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Intro music: Bags are packed, are you ready to go?…This time tomorrow we’ll be on the road…riding with you into sunnier days…I wouldn’t want it any other way. 

Julie: It’s time to name the neglect from typical food advice. Welcome to the Find Your Food Voice podcast, hosted by me, Julie Duffy Dillon. I’m a registered dietitian with 20 years of experience partnering with folks just like you on their food peace journey. What have we learned? Well, cookie cutter approaches exclude too many people, and you don’t need to be fixed. It’s not you. It’s not me. It’s all of us. Only together we can start a movement and fix diet culture. And we will. Let’s begin with now.

Transition music: I want to see how the world turns round…Let’s go adventure in the deep blue sea…home is with you wherever that may be…home is with you wherever that may be.

Julie: Hey, there, welcome to episode 358 of the Find Your Food Voice Podcast. I am Julie Duffy Dylan, registered dietitian and partner as you are navigating all of the things just to access healthcare and have a relationship with food that I don’t know, feels nourishing. And this is a podcast all about Finding Your Food Voice, which is a way for you to reconnect and mend your complicated history with food. Today’s episode is focusing on fertility treatment and your relationship with food. I get a chance to have a recorded chat with Judy Simon who’s a fellow dietician. I say recorded chat because I actually got to meet Judy for the first time, um, a few months ago and planned this interview. I was so excited to actually meet her in person. She’s someone that I’ve gotten to know over the years because we both work in a way that’s against dieting and have these kind of specialized niches. And she sees a lot of people with PCOS and then specializes in fertility. Since I work with a lot of people with PCOS, but don’t specialize in fertility. I have googled the heck out of the things that she has said about fertility and now she has a book. So this episode is jam packed. But one thing I will tell you about um this interview is I got a chance to read the book before the interview. And some of the things I brought up with Judy is while we are both anti diet and think weight is getting too much in the way of health. It’s just, it needs to be teased apart. Uh We have different ways of helping people to mend the relationship with food. And if you look through her book, you’ll see some of that um in there, especially if you worked with me in person. Um You know that I have kind of a permission based and um Judy has a more kind of how do I say it? Uh specific kind of recommendations like eat this, not that. And while I say it so exact like that there is a lot more nuance and I’m glad I got a chance to talk to Judy about that so. She does unpack that in this interview. 

Julie: But we spend the majority of time talking about how fertility treatments are inaccessible to many people because of their body size. So we talk about how you can advocate for yourself. And do we see any changes happening? Um And then also we talk about things that someone can do who are trying to mend the relationship with food and promote fertility. Are there things you can do without having to advocate for yourself at the doctor’s office? And so I’m really excited to get to this interview. 

Julie: But let me tell you a little bit about Judy. If you haven’t had a chance to read any of her work or work with her, Judy Simon is an award winning registered dietitian nutritionist who specializes in reproductive health. She is the founder of Mind Body Nutrition and a clinical instructor at the University of Washington. She has expertise in fertility PCOS eating disorders, weight, inclusive medicine, and reproductive health. Judy has held leadership roles in the American Society of Reproductive Medicine Nutrition Specialist interest group and is a fellow of the Academy of Nutrition and Dietetics. She integrates mindfulness, intuitive eating, and eating competence while taking a nonjudgmental inclusive down approach to help people have healthier more fertile lives. She’s the co founder of the Food for Fertility program and co-author of the upcoming book Getting to Baby: a food first fertility plan to improve your odds and short your time to pregnancy. And that is coming out this month, April 2024. All right. So we are going to get to my interview with Judy Simon after a quick sponsor break. 

Julie: Hey, Judy, how are you doing? 

Judy: Doing great. Um Looking out at the rain in Seattle today. 

Julie: Oh, it’s actually bright and sunny where I am in North Carolina, but I’m glad to see you. Um You and I connected at the Super Bowl for dieticians – FNCE – back in October. And you let me know about this book coming out. So I’m glad that we actually were able to like make this interview happen. And um you know, I’ve already introduced you to my audience um a few seconds ago, but I am curious what got you into ferti fertility nutrition because you and I both know like 20 years ago there weren’t dietitians in that space. If they were, they were not like, it just wasn’t a place that we were in a lot. So, yeah. What got you into fertility nutrition? 

Judy: Uh Well, thanks for inviting me and really, I think it goes back to um I’ve been a dietitian a long time, but I really went on my own fertility journey and I think that’s the way for a lot of us that work in PCOS. Uh not PCOS. And um I actually started my journey young and I just always assumed I would get pregnant and everything would be great. But, you know, a few years into it and I really didn’t know much about fertility. Like, you know, what are the percent chances that someone conceives on any given cycle when they’re ovulating? And, you know, I finally said to my doc, hey, what’s going on? And so, um it took me, I had unexplained infertility and I felt very alone, you know, as a person, not as a provider, but as a person, there were no support groups back then. Just before social media, I really didn’t have anyone except for a few of my friends that were like lactation specialists. You know what I mean? I, no, nobody really specialized in fertility and it was just starting to be a thing. So that was always part of my interest, my frustration. What could I eat? Was it OK to drink when you’re trying for years to get pregnant? I have to give up caffeine. I never knew because there wasn’t really much research and I always enjoyed prenatal preconception nutrition. You know, we, we were trained as dieticians how to help prepare women for pregnancy, but never really understood the fertility piece and really, um and, and I will have to say with a little bit of help, I did end up, you know, building a family of two. The first one was some help. And the second one, I don’t know, I moved to the Pacific Northwest and happened on its own, my bonus kid. 

Judy: But fast forward when I started my career career working at the University of Washington. I’m going to admit that 22 years ago, I had never heard of PCOS, never heard of it. So I started to see these women in the family medicine practice with a diagnosis of PCOS. And they were often in their twenties and they would talk about how when they went off the pill, which they went on to regulate their cycle. Um all these changes happened in their body, all these changes. So whether it was excess hair, craving food, gaining weight, despite not doing anything different. And I said, I, I have to figure out what this PCOS thing. So really, that was my entry. I went, you know, across the building. I met the reproductive endocrinologist and said, come teach all the dietitians what PCOS is. And I think a lot of folks don’t realize that whole connection with even insulin resistance, PCOS, didn’t happen until the nineties. You know, this came later on and this is like 2001. I was trying to figure it out and then came the fertility piece. These women with PCOS were really challenged when it came to fertility. So I just like jumped in, this was the, these were my people, this is my world. And um I, I really had to leave the nutrition world and go over to the reproductive endocrinology side and say, teach me, let, let’s let’s figure this out. And there were very few dietitians, you know, um this is before Instagram, there are very few dietitians out there, you know, working with women and, and how to optimize their fertility. 

Julie: Uh You know, we share so many similarities in our lived experience because I, I also have had my experiences with infertility and I, when I was in the zone of, you know, thinking always 40 weeks ahead, you know, I remember that’s what my, my brain was always doing when I was trying to get pregnant. Um how like the nutrition piece um I learned so much just trying to figure out how to like help promote fertility. But then as um I moved away from that season of my life, I have found, yeah, I have not kept up with it and it’s like, it’s amazing to see how medicine is so much different from even like 15 years ago. Um Yeah, the nutrition conversation is different. A lot of it is because of social media, like we just have access to dietitians more now. Um You know, as you were talking about the PCOS part, like how you connected with PCOS, I remember that’s how I think I learned. Your name was probably some email list serves because you were one of the few dietitians who was talking about PCOS and also was willing to, like, not just say, oh, weight is the cause of everything. Um, you know, when you find someone, especially when it comes to PCOS who talks like that, you have to cling to each other because we’re so few and far between. Um, so that, yeah, I think when we saw each other at FNCE and meeting in real life, it was like, yay, finally we’re meeting um because I do feel like I’ve known you for a long time even though, yeah, we’ve never met. But um that’s really helpful information to know like, yeah, like kind of how you got into where you are. And you know, I, one of the things that so many people talk to me about um with PCOS and, and then also folks who don’t have PCOS but are struggling with fertility. Um is like, how can they make sense of this conversation when they’re also trying to break up with dieting and something that I appreciate? I know you’ve presented on this and you’ve done a lot of advocacy in reproductive medicine circles on, hey, let’s not talk so much about the push for weight loss. What messages or what information comes to mind for you on like the I’m thinking like, what are the false truths that we’re learning about weight and health and uh fertility? And what can people do if they’re like, I can’t lose weight because I can’t focus on that because I’m trying to protect my recovery or something like that. 

Judy: Oh, this is my favorite thing to talk about Julie. So this, I, I’m so glad you bring this up. And, um, you know, in the beginning when I opened my private practice, fertility doctors would just send me, is, is it OK to use fat? The word fat and large bodies? What do you feel comfortable with? 

Julie: And I’m glad you’ve been bringing up. I think that’s great because I, we may have a listener who’s a longtime listener. We may have a listener who is new to the show. And um I tend to personally um use the word higher weight just in case someone’s never heard that. But I’m assuming by you saying that you’re using fat as a neutral descriptor instead of a disparage. 

Judy: I’ll use higher body, you know, um higher weight body. So those were the women who were always um referred to me like, and the doctors kind of thought, well, you know, they’re not ovulating whatever. Let’s just send them to Judy, the dietician and, you know, maybe they lose weight and that will help the cycle. And I really think, you know, 18-20 years ago, that was the push we saw because they looked at data and they saw like, oh, the higher BMIs are taking longer time to conceive, right? So then, you know, the thinking was, well, why don’t they just lose weight? And I mean, I, I’m gonna say in the early days I was part of ASRM and I would talk about the nutrition part and, you know, it was just throwing the spears at weight up. There’s, there’s a devil. Weight, weight, weight, weight. Um, but what we really found out about is, and I found out just from working with these women, one on one and then eventually in groups is um when I worked with them as individuals and really respected their autonomy and what things would they like to do? What did they want to explore? Um Were they interested in doing more movement? How could that be helpful? Were they interested in eating more produce and maybe choosing to um have more of a balanced meal, you know, that could help um with PCOS that they actually didn’t really have to lose weight to get pregnant that, you know, changing the focus to health. And that has been my mantra just for so long, you know, um because I, I see the changes and I see them on a regular basis. I have patients with higher weight numbers and some of the doctors write back to me and they go, I’m kind of shocked that she got pregnant and went on to have a wonderful pregnancy and a healthy child because I follow a lot of my patient too. Um So, you know, getting, getting back to your question. I I, I think that it’s a long time coming that in obstetrics and in the fertility world, we, we really have to knock out the weight bias. And there have been um more studies and I was really excited that there were two, what we call them abstracts presented at American Society of Reproductive Medicine. And one of them was a major tertiary hospital in Boston. And they looked at data for like over 12 years and if it’s OK to say BMI numbers just in reference to the study, the BMI is worth 30 to 60. OK. So wide range these this was in a tertiary hospital where they had access to really good anesthesia professionals, maternal fetal medicine, reproductive endocrinologist, all that. Well, they looked back at that data and they looked at um they compared based on did they have successful outcomes with IVF meaning live babies like births, because a lot of people can get pregnant but not have a like birth. And then they looked at how was the health of this child of the year, were these healthy babies? And guess what? There was no difference. So if we can provide the appropriate medical care which we should be have available for everyone, we would be able to um you know, help women wherever they are in their fertility needs because you know, infertility, it’s a disease, right? It’s not, you know, a chosen, you know, plastic surgery diagnosis like I’d like to get IVF. Usually if somebody’s getting IVF, it’s because there, there’s an issue that they, um, they can’t conceive, there’s a medical issue. 

Judy: So, um, I think that’s where, um, with a book and all, and the work I’ve done is I’ve really wanted to show that the focus on health and that’s a choice. I mean, people can eat any way they want. We all know people that, like, how the heck did they get pregnant? You know, we might think they smoke, they drink, their eating habits are poor and they conceive, you know, and age is a lot of different things of a lot of different factors. But I think, you know, advocating for our patients, um fertility can be a long journey and there’s a lot of waiting and they’re like, well, what can I do? You know, and we could, you know, offer them, hey, do you, you do you want to take a cooking class? Are you interested in taking a look? If you want to add things, if there’s changes you might wanna make or just check in? Sometimes you’re just getting the assurance that, you know, that looks pretty good. You’re getting a lot of the foods that are going to support fertility and, and getting that um feedback that like, oh, I am doing good things, which can be really empowering rather than thinking that you’re broken because that’s how a lot of people feel on a fertility journey. We feel like we’re broken. 

Julie: Yes. Yeah. Like you said, it was, it’s like this very time consuming kind of disease to have to try to manage. And then if you are blocked access, just because of how much space your body takes up to not even be able to access all those interventions. That’s what’s so heartbreaking and infuriating for me. Like especially since you and I have both experienced infertility and I’m assuming we both had access to what we needed or at least, you know, had doctors who were willing to see us because of our body size. Um Yeah, I get really angry thinking people can’t even get appointments with a reproductive endocrinologist sometimes because of their and you know, hearing that study, I’m so glad that you told us that study because I haven’t read that. And like, that’s such a great like tool to just, you know, scoot across the table to someone be like, make sure you check this out. But um what do you think it will take for it to become mainstream, like knowledge in reproductive circles that BMI is not, should not be like a reason to prevent access? 

Judy: And you know, ASRM is addressing it and they have, they have had some positions, 

Julie: let’s say what ASRM is 

Judy: American Society of Reproductive Medicine. And that is basically the umbrella organization for reproductive endocrinologists and people who work in the field, both in research and in clinical practice. Ok. And they do have like specialized interest groups. I’m in the nutrition one which is mostly doctors that are interested in nutrition, and a handful of dieticians and other folks and things like that. So, one thing about fertility clinics is they keep a lot of data, especially if a patient is. 

Judy: And I don’t know if your listeners are kind of familiar and let me step back as I can talk a little about what fertility treatments are, right? So who might, who might go to a fertility clinic? So if you’re under 35 and you’ve been trying to get pregnant for a year, um that is considered, you know, um you know, infertility. Um you know, you may want to go see your OBGYN or your primary care provider or even go into fertility doctor. Quite honestly, if you have a PCOS diagnosis, I wouldn’t wait a year. I would, I would go at six months. Why you already know you have PCOS, your cycles are all over the place, find out what your options are, you know, a lot earlier. Um But with age over 35 because egg quality really takes a dive after 35 and age is a big driver in fertility. Um That’s when we say six months. Ok. And a fertility work up is um you know, a standard work up of questions and both partners or it might be someone who’s single, there’s a lot of ways to build families. I’m not going to go into all that, but really looking at whoever is the, the gam eats, you know, the, the, the eggs and the sperm and checking out their health because it’s 40% female, 40% male. And then there’s that, you know, group of overlapping. Ok. So, um they collect a lot of data and, and, and sometimes, you know, it might be a lifestyle diagnosis where they could be recommendations sometimes very commonly, especially with women with PCOS, they may use something to stimulate their ovulation, like Letrozole or Clomid, they might have cycles that are um monitored, using ultrasound and you know, different ways to have to be, you know, um more likely to conceive. Um then there’s a inter uterine insemination where um um especially if there’s um male factor issues to improve um fertility rates and then there’s IVF, in vitro fertilization where um that’s where there’s a lot of data. So all the fertility clinics across the country, they have data, which is actually helpful because if you’re someone and you’re deciding that the IVF is offered as an option to help you with your infertility, your doctors can give you pretty odds based on a lot of factors because they have the data and they have the data from their lab, you know, clinic X and clinic Y may have different success rates, you know, all that. And then another thing that’s important to know, is about 22 states in the country have mandated um fertility um insurance and the rest don’t. And when you talk about weight, isn’t this interesting that the states that have mandates tend to have lower BM I cutoffs? So they put more exclusions, more exclusionary

Julie: not coincidental, Judy: not coincidental. And they do it in England where they have socialized medicine, they have to BMIs, so 65% of the clinics that participate in those are, you know, the data collection have a BMI threshold of 35 to 45 only one exceeded 50. And this is from the last year, but the most frequent reason. And I think your listeners really need to know this. It’s not because you have mean reproductive endocrinologist. I mean, yes, there is weight bias. It’s the anesthesia people because there is anesthesia used in the retrieval process. It’s in the retrieval process of removing the eggs from a woman’s ovary that have been stimulated. Um There is anesthesia. Um Many clinics are freestanding. They’re not in a hospital. So they have their own little surgical center and they probably have to bring in their a anesthesiology folks and they often have a cut off and most common in my community is 40. OK. So what they will say if you have a BMI over 40, they’ll say come back when your BMI is under 40 they might give you resources um in, in, in my particular area in the Pacific Northwest we have two tertiary. Um, well, one for sure, in Seattle, but in, in Oregon where they don’t have a number, they evaluate each woman on her individual health. And I’m good friends with a lot of fertility doctors. I’m like, hey, can you just tell me the difference based on body size? What’s the difference of someone with a BMI of 39 or BMI of 41. Why does it make a difference? Right. And so really, I should have a fertility doctor speaking, but I know enough about this to tell you that um some of it is the, the talent of your reproductive endocrinologist who’s going in there and they will say it depends on the woman’s body. Yeah, because it’s sometimes harder to get to the ovary. It takes longer to do the retrieval. But I also feel like if you’re going to a hospital or clinic that does these all the time, they’re going to be really good. Do you know what I mean? 

Julie: It’s more the skill of the doctor and probably the lack of training on diverse bodies and that’s part of it. 

Judy: And some of the clinics don’t even have tables that will hold women over 300 pounds. And when I’ve asked them about it, they go, you know, those are really expensive. I’m like, OK, let me tell you, this is a high flying field where they’re doing all the things to make their clinics look beautiful. They can afford it. I mean, so even if a woman had to have D and C after a miscarriage, she’s often sent somewhere else because the table isn’t large enough, which is really, to me, very weight biased and, you know, not patient. 

Julie:It is unacceptable. Yeah. And you know, the thing, I, I don’t, I’m sure this goes through your mind too. Anesthesiologist or the reproductive endocrinologist. They’re not wanting to, um, do these procedures on higher weight folks. But yet the, those same folks are told that they can easily get, um, gastric bypass. Yeah. 

Judy: And some people recommend it for fertility. They do. I mean, they’ve got a high BMI, 

Julie: every day we hear

Judy: I know patients, I’ve seen people who did it and their BMI still is in 40. It’s kind of like the people who walk in and, you know, if you lost some weight that might help you ovulate and they’re like, well, I already did lose weight. 

Julie: I know, but you never asked. 

Judy: I already lost weight. So, what are you saying? I did what you wanted me to and I’m still not pregnant. So the weight is not the answer. But I would say anesthesia is the biggest thing. So what I would do. So what I think patients need to advocate for, like, if they do a screening phone call and I, I have a slide that I use in one of my presentations with permission from the patient, someone on the phone and her BMI was 55 and they asked her what it was and the clinic told her we have nothing to offer you. Can you imagine? we have nothing to offer you. 

Julie: I’m thinking of expletives right now.

Judy: Horrible. I think about how that person feels when I have patients with BMIs that high who have healthy babies. It’s gotten help every day. It’s happening. Yeah. And so I think what I encourage people to do because your listeners are from all over the country. Possibly they’re global. I don’t know what’s going on, all the other countries. But I know that in the United States, um, I, I think what you really have to do is you, you have to advocate for yourself and if weight comes up to a barrier, like a stop gap, like, oh, you can’t have this procedure, you can’t have an IVF procedure. You need to say, ok, then where do I get this procedure? If you’re not able to, they, they should, to me it’s their job to be able to say, oh, you could go to this other clinic, you could go to a tertiary hospital. There are other places where you could be evaluated because, sadly, I had a woman wait recently and I’m telling you this wasn’t my idea, but she went on, you know, one of the new weight loss drugs, you know, to lose weight with PCOS. But her age was so high and I’m thinking one year is gonna affect the quality of her eggs. So, and it did and guess what? She got down to that weight and had two failed cycles. And now we’re looking at maybe a donor cycle for her. Well, I wish her doctor, maybe her doctor been upfront. I wasn’t in the room. So that’s a big issue for women, you know, is the weight, but they hardly ever bring it up with a male, you know, and you know what, you know, just the way nutrition can enhance female fertility, it can enhance male fertility. We have research. There’s this great study where the head guys eat a handful of nuts every day, eat whatever you normally eat, add a handful of nuts. 12 weeks, all the semen, all their sperm parameters were better. Now they did look at live birth outright, but their product was better. So if the product’s better, you got a better chance of fertility. Well, how easy is that? You know? So, you know, and, and so so much goes on the woman and I, I hope you have male listeners too, but I’m just saying even if it’s a male factor issue and they’re preparing for IVF, it’s always so much pressure is put on women. 

Judy: And so that’s where um I have to share with you though that I was on a panel on weight inclusivity and we had a fertility doctor, a psychologist, and myself and I specifically spoke to weight inclusive approaches to fertility. And people are listening. And I know the division had at the university hospital that I work with. She spoke at um kind of a social determinant panels of health of like, how are we denying access? And she is the biggest advocate on weight. And we decided hopefully next year, we’re gonna do a grand round to all our OBs because they need to hear it is OBs before, you know, because I know what we’re doing in our fertility clinic is good and ethical. This is an ethics issue. It is here. It is an ethics issue. Would we deny cancer treatment for someone because they were too, too big. No, we would give them treatment. Why aren’t we? And it really, it comes down to anesthesia and access to care and most states have a lot of legislation right now and I hope it’s gonna be mandated because you may know fertility coverage is very expensive. And I feel like the people who have the coverage are the people who have high salaries, not the people who actually need it. 

Julie: So then when people are denied it and they already have so many hoops to jump through. It just is, it just angers me so much. I know it does for you too. And you know, from what I’m hearing you say too, it’s like age is really the bigger factor than weight. But yet people are, um, going through IVF, older and older, you know, they’re, they’re considered ok to take the risk with why, why not with people in higher weight bodies. 

Judy: Julie, I want to share one more study really quickly. They have had a couple of studies where they did these very intensive 12 week kind of weight loss programs to get these women ready for IVF. And they said our goal is you’re gonna lose 5% in 12 weeks. Ok. I’m sorry, this was like prepackage food, low calorie diets. And they even gave them that horrible drug that blocks fat absorption. I mean, they, they threw it all at these women in 12 weeks, right? And the other group, they said just go ahead and go through IVF. Well, they did not improve their outcomes, losing weight. In fact, their outcomes were poor. And if you think about it, those eggs were three months older. So for someone who’s over 40 or late thirties, maybe they lost an opportunity to have a healthier cycle. So I think my, my whole philosophy is focusing on health and in a positive way. And I also train residents and I speak at the fertility um meetings a lot about disordered eating and that, that comes in all sizes. And I really advocate for women to demand a health at every size approach or weight centric, you know, weight inclusive approach for their care. And I’ve had women put it in their charts and they’re doing it all the way through obstetric care and you know what they’re going along with it, they’re going along with it. And some of them, like I had no idea. You don’t want to be weighed. When you’re pregnant, we can take that off. We can, you know, we, we can do that and that. 

Julie: Yeah, when people do that, um, it really does help the next person down the line. It does and I tell them that, yeah, and everybody who’s in a straight size body, a thinner body, you know, doing that kind of stuff, it does help. Um, so, you know, for people who are experiencing that kind of, um, discrimination to not have to speak up, you know, when they’re experiencing that, I think is a good way, we can, I can all work together and, oh my gosh, I want to keep asking about that, but we need to move on to because I know we could talk forever about food too. But, but it’s such an important issue. It’s very important and, and I really appreciate, oh, this is the thing I was going to mention to you because you were talking about that study that like for 12 weeks, you know, preparing people for uh pregnancy and, and weight loss and like what even about like the diet itself, how that is not a great idea when you’re trying to conceive or right before you’re conceiving. Like that is something that has always been contraindicated. I remember teaching the lifespan class and nutrition like it was. Yeah, you don’t, you don’t wanna diet right before you trying to get pregnant. 

Judy: Like I don’t want to deny your future baby food. Right. And, uh, there was a study, an obstetric study that came out a year ago and I just did a little write up for the women’s health group that um uh women like what you eat at the time of conception can actually be a bonus to reduce adverse outcomes of pregnancy aka gestational diabetes. I have so many women. They are already scared before they get pregnant that they’re gonna have gestational diabetes, which I tell them not to be scared of because we can treat you. And I said, well, if you like walking, take a walk every day and eat balanced food, you know what I mean? Eat, eat well, nourish yourself. Well, that’s the only thing that you have in your power to do and let you, I, I’m a big advocate of let you OB know, remind them if you have PCOS and ask them to screen earlier and I work with my patients earlier and if I think they need a glucometer I’m like, let’s just check, you know, once in a while, we find type two diabetes first trimester, which is often missed in some of the higher risk people. 

Julie: So Yeah, what you eat? So why would you want to put someone on a diet and then thinking about long term, then people will um, I can see how like the medical community could assume that um it was the higher weight and not the diet causing the harm or the problem. So, but ok, so one thing I wanted to mention um with your book, which, what is the name of your book again? 

Judy: Getting to Baby

Julie: Getting to Baby. So, and did you co author it or did you did it yourself? 

Judy: Oh, gosh, actually I’m gonna say I’m the second author because Angela Thyer, who’s a reproductive endocrinologist, OB and even lifestyle medicine. And she’s a certified chef too. She loves food. She’s a foodie. Um We’ve worked together for like 20 years and I have seen so many of her patients and we started teaching the Food for Fertility classes together. I mean, I ran them in the beginning and she joined in. So she was really the primary author. She loves to write. It would not be done yet, if I was a primary author, I don’t know how you would write. I don’t, I don’t, I, I can’t, you know, but we gave, I gave up a lot of weekends of my life and I want them back. So now I’m, you know, it, it’s a lot of work to do a book. I can see why um, a lot of people put it off and just do their social media YouTubes because they can just talk and get the information off it. But we, we, we did, you know, we really wanted a book because so often I’d be at a conference and people say, oh, you just get that talk on nutrition. Is there like a great book for a resource for my patients? And that’s what we wanted to build. So you have to remember we had to think about everybody of every size. Mhm. Cultural differences. Um We, you know what resources we wanted to make all food affordable, budget friendly, not too hard to cook, doesn’t have to be organic. You know, we really wanted to be realistic. We want to be global. We want to be inclusive. And I mean, one of the stories in our book is someone who really had well, more than one had eating disorder but in a smaller body and nobody caught it. I mean, not a small bread, well, smaller than some of the other women, but at the sunset, she was really a restrictive eater and none of her doctors, it just said, oh, you have really poor egg quality. Well, yeah, you don’t eat. It’s not gonna help nourish your eggs, you know. So I wanted to bring out a story like that, but we really include at stories from over the year of women who had been in our classes. And um you know, PCOS is the number one reason a woman goes to a fertility clinic. So a large number of the women, I mean, some were diminished ovarian reserve, endometriosis, male factor issues. A lot of um reasons that um you know, unknown. Um but a lot of women with PCOS. Yeah. 

Julie: Yeah. And that’s why I’m so glad that your book is out there. There are so few options, especially if you’re willing to like not push weight loss. And um you know, I know you and I talked about this uh over email before, but when I was like reviewing your book, which I’ve read a lot of it and just not all the side of being totally transparent to listener. I’m like, thank you, catch up eventually and finish it. Um But yeah, so thank you for sending me a review option. And, you know, listeners on the podcast know that I talk a lot about like adding foods instead of taking away and, and a lot of that is because of recovering from a diet culture, recovering from the eating disorder. And um some of the things that you talk about in the book are adding certain things but also taking away certain foods. And so if a listener is like, I wanna promote fertility, but I can’t focus on removing um a certain food that maybe suggested in the book. Is there something you have found that can help that person to promote fertility without like abstaining from anything and 

Judy: Really you know, Julie to be totally transparent when it comes to nutrition and fertility studies, they’re really hard to. Right. We have a lot of these are prospective studies. You know, we follow the nurses how people tell us what they ate. You know, they’re not randomized control trials. So, you know, remember during pregnancy you can’t, you can’t. So we really tried to, you know, marry evidence-based research. So we’re not making stuff up and the experiences that we’ve had the last 20 years. I mean, I listen to women maybe six women a day and what they’re eating and I see their journey and so I think what we really wanted to, to bring out was you don’t have to be a vegetarian, believe me, I am not. Um but making sure you’re including plant food and I like to call that because otherwise people get hung up on vegetarian words. Um and in asking them to try things and that’s what we did in our classes, try beans and lentils. See if you like them, you want nature’s inositols, that’s where you’re gonna get them from right through insulin signaling. They come from buckwheat from soba noodles. We are really a food first plan and we wanted to be able to answer those questions like, what are those foods? Yeah. Try to have soy. If you don’t like soy, don’t eat it. That’s ok. So like we kind of felt like if you went through the book and you found a couple of chapters, spoke to you like, oh, you know what? I had no idea that eating fish two or three times a week. I haven’t eaten fish since I’m a kid. Maybe I’ll try salmon, maybe I’ll try shrimp. You know, just because there have been multiple studies that have seen a shorter time to conception when couples consume fish. Probably omega threes, probably they’re eating less saturated fat. But we really didn’t want the book to be dogmatic because I don’t think we have all the answers. We don’t have all the answers. So like even, you know, I’ll say, and, and um when we, we did like the chapter about protein and animal proteins, we, we really wanted people to understand and, and you brought a, a good question with me about this Julie, you know, with like PCOS, the people like eat your protein, get your 20 to 30 g of protein, get protein. And so we have like a lot of little charts to show people, short charts. We don’t wanna overdo it that there’s protein in all your whole grains, there’s protein in your quinoa, there’s protein in your beans, there’s a lot of protein in your tofu that you don’t have to get it all from animal products and that if you want to try and see how does my body feel on, you know, having a day, a meal that I don’t have meat. How does it feel or, you know, maybe I’ll try a smaller portion of beef. I, you know, if you love beef, maybe I have less, but I’ll make sure you have vegetables with it. I mean, I’ve had patients that they go Judy, the thing that helped me is I keep bags of frozen vegetables and then with what I eat, I add some veggies to my lunch and dinner. I feel so much better and they saw their cycles regulate, they had more vegetables, they had more antioxidants. 

Judy: So I am totally on the addition, but we did want to offer people. Here’s what we know and that there have been some studies, especially in some of the male studies. Um that um if you ate more, let’s say, you know, deli meats, and processed foods, and ultra processed foods, they’re not gonna be as nutrient dense and you may um you may not have the same benefits is, is kind of what you want to be, because believe me, we’ve rewritten this book about three times, you know, and probably no writing like you turn it in your manuscript and then you rewrite the whole book and you have a lot of people read it. So we really do and, and really what we’re trying to talk about in the podcast too and we talk about the book is take out of it, what speaks to you and resonates with you and we always wanted to be, we want the food to taste good, which is why I put in all the culinary tips. We wanted to put in culinary um cuisine tips and, and something I was saying in another podcast was, I live in the Pacific Northwest and probably half of my patients are Asian, either South Asian or Asian. So when I do all these cooking classes and you talk about roasting vegetables and then they text me like, I’ve never turned my oven on. I only cook on the stovetop. So now I have a cooking pop up coming up. I make sure I put in the directions that here’s the equipment that you will need. Reach out to me if you need help with that, if we need to modify how you do that recipe, because if you only cook with a wok or you cook um South Asian food, you’re doing stovetop. So we wanted to really be global because all global cuisines are fertility promoting, especially when you get down to the roots, what they really have, whether you live in the South or you live in the Pacific Northwest or you’re from Cincinnati. There are roots in your food that can really be promoting and you don’t have to give up your favorite food. We want the food to taste good. And that’s why I love the stories in the book where people like I never tried quinoa. I really like it. It’s easy to make. It’s a, it’s faster than cooking pasta. You know what I mean? So, really? So we wanna expose people to different things and so no, no shame. I mean, we don’t want any shame if they’re like, there’s no way of eating beans, if no way of eating beans, you know, it, it’s kind of funny. One person goes Judy, I just hate the texture of beans. And I, and I go, do you like soup? Do you just love soups? So she pureed the beans and put them in her soup. She goes, I don’t even know they’re in there and getting all that soluble fiber, which is so good when you’re talking about gut health and PCOS and you know, lower glycemic index. 

Julie: Yeah. A lot of people with PCOS will tell me that they feel a difference of adding fiber in and you know, from what you’re saying, what I’m hearing is like, you can still use your body to let you know what direction to go that you can still focus on recovery. And you know, the the I’m also glad you highlighted kind of what we may always lack in fertility nutrition is long term research. And because there’s definitely like just general diet research, you know, short term dieting of any kind seems to help improve egg quality. But like um those are just like four or six week long research studies which I’m like, who, who cares about that really? But if you are trying to get pregnant. I would appreciate. Some people are like, that’s all I need. I just want to get pregnant. Um, but then to have informed consent that long term that could make it worse. Um, it could also make your recovery worse. Um, and so

Judy: and, and that’s a really good point and quite honestly, um, I screen every patient that I see for eating disorders, of course. And quite often sometimes they have no idea that they have an eating disorder. 

Julie: Dieting is so normal, right? Not a normal body. 

Judy: I mean, a typical patient for me, Julie is someone who comes to see me for fertility nutrition. They have one embryo left and for your listeners, that means, you know, they’re really hard to make an embryo when you’re older and you don’t have that many eggs. Um It’s, it’s not a very productive process. You lose a lot on the way and they tell me that for their last cycle, I don’t think I worked hard enough. I gave up gluten, dairy and soy, and maybe I didn’t give up enough and I’m like, oh my gosh, um let’s talk about this, let’s talk about all those foods are actually nourishing. So I find out what they like and how to nourish them with the foods that they like. And I’m sorry, but the restrictors, they have no idea how much they’re restricting and that, that nutrition the last place that trickles down this to your reproductive access doesn’t matter what you weigh on the scale if you are restricting yourself and you, I’m sorry. But if you’re on keto and stuff and you’re not giving yourself grains and nutrition, you are denying your body nutrition that it needs. So, II I think of myself as a liberator like no, you and, and people are just so surprised you really want me to eat that much more. 

Judy: I’m, I’m seeing someone today who said I could share her story. She’s 17 weeks pregnant. I worked with her last summer and she was so undernourished. I saw her once. I never saw her again. She just didn’t follow up and then I just get this email like, hey, I’m past the nausea in pregnancy, I did everything you said, I ate more. I let my body eat. I got pregnant on my own. I hear the story so that so much. 

Julie: Oh my gosh. I just wish that would happen to everyone. So they didn’t have to worry about jumping through all those hoops that we were talking came out earlier, experiencing all that discrimination and I have a million more questions for you, but we need to wrap up. So maybe it just had to be enough time. Um Thank you when your next book comes out or the next, the next edition. But you know, um if someone wants to find out more about you or wants to order the book, where should they go? 

Judy: Well, I’m excited that our book Getting to Baby is available from for preorder. It’s out on the shelves, April 9th, any major bookseller we have a website gettingtobabybook.com, which I’ll share with Julie for show notes. Um You can follow me on Instagram at Fertile Nutrition. Um and I have a Facebook page and all that good stuff. Um But yes, we’re hoping to really promote this book as a really accessible look free from diet culture, just kind of, here’s the facts, here’s some ideas, see what resonates with you. And if you get a couple ideas, it might really help you in your fertility journey. And we do say when to see a dietician for more individualized care, when to work with um a physician in there. Yeah, because we don’t want you to go on this journey forever. And uh you know, find, I don’t know if your tubes are blocked. You know, you, you need to work with a team and I’m nervous about nutritionists and influencers who are saying I can help get you pregnant. Oh, I never promised that you, you have to have the whole team to be able to help you because there’s so many things that impact your fertility. 

Julie: Oh, I’m so glad that you um wrote this book and I’m excited to hear how it goes and you know, see how this helps to advocate for folks to have more access. So, so thank you and thank you for your time today. 

Judy: Thanks, Julie. It’s been a joy. 

Julie: So there you have it. I hope you enjoyed my interview with Judy Simon. All of the links that we talked about are below in the show notes are also on my website, julieduffydillon.com/podcasts. 

Julie: Before I go. If you have just maybe three seconds, would you be willing to leave a five star review in Apple podcast, Spotify or whatever, whatever app you’re listening to this doing that really helps more people find this podcast. And I don’t know if you realize this, I have a feeling you do, but there are 42 bazillion podcasts now and so many of them are not independently run. 

Julie: And so people like me, we, I don’t know, people aren’t finding our show as easily as they used to. I’ve been doing this since January 2016. And um yeah, I’m finding it’s harder for people to find the show. So if you leave a five star review that helps just bump it up as people are looking for shows about mending their complicated relationship with food. So thank you in advance for doing that. And I look forward to connecting with you in just two weeks until then take care.

Julie: Thank you for listening. I am Julie Duffy Dillon, and this is the Find your Food Voice podcast. Ready to join the anti diet movement and take the food voice pledge? Go to julieduffydillon.com and sign your name to the growing list of people saying no to diets and yes to their own food voice. The Find Your Food Voice podcast is produced by me, Julie Duffy Dillon, and my team of kick ass folks. I couldn’t make the show without Yeli Cruz, Assistant Producer and Resident Book Fiend. And Coleen Bremner, Customer Service Coordinator and professional Hype Master. Audio editing is from Toby Lyles at 24 Sound. Music is Fly Free by Hartley. Are you looking for episode transcripts? Get them at julieduffydillon.com, where you can also submit letters for the podcast, give us feedback, and sign the Food Voice pledge. We need your voice to end diet culture. We literally can’t do this without you. Subscribe to the Find Your Food Voice podcast to get weekly inspiration and education on how we can defeat diet culture and reclaim our own food voice. I look forward to seeing you here next week for another episode of the Find Your Food Voice podcast. Take care.