Septmber 26th, 2022

I received this email recently from a colleague who was ok with me sharing it de-identified:

Hello Chris,

I hope you and your family are doing well and have enjoyed your summer. I am in the process of revamping some of the integrative Wellness Nurse education sessions we provide for our patients. One of them is on nutrition and while providing the lessons I have been challenged by a dietician here at XXXXX about “shaming “ people and proper terminology, what to talk about , what not etc. I was wondering if your wife would have any time to answer a couple of my questions and or look at a power point. I could even look into paying her for her time.

Some of the topics are :
• Taking out addressing sugar in our sessions
• Not calling any food bad (“all food is food” )
• Topic of Go foods(healthy) , slow foods Whoa (unhealthy) foods
• Understanding labels (reading labels may cause or add to eating problems)

My response:

Between you and I, I am very disturbed by this trend in normalizing food quality across the board. Food shaming a person directly is not ok. Obese shaming is not ok. Shaming in general is not ok.

However, To say a broccoli is the same as a donut is tantamount to child abuse slowly by a thousand cuts and goes against our Hippocratic oath of doing no harm as well as going against every ounce of science that exists.

To not address excess sugar consumption as a risk factor for so many diseases is like avoiding discussing cigarettes due to shaming the smoker. This would amount to a resurgence of smoker related death. It is all about the way in which the topic is discussed. We teach. We do not shame. Education is not shaming.

Are we next not allowed to teach about excess screen time, not exercising or drug use or other healthy tips because a person could feel shame?

The topics listed below are not science based. They are social constructs to normalize a social belief that will hurt the person over time through disease and mental health.

Nicole and I would not want to enter these waters as they are not science based or coming from a place of love for the child. I love my patients so much that we have hard and loving conversations about what it is to be healthy in today's world.


This is exactly my concern as well. Although you are so much well spoken (written ) . When the dietician saw what we are doing she basically shamed me that I was part of the problem by addressing things as “healthy” foods stating that this made someone feel inadequate or bad if they did not eat these foods.
She wants to take out using health and unhealthy in terms, not address sugar content in foods or label reading as it may 1. Shame a person, 2. Cause a person prone to eating disorders to become bulimic or anorexia etc.

I will stand my ground but wanted to make sure I am correct in what I am thinking, be trauma informed in my ways and always be evidence based. The tendency is to address an issue with extremes and I feel this is one where we are so concerned with making someone feel uncomfortable that we actually are adding to the very thing we are trying to address – whole person wellbeing."


For me

What a mess for the children at large. Food is not neutral no more than diesel gas is the same as 97% octane gas. There are foods that promote adequate and optimal physiology and those that worsen it.

Shaming is not OK - It only develops a power gradient between two humans which never ends in harmony. This is not the same as teaching an understanding of the fundamentals of physiology and disease genesis. The exact thing which food neutrality aims to do will worsen the underlying physiological mechanisms driving mood and health.

I for one will not be a part of this Anti-Hippocratic Oath push in the name of being trauma informed. Pediatricians are at the forefront of trauma understandings as much as we are at the forefront of disease genesis. The whole child deserves love from the mental side to the nutrition side to all sides. Neutrality in this context is a false premise that leads to disease.


At least we see some positive coverage on the state of US food. From Allison Aubrey via NPR we see the following:

1) Treat food as medicine
2) Focus on quality of calories
3) Expand access to dietary and lifestyle counseling
4) Support food entrepreneurs
5) Increase the number of new farmers growing healthy foods using regenerative farming techniques
6) Make school lunch free for all children ( I would add that the current form needs a dramatic tune up to reflect 1 and 2)

The battle rages on. Do we teach or do we bury our heads as the above person would have it be?

Dr. M