose weight.

Lots of money.

Yeah.

Yeah.

We can change it and we'll be healthier and happier.

Yeah.

Oh, and I love, you know, diet culture, how they're like, you know, the failure

of weight loss is on the individual.

Yeah.

And yet the diet industry is over 70 million, billion dollars, million.

I don't know.

Yeah.

Okay.

Thank you.

I just remember it's in the, Oh, it's like, it just keeps growing.

Yeah.

It just keeps growing, but the weight.

issue in society, if you want to call it an issue, isn't getting better.

So clearly they're failing and yet they're still outwardly claiming that they're not.

And , at some point they're just going to hit a magical point where they somehow

solve this quote unquote obesity epidemic.

Yeah.

But you're just not trying hard enough.

Right.

It's all about your motivation.

Exactly.

Exactly.

So I got an advertisement and this is so like off topic, but I just, I

really want to talk to you about it.

I wrote a comment on some advertisement that I saw on Facebook that came

up about some weight loss thing.

And I was so angry at what it was promoting that I commented on it and did

a whole angry rant at diet culture and.

Anyway, I got hundreds of likes and loves and people saying, Oh, you like,

you said it so well and lovely things.

Lovely things.

Amazing.

Yeah.

Yeah.

But then slowly over the following few weeks, every now and then.

I get a notification that someone else had commented and sometimes it would

be more niceness and then other times it would be people saying things like,

yeah, I agree, this is rubbish, but it's not good to be in a larger body

and we should all be trying to be thin.

And I'm like, Oh my goodness, you're missing the point.

I find it hard talking to people who are so blind by their own unconscious

bias and really unpacking that.

Without them being so defensive and so convinced of whatever lies they've been

fed around, you know, the morality of weight and how weight is the problem

when we all know that actually weight cycling and restricting are the

problem and not being in a larger body.

Yeah.

Jess Baker, I don't know if you know.

Oh, I love Jess baker.

Yeah.

She's written some really awesome books.

She has a really good analogy for that, which I love, but she's

all talking about body currency.

So it like, she talks about it in a way of like, these people who are in Thinner

Bodies, they have been investing in their bodies, they've been eating the

quote unquote ripe foods, going to the gym, getting, you know, like shredded.

So they've been like, invested in this idea that being in

a thinner body is awesome.

And we're basically turning around and telling them that their money is

worthless, like all the time, effort, energy they've been putting into this.

It's all a load of bullshit.

It has no value.

So of course they're gonna be, right, angry, right?

Like, they have put every, you know, like this is their whole personality

is being like a gym bunny or a gym bro.

Like, this is what their whole life is about.

And all of a sudden we're telling them, nah, it's worthless.

Like, I can understand why a lot of folks get angry about that.

I can too.

It's their whole world, right?

And we're like, we're taking away the foundations and everything,

and everything is crumbling.

Yeah, we're invalidating them.

Yeah, but it doesn't mean it's any less bullshit, but it just, yeah.

Some people are just not ready for it, and that's fine.

And if, you know, I just don't have time for that people, and if it's my messages,

not for them then they can go and do their own thing because there's plenty of

other folks who are going to be open and interested in talking about this stuff

so I try not to worry about those people.

Yes, I'm so glad I brought that up because I really needed to hear

that because I think sometimes I can get on such a crusade that I'm

like no everyone in the world should understand this and I never want to stop

fighting but it's at my own suffering.

Everybody's ready to exactly like you can't fix everyone's.

idea of the world.

And yeah, no, I, I love Jess.

She's great.

So I figured we're on a podcast that mostly talks to neurodivergent

people about stuff that affects neurodivergent people.

So I thought.

We should probably share with our audience that you are currently

seeing if you are ADHD and by seeing I mean getting a diagnosis because I'm

pretty sure you know, you know, right?

Yeah, I have been like on this beginner's path for I'd say maybe about a year now.

It all started because I think all of my children have got

ADHD and they are very classic.

It helps that they're a boy because obviously that does mean

more about young boys and ADHD

especially with the combined type.

Yeah.

Yeah I am Super confident.

Again, he hasn't had my diagnosis yet because I know how bad the waitlists are

and everything around COVID and stuff.

And he's doing really well in school.

You know, we found him a lovely place where he's thriving.

So I'm not too worried right now.

But yeah, obviously the more reading you do about ADHD, the

more I began to recognise that yes, there's a genetic component.

Yes, folks with ADHD tend to have parents that have ADHD.

So I was beginning to like put the pieces together and there's so many

people in like the online business world that I follow, that I've

worked with, that have in the past five years got an ADHD diagnosis.

And, you know, the more that they talk about it and there's obviously like

TikTok where there's like an explosion of folks talking about ADHD and it's

just You know, like every, yeah, every single time I see something, I'm like,

okay, you know, like, wow, wow, wow.

Yeah.

Yes.

So I'm still in the process of deciding whether it's worthwhile

going to get diagnosis or whether I'm happy just being self diagnosed.

Um, both, you know, I've come to acknowledge a completely valid options.

Um, and Yeah, it's been really, really helpful for me to just begin

to recognise that my brain doesn't work the same way as other people's.

And whether that's ADHD or something different, it doesn't really

matter because it's just more about figuring out ways to support

myself and my own mental health.

Yeah.

Because my mental health took a nosedive after I had babies.

Yeah.

I really struggled to leave the house.

I really struggled to Do stuff, and of course when I went to get, you know,

some help from the doctors, they just recommended Slimming World to me.

Oh my, of course they did.

And I'm just like, for God's sake, like, this is utterly ridiculous.

Of course my mental health is not going to improve just because I'm in a small

Please restrict your eating.

Then you will be better.

Besides that, yeah.

But looking back now, I can see that because I had, you know,

because my life had completely literally changed with children.

All your supports have changed and gone out the window.

It's very common.

All my systems

just fell apart.

Um, of course I couldn't cope and I'm experiencing the same thing again

now because we've just got a puppy.

He's like four months old, which I love.

I love.

And it's been really helpful for, You know, like getting out and

walking and doing things like that.

But again, like that change in systems, that change in how I like spend my time.

Especially like any sort of executive functioning demands that come in,

which as you know, babies are huge executive function demands and puppies

are pretty bloody demanding as well.

So, uh, you know, but it is very common both for

autistic and ADHD is to really struggle with any big life transitions

where everything that they've figured out to cope and adapt

and get by goes out the window.

And you're starting basically from scratch because you've got all these new

layers that you've got to figure out.

So you're absolutely not alone there and it just blows my mind.

It doesn't really, because I've had the same experience where I've gone

to doctors about my mental health and been told to try a different diet.

Like, yeah, it's, it angers me, but I have to laugh or I'll cry.

Oh, wow.

But no, it's, it's funny because, um, my own story is that I, I got diagnosed

with PTSD from the car accident.

And that was really a big turning point for me because, I kind of

hit a, hit a state in my, you know, I'd been solidly in and out of

surgeries and doctors and therapy and psychology for five years by then.

And I was like, that's it.

Like, how have I had PTSD for five years and no one's noticed it?

And I've been in consistent therapy.

That was a very big turning point for me to, to really take back the control and

the narrative and, and really invest.

Like, it's not that I wasn't, researching and being invested

in my health before that I really was, but it was like next level.

Like I refuse to ever take any of you people seriously again, and I'm just going

to learn it all myself, whereas before

I just learned whatever they told me.

And now I was like, nah, I'm going beyond that because clearly you

guys don't know what you're doing.

Uh, and, and that's when I actually came across the overlap of how PTSD symptoms

and ADHD traits look quite similar.

There's quite a lot of overlap.

And what, what happened for me was looking at that made me be like,

okay, well, what is the overlap?

And that's when I realized, oh, okay.

So I've definitely had ADHD my whole life because obviously the PTSD,

those symptoms only exist after the trauma, whereas the ADHD is lifelong.

So that's kind of the biggest differentiator and there are some,

there are differences, but there is a lot of overlap and that's what really

got me looking into ADHD myself, which was, four or five years ago now.

And then it was when I went to see a psychiatrist to get diagnosed

that I found out that I was also Autistic, which I knew nothing about.

Anyway, but yeah, I just, yeah, I love that you're figuring this stuff

out and I'm sure you know that, ADHDers have quite a higher chance of

having binge eating disorder as well.

Yeah.

Yes, I had seen something like that and I've been kind of like digging more

into that and I find it Fascinating.

So

fascinating, isn't it?

I, I am a little bit obsessed around, um, autism and ADHD and eating disorders.

Yeah.

That's my special interest because those things have affected my life so much.

And I've tried navigating them both and have just seen so many massive

gaps in the health system around trying to be supported to recover from an

eating disorder, while also, you know, acknowledging and appreciating and

affirming my neurodivergent traits, which usually go hand in hand and, are seen, you

know, a lot of our traits are seen as not so good in behaviour, like observationally

the behaviour is seen as negative and because most of the research has been done

by neurotypicals who are just witnessing and judging and not experiencing and

feeling, they put all this value and judgment and morality on our behaviour

without understanding why we're doing it.

Which is a very big issue because All behavior is communication and yeah.

And they're not getting what we're trying to communicate.

Uh, and, and so with, with eating disorders, uh, and aDHD and autism,

especially, you know, we've got the distractibility, we've got the focus

issues, we've got, some of us have introception issues around being able to

tell if we're hungry or if we're full, which means you're much more likely

to forget to eat and then you're much more likely to overeat because you're

not getting those satiation signals.

It's so complex, but it's also, it makes so much logical sense to me

that ADHD'ers and autistic people struggle with eating disorders.

There's just so many reasons why I think we're very susceptible to them and how

critical it is to actually, you know, support us and our different needs.

To neurotypicals with eating disorders, because I just don't

think you can separate them, but I'll get off my, my little diatribe.

No,

no.

And layer in, you know, if you layer in a level of fatness of that, like

there's already so much anti fat bias within the eating disorder world.

You know, fat people not being recognised as having eating

disorders, like atypical anorexia, you know, fat people have anorexia.

Yes.

So many layers.

So when I went to talk to the endocrinologist about gestational

diabetes, I was very upfront about, you know, I've got an eating disorder.

Uh, I don't want to talk about my diet.

I will not be changing my diet.

I will not be discussing my diet.

And I was so ready to fight them.

And he was like, yep, cool.

No worries.

And I was like, what?

All, all these years.

And all I had to say is this is not a topic that we can discuss

. It was so mind blowing.

And he even said, 'cause at the start he was like, oh yeah, and you know,

we'll send you to see the dietician, you know, the diabetes dietician.

And he's like, oh, you don't even have to go to that if you don't want.

I was like, I'm not going.

Great.

Yay!

Yeah.

And, and it was so good.

And, and to be fair, like through, I ended up on insulin, but only a low dose.

And, um, there were times where they were trying to get me to track

what I was eating, just so they knew what was spiking it so that

I could know what, you know, what

meals that I might have to take some insulin on or a bit more on or whatever.

And I even refused to do that because it was too triggering.

And they were, respectful of that as well, but, I just, I can't

believe I was allowed to say that and to have it listened to after

years of being completely ignored and spoken down to and infantilised

and it was just so refreshing.

And I, I thank that doctor.

I, I didn't actually see that, that doctor again.

I saw a different endocrinologist, the next few times, but they

were all equally as respectful.

And I, I praised them for it because I was like, I really did

not think you'd be like this.

Um, and I just, it just makes me think how many people are out there that

don't even know that it could just be as simple as saying this isn't.

Okay for me to talk about, like, you don't even have to

say I have an eating disorder.

You don't have to say I'm traumatised.

You can literally be like, this is not a discussion topic and, and

set that boundary and maintain it and any doctor that ever tries to

say, well, we have to talk about it because it's about your health.

That's when I think, you know, your stuff can really come into play around

your resources on, well, show me the evidence that it even matters because

you should be treating me no matter my size and my size shouldn't influence

the adequate care I get from you.

Um, and if, if anything, if you're a doctor that thinks weight

matters, then I'm a person that doesn't trust you as a doctor.

Because.

you know, I just immediately assume you've got such a weight bias that

you're going to give me inadequate care and sometimes even neglectful care.

Yeah.

Yeah, absolutely.

And I mean, it's, you, you can't control what other people do.

So like you cannot control a doctor, you know, often their opinion,

and sometimes you can't even control who you're going to see.

So all you can do is your best and sometimes you'll get a great result.

Like you did other times, like people will not be open to receiving that.

And that is not your fault.

And this is just, you know, you shouldn't have to do this work.

It can be so emotionally draining and we should not be put in a position where

this is the stuff that we have to do.

And you know, it's exhausting.

But yeah, sometimes we have to because the system is just not set up to support

us and it's hard and it's okay to cry and it's okay for it to be really

stressful and, you know, you've just got to do whatever you can to care

for yourself during that process.

It sucks, it sucks so much and I remember this was before I got pregnant and this

was when I was very sure that I'd be having fertility issues because like

you, I'd never had a regular period and all the things that come with PCOS and

so I was just, I was absolutely sure.

From everything that's out there, that I would be one of those

people that wouldn't get pregnant.

And so I was very aimed at the ready to fight for fertility support.

You know, how letrozole is better on, I think larger bodies, then there's a

different one that's more commonly used.

Clomid.

Clomid.

Yeah.

My OBGYN talked about Clomid when I was doing my preconception stuff.

Um, and I was like, Ready to be like, no, I want Letrozole . Like

, I know this stuff.

Yeah.

I did a

post about that.

I mean, Clomid's great, like Clomid can be really helpful.

Often.

Sure.

Folks need more dose, like tend big people in bigger bodies

tend to need larger doses.

Yes.

But obviously well different.

Um, yes.

But yeah, some people can be Clomid, resistant, which means

their body doesn't respond as well.

Gotcha.

And yeah.

There's some really great papers around that drizzle out there that show that

it actually works better for folks in bigger bodies, which is so fabulous.

Yeah.

And exciting.

Yeah.

So good.

The other thing that, I've heard you talk about that I'm sure people interested

that are listening might care to hear is, the thing that really shocks me

is, the limitations in the NHS to, to get support for fertility treatment.

And, and wasn't it, your BMI only has to be over 30 to not have

access, which is pretty, pretty low.

Like that's, that's only

Like a third of like people who might want to access it.

It's wild.

And I mean, even like private stuff, like in the UK, you can't find a

clinic that will help folks over 40.

I know in Australia it's really hard to find, even the private

clinics that will support folks over like 40, 45, US, similar.

I mean, they tend to be a bit more lenient, like some clinics

will go up to 50, but yeah.

Talk about eugenics.

It's wild.

Oh gosh, yeah.

Oh

my human rights.

That's

so bad.

Uh, well yeah, it is a violation of your basic human rights.

Yep, yep.

But Absolutely.

Yeah, people don't want to listen.

No, exactly.

Exactly.

I don't, and to be honest, when I did get pregnant straight away,

I was just so relieved because I was ready to fight that battle.

Cause I was well over 30 BMI unashamedly.

And I was absolutely ready to fight for those rights.

When I got pregnant, I was like, thank God, because I did not want

to face that very uphill, very unfair battle that so many people

like us face that is just so unfair.

So the thing with the overlap of neurodivergence, and I'd be interested

to hear your thoughts on this, is when we talk about papatholosising larger bodies.

You know, the O word, obesity for people who don't know, um, and even overweight,

which is slowly starting to not be used as often, but it's still very heavily

used, uh, in, in medical terminology.

And, you know, nowadays it actually shocks me when I hear a

doctor say it because I'm like.

Really?

You haven't caught up with, with the world?

Don't you know?

It's similar to when I hear doctors say like person first language, like

someone with autism, I'm like, Oh, wow.

I immediately don't know.

It's the red flag, isn't it?

Yeah, exactly.

I'm like, okay, you have no feelings.

No

idea what's going on.

Yeah.

But

yeah, I just, you know, as someone who's experienced this both from

a large body angle and also, a neurodivergent angle, there's a lot

of overlap between how I feel about.

The O word and how I feel about certain ways that autism is described,

especially, um, you know, it's a disorder autism ASD with autism, rather than

the really, you know, identity first prideful way of saying I'm autistic.

I don't have autism.

It's not a handbag.

It's a part of me.

It's my identity.

You know, I don't have obesity.

I am fat.

Yeah.

You can't separate it.

And talking about it like that is really demeaning.

It just surprises me that people really can't comprehend how

this language is so offensive

and why we fight for it to change, you know?

I mean, it's wild, isn't it?

Like they, you know, if they could have a conversation with any

fat person who's, you know, been doing this work for a while, then

maybe they'd understand, but they're so, they're so set on, like, being the

expert and going, you know, my way's the right way, and of course these fat people

couldn't possibly understand the science.

Um, but yeah, I mean, even the word is so stigmatising, like, it comes from

the term in Latin, like, to eat until you are fat, or, like, it's something

to do with This idea that, you know, it's gluttonous and it's greedy and,

you know, all these stereotypes.

Um, yeah, and the morality around it, and, you know, like you said, it, like,

it medicalises a really normal state of being, you know, like, being fat,

it's fine, and, you know, we haven't even touched on the racism around it,

you know, like, it's built in our healthcare system for a reason, just

like racism is, because, you know, In the old times, they wanted white

people to be the superior race.

So they did everything they could to make it so, so, you know, like

the system set up that way and it's, we need to break it down,

rip it apart.

Burn it.

Yeah, and I think like, you know, it's, it's so harmful to be practicing

a profession where you don't actively acknowledge all of these

things and which many people do.

And I think most of it is just ignorance.

Like I don't think people intentionally do it, but at the same time.

I don't really care if it's intentional or not.

It's harmful.

It's always, yeah.

Yeah.

Impact over intention.

Right.

And it's about, you know, if you are harming someone, then you need to do

better because it's not good enough that you just, Oh, I didn't know.

Like, that's not good enough anymore.

It's not with the information we have available these days.

Yes.

Yes.

Especially now, like I think even with COVID and you know, Black Lives Matter

and Me Too and all the things that have happened in the last five years.

It's just, how can you be ignorant to that now?

I just don't think there's an excuse anymore.

Um, yeah.

And I really hope that like, you know, I have a lot of privilege in

so many ways, you know, uh, I'm white, I'm middle class, uh, I have all the

privilege, but then equally I have a lot of marginalisation as well.

And, and it's not about.

how much or how little of either, you know, everyone has

different levels of privilege.

It's interesting to me because, and I'm sure people, the more marginalizations

you have, the more you're aware of this, but how each different part that's

marginalised is treated so differently.

you know, the visible versus the invisible.

marginalisation and, you know, we can't hide our fatness, but I can

hide that I'm autistic and ADHD, you know, maybe not super well, but mostly

pretty well and maybe at a cost to my mental health, but, and energy

levels, but you know, that, that helps.

and that's something that I think, you know, in my life.

when I was growing up and, and I was dealing with weight issues

and bullying, which so many neurodivergent people experience.

I put all of it down to my weight because the weight was the visual thing.

And I, I didn't know the other stuff and it was so hard to put my finger

on that stuff and to work out why the world felt differently about

me, and how people experienced me.

It's just interesting to me and I'd be interested to hear what your experience

is going into doctor's surgeries as a new patient because I've, I've done

that many times and it's, it's mind blowing the treatment that I get.

I walk in to any new doctor's office and I've done this

many times for the last year.

Seven, eight years and majority of them, and I honestly, when I hear myself say

this, I'm like, people must think I'm exaggerating, but I'm absolutely not.

And it's sad that I'm not.

I wish I was, but the majority of them initially start talking

to me as if I am very stupid.

And as if., It's going to be a very painful consult.

And so I, you know, and this is in a period of my life where

I've been in a much larger body.

And usually I'm not putting much effort into how my hair or clothes look.

Um, yeah, yeah.

Who cares?

Cause you're at a doctor.

You don't have to look like you're at a business meeting.

Yeah.

Uh, not that that matters to me either, but anyway.

And so.

It's really interesting to me, and it actually makes me sick to my stomach,

that what happens in these appointments is that that's my initial interaction.

And within a few minutes of me speaking, they completely changed their tune.

Because I am extremely articulate, I usually drop the line that I'm

a lawyer, which usually makes them wake up, which is disgusting.

Yeah, I should not have to do that, but I'm like, look, I might look like

what you think is a lazy, gluttonous, uneducated, whatever you want to

label me with, but looks can be deceiving and it shouldn't matter.

You should treat all patients with the respect and dignity that they deserve.

And it disgusts me when they change their tune and treat me better once

they know that I can articulate myself.

And that I'm not what they first assumed.

It's just such a stark contrast

it's so

dehumanizing.

It

is.

It's so dehumanizing.

Have you experienced doctors sort of treat you like that on an initial

engagement or have you mostly sort of had like good or neutral?

I'm hoping you say you've had good experiences because I've had

enough bad ones for the both of us.

Oh,

yeah.

I mean, it's been mixed.

I haven't, luckily haven't had the need to go and see many

doctors over the past few years.

And I don't know whether that's because I don't want to go and see a doctor.

So for mild to immediate things, why would I put myself through that?

But yeah, I mean, of the kind of occasions, you know, I've been in for

my, like, regular smear tests and, things like that, and I feel like I have to mask.

I feel like I have to be, like, super perky, super engaging, you know, like,

a really, nice person, and I think nice has just been my mask for most of my life.

But yeah, I, and again, I totally understand why people do, like, put on

loads of makeup and put themselves really well dressed to kind of put across that

idea that they, you know, like are a quote unquote good fatty, you know, like

we do whatever we've got to do right to make sure that the care that we receive

is adequate and it's so wrong that we have to go above and beyond but like I

can't put makeup on at the best of times so I'd have no chance of doing that but

yeah, you know, I can completely get why people do that and Yeah, I've been

lucky to not need to go to the doctors for a while, but yeah, I have a new

doctor, so we moved house about a year ago, and I haven't been in to see the

doctor that I'm registered with now, so that will be an experience, but I should

definitely do it sooner rather than later.

Anyway, I feel like I could talk to you all day about this stuff, and I

just appreciate your time so much.

Thank you.

Yeah, I love that.

I love being able to talk to you because I feel like, I feel like I have talked

to you just by listening to all your interviews over the years and reading

your book, but it's so nice to, to be able to have my own personal sneaky chat.

So I feel like this podcast episode has been so much more for me than

probably the listeners, but hopefully someone's gotten something out of it.

Yeah, I hope so.

Yeah.

Yeah.

I hope so too.

Let's wrap this up with what's your.

key for self advocacy, and, you know, setting those boundaries of,

fighting for the respect that we already deserve in a larger body,

navigating fertility and pregnancy.

I think in general, it would be like.

Don't question that you deserve that care because you absolutely do.

Like, whatever you have or haven't done in your life, that you're born

worthy of receiving appropriate, respectful, and evidence based care.

It's bloody hard to get sometimes, especially if you're

marginalised in one way or another.

But never question that you're worthy of that care.

And it sometimes just takes practice.

Like We're not taught this stuff.

We are not taught the skills of advocacy.

So it's just about trying and trying and trying again, trying to get a

different doctor if your doctor's crap, trying to, you know, like have

a different conversation around, you know, getting them to, to be

on your side, to be on your team.

Cause you should be on the same team.

You should both be working towards the goal of, you know, supporting

your health and wellbeing.

And it doesn't often feel like that, but you are.

Without a shadow of a doubt worthy of that care.

100%.

That is the best advice ever, as usual.

Everyone listening to this, if you've even like slightly enjoyed this, which

I can't understand if you haven't loved it, Um, you should absolutely

just go look up Nicola Salmon on, You know, any platform and listen to every

ever done cause they're all magical.

And there was one I listened to and you were talking about bodily

autonomy and, Oh, I just loved it.

You said it so beautifully, just talking about how, you know, all we want is to

be able to actually access our bodily autonomy, so powerful because I feel

like that is not only so relevant for us fat folk, but it's also so relevant

for neurodivergent folk, right?

Because so much of the treatment that Autistic and ADHD'ers is get

is focused on how the medical profession or, you know, the external

world thinks we should be treated.

And it's not about empowering us to decide what we want for ourselves

and our own bodies and our own mind.

Just thank you for giving us your time and, Oh, my pleasure.

And thank you for sharing your wisdom.

You are doing incredible things and impacting so many more people

than you could even imagine.

And I'm just, I feel so privileged to help spread your message because

it's so important to be spread.

I'm so grateful.

Oh, thank you.

And I just really, I hope that there's someone out there like I was back

then, who's, you know, gonna have such a good experience with their

own pregnancy journey, just from having this in their back pocket.

So thank you so much.

Thank you for being here.

for your chat and thank you for letting me have a therapy session

with you because that was very cathartic and I really needed it.

Amazing.

Yes yes but anyway I should let you go but thank you again I really appreciate it.

Oh my pleasure./

This is future Annie coming to you from many months after we recorded this

fabulous conversation and since then I've had multiple miscarriages unlike my

first pregnancy, which was very fortunate to happen on the first go and give us

our beautiful almost four year old.

If you're out there and still trying, Or yet to try, But worried

about what you might face, Like I was, Just know you're not alone.

And there are people like Nicola who you can reach out to and get support from.

People who will honour you in whatever way you may come.

Whether you're neurodivergent, fat, disabled, or any other

intersectional identity.

People who will honour you for who you are and support you through

this with autonomy and empowerment.

I just wanted to add that my heart goes out to you and I see you.

Thanks.

/ if you'd like to hear more from Nicola, check out the show notes

for a link to her book and socials.

Remember your voice matters and together we can create a world where

neurodivergent individuals are truly included and have their access needs met.

If you enjoyed today's episode, please subscribe, rate, and leave

a review on Apple Podcasts so we can reach more magnificent minds.

For more resources and a library of exclusive interviews, join our

community by visiting neuroaccess.

com.

au

and follow us on Instagram at princess and the pea podcast.

I'm your host, Annie Crowe.

And until next time, keep advocating for yourself and others and day

by day, we will make this world a better place for all sending many

spoons, your way, over and out.