When The Pregnancy App Talks About "Belly-Only Weight Gain," We Have Work To Do.

How you feel about your body does not exist in a vacuum. It’s not just about your body, it’s about all the things in your life. So I ask people to really reflect on how size-friendly is their life? Welcome to Burnt Toast! This is the podcast where we talk about diet culture, fatphobia, parenting, and health. Today I am chatting with Mia O’Malley, a content creator on Instagram and the creator of @plussizebabywearing. Mia’s work sits at the intersection of fat advocacy and momfluencing. She’s doing a lot of important work on access to fat friendly doctors and we also talk about influencing—and the potential and promise for fat advocacy in the space. PS. Friends! The Burnt Toast Giving Circle is up to almost $8,000! We are so close to our goal. And if you’ve been thinking about joining, we still need you! Here’s the Burnt Toast episode where I announced it, ICYMI, and the link to donate.Episode 36 TranscriptVirginiaHi Mia! Can you tell listeners a little bit about you and your family and your work?MiaHi, I’m Mia. I am @MiaOMalley on Instagram and @plussizebabywearing on Instagram and TikTok. I’m a content creator. I’m based out of Connecticut. I’m a mom of an almost four year old and I do a lot of work on my social platforms on advocating for people in larger bodies and sharing resources for people in larger bodies and how to navigate the world. I’m a babywearing educator, as well, with a focus on celebrating parenting in larger bodies.VirginiaSara Peterson was on the podcast recently and we sang your praises on the babywearing piece in particular. That was something I struggled with, with both of my babies. The bias against fat bodies, fat moms— all of that came into play for me. So I’m grateful for the work you’re doing to change that conversation. As I was doing my homework for this episode, I read your interview on Cup of Jo—which has great fashion inspiration—and I love that you said you look at fashion as an advocacy issue. Was this always your plan? How did this come about?MiaI was pregnant with my son around 2017-2018 and I felt very isolated as a fat pregnant person. I had taken these beautiful maternity photos. But when I shared them, I was like, “This isn’t the whole story.” Because those photos were really hard for me to take. I couldn’t find anyone who looked like me who had done maternity photos. Like for inspiration, if you looked on Pinterest, there were no bodies like mine. And that’s how I felt going through all of my pregnancy. I never saw people in similar bodies being pregnant. I felt very underrepresented and isolated. So when I posted my maternity photos, I kind of said that quiet part out loud. I said, “I feel invisible as a plus-sized pregnant person.” And my world kind of opened up with that post, just in the sense that I kept saying those things that I kept to myself. I realized that there are other people like me who are feeling the same way. To be in community with those other people is amazing. It made me realize that the fat experience is so, so shared. We’re all going through a lot of the same things, across generations. And fashion is just another one of those issues. I can’t talk about fashion without seeing it as an advocacy issue. There are people who can’t find winter coats! There are people who literally don’t have a bra that fits them at their size. It doesn’t exist. I talked to someone who was a C-suite executive and she has nothing to wear to meetings with her colleagues! She had no suits that fit her. She talked about just how humiliating that was for her. When we say those quiet things out loud, they become advocacy issues because so many people have that shared story. So yeah, I talk about fashion, but it often becomes about sharing resources because there’s so many people that feel like certain things are inaccessible for them—and are truly inaccessible for them. The same thing goes for babywearing. So many parents said to me, “I didn’t even think I could wear my baby at this size.” And that’s not true! There are plenty of options for all bodies to wear their babies. But there’s a perception that this is an inaccessible thing to do because of marketing, because the lack of representation. VirginiaWas it scary to start sharing? Because I think a lot about how what advocacy asks of us is to share in this very personal way. It’s so important because you’re articulating something that someone else hasn’t been able to say out loud, but that also means you’re the person who has to say it out loud. MiaI have to take really long breaks from some of the work that I do. I will take a week or two long break where I don’t post content and I step away, because I hold so many people’s stories. Most of my time spent online is in DMs, sharing stories and resources. But that comes a lot with having to face my own experiences that were hard. It’s a lot to hold on to. So I do take a lot of breaks and I do experience burn out, but I also find it incredibly rewarding. It’s the part of this work that I love the most.VirginiaI’m glad you have that strategy. It has taken me a long time to figure out that I also need those breaks and need to build in that time. Previously my experience as a writer / advocate was as “medical mom,” and a sort of similar thing happens where once you’ve been public about your experiences, people send you their stories and those stories are often tragic and linked to my own trauma. I can imagine there’s a similar thing here where people are sharing with you traumatic experiences that you have also lived. MiaThat’s why I’m so passionate about resources. Some people will ask, “What’s your advice for feeling better about your body?” And there are so many strategies and there are people who do this professionally. But I tell people that how you feel about your body does not exist in a vacuum. It’s not just about your body, it’s about all the things in your life. And so I ask people to really reflect on how size-friendly their life is. How comfortable are you in your body on the day-to-day? Is your work chair comfortable? Is your partner supportive of you? Is your car comfortable? Do you have a winter coat to wear? What is your workspace like? How comfortable is your bed? Is your couch comfortable? You know, all these things. It’s about the world that we operate in and how comfortable we are in the body that we’re in right now. That really influences how positively we can feel about our body. It’s just not about how positively we feel about our thighs or our belly. It’s much bigger. VirginiaDiet culture teaches us that weight is this personal responsibility project. And we know that’s b******t. But often, the next part of the conversation is that loving yourself is a personal responsibility project. And that’s also b******t, in a world that’s not built to support your body. Instead of saying, “How do you do this internal work?” which may or may not need to happen at some point, it’s “How do you recognize how the larger systems of your life are failing to support you?” MiaYeah, it has to be looked at that way. And we can’t discount how chronic discomfort and chronic pain influence how we feel about our bodies. Sometimes there are small changes that can make you physically comfortable. But a lot of us who exist in larger bodies are so disconnected from our actual bodies that we can’t even tap into that. VirginiaSo I recently wrote about this big debate that comes up every so often about whether to get weighed or not at the doctor’s office, and if you do want to decline it how to decline and I think it’s an important conversation. If you have a fat friendly doctor, it basically becomes moot because even if you get on the scale, they’re not going to use that number against you. If you don’t have a fat friendly doctor and you’re fat, your weight will be weaponized whether or not you get on the scale. So you have been doing the hero’s work of building this database of fat-friendly health care providers. So tell us about this project.MiaI would love to, but first I do want to shout out Jen McLellan from Plus Size Birth. She’s @PlusMommy on Instagram. Literally, her work changed my life as a pregnant person. She wrote the book on plus sized pregnancy. Her resources on plus size birth are so critical. And she does a lot of work training other medical professionals on how to be more size friendly. I just want to shout out Jen, who I’m proud to say is my friend. She has a directory for for doulas, OBGYN, and midwives on her page. There’s another colleague of mine, Nicola Salmon, who runs Fat Positive Fertility. She also has a book and resources on fertility services for people who exist in larger bodies and how to support yourself as you’re navigating how to conceive in a larger body, which is incredibly fatphobic and very hard to do. She also has a directory! So I want to shout out those two resources. Obviously, there are other directories that exist, but my community is a very interactive community for Instagram. We share a lot of recs and I couldn’t get around not sharing recommendations for health care providers. People need size-friendly care providers. I don’t know that a lot of people understand how critical it is to connect with a medical professional that does not operate with a weight bias or weight discrimination. It’s a literal life or death issue. So I have a sheet—a Google Doc, basically—of providers that have been recommended to me that I’m pulling together into a more formal database as we speak, actually. But right now, it’s a Google sheet of shared recommendations. Having a size-friendly care provider means that you have people who are going to see a doctor more. A lot of preventative care can happen there. It also can mean a vastly different experience in your pregnancy, your birth, your postpartum. I have spoken to countless people who have been trying to conceive for years and have been told to freeze their eggs and seek weight loss surgery first. I have talked to people who have been unable to have doulas at their birth because of a high risk determination that was not evidence-based, because they are with a non size friendly care provider. I’ve talked to people who have serious issues, life or death issues, that were ignored for years because everything was so focused on weight. This is such a critical resource for people in larger bodies to have. Just to be able to do that work is the most important thing to me, out of all the things that I spend my days doing. VirginiaWe will definitely link to the size friendly care provider list. You also have a form for people who want to submit their providers. MiaYes, I hope that there’s going to be more of a universal database. Also Jen is focused on the training, and I think that’s something that needs to be talked about more. As well as the sharing of these gems of care providers that are somehow treating us with dignity and giving us medical care that we need. I was four months postpartum and I had decided to go to my PCP at the time. I had horrible, painful water retention and my legs were swollen. It was hard to move my legs. It was hard to sit down. She barely looked at my legs, she was focused on the fact that I had gained weight after my pregnancy. She really dismissed me. It was because of my community that six months later, I went back and I demanded that I get a water pill. Within like a week after that, my swelling was gone. I’m not directing anyone to go get a water pill, but I am directing them to advocate for themselves if they feel they’ve been dismissed. And immediately.VirginiaThat’s six months you were in pain.MiaI was in so much pain! Immediately, you have to seek out those other care providers. Those care providers that will treat you well and will listen to you, they do exist. You have to decide that you want this for yourself. If your insurance allows for it, if you’re able to make that change, please make that change. Because those care providers do exist.VirginiaI’m so glad Jen is working on the training piece because it seems like we haven’t even yet agreed upon the standards that you should have to meet to be a weight inclusive provider. What I was seeing come up in a lot of my DMs were people saying like, “Well, I don’t know if this person is really Health at Every Size, but at least they didn’t give me a hard time about X.” The bar is way too low about what we’re willing to accept. We need more of a consensus about what this really should look like and what you should be able to demand. I think fat people are just so used to expecting nothing—or worse than nothing—that it can be hard to even know where to start advocating for yourself. MiaIt also becomes really tricky, because fatness is a spectrum, right? So, someone who goes in at a certain weight might be treated one way. Someone who is 30 pounds over that weight might be treated vastly different and categorized completely different. Then you have further intersections of that—if you are BIPOC, if you are of the LGBTQI+ community—those intersections would make one healthcare provider considered size friendly by one person be completely different with another. So it does get tricky. I would always tell people to call first. Or if you don’t feel comfortable calling, maybe have a friend or a partner come with you or advocate for you. Or you can go in and and talk to the front desk and just say these are the things that I’m looking for. Or you can email, whatever. Somehow to just start the conversation and go in advocating for yourself and be ready to advocate for yourself because even with these directories, you never know what the experience is going to be like and you have to be prepared to advocate for yourself.VirginiaShilo George, who is a wonderful advocate on these issues, I interviewed them for a Health.com piece last year, and a strategy they have is writing up a one sheet of your primary health concerns and stating some of your boundaries. Just being clear about what you need from the provider. I think that can feel very scary and people are worried that they’re going to make the doctor angry or start off on the wrong foot. That tool may not be for everybody, but I just want to throw it out as another suggestion. I think there are ways to do it that can be really empowering and very helpful.MiaYeah, it could be good. It could be a gentle hand. There’s a lot of different ways to do it. Ragen Chastain, on Instagram, has amazing resources and a course that you can take and a lot of free resources, and has been doing this work for so long—discussing medical fatphobia and how to advocate for yourself. VirginiaI do think it’s worth thinking through what strategy feels comfortable to you. Maybe you want to write down that sheet and it’s not something you hand to the doctor but it just helps you organize your own thoughts. That could be a useful tool. MiaI just want people to know that if you are in a larger body, you deserve to be treated with respect in a doctor’s office. Shame is not a an effective tool. If you don’t want to talk about weight, you do not have to talk about weight. I want more people to realize that that’s even a thing, because there was a time in my life where I didn’t realize that was a thing.VirginiaI’m curious, for someone who’s doing the work and doing the work in a fat body, how do you think about your work as an influencer? What do you love about it? What do you want to see change?MiaThat is such a good question. I don’t know where the industry is going, but I do know that the representation has gotten much better since I started doing this in 2017. As more body positive influencers become parents, it’s changing the momfluencer world to be a little more inclusive. But I think that some of the strongholds in mommy brands and parenting brands need to also change with that. I’m not necessarily seeing that change in terms of choosing parents that are in different bodies or represent different communities. I think they could be doing more to use different bodies in marketing. Why am I not seeing more bodies that represent the average? When you go on Pinterest, and you’re looking for maternity outfits for your photoshoot, or you’re downloading an app for your pregnancy and the first thing it talks about is “belly only weight gain”— is that influence really happening? Is it influencing the spaces that it really needs to to change how people feel about their parenthood? VirginiaIt’s making me think about when we do see influencers in bigger bodies doing a campaign with a brand, it’s often because the brand has decided they want to brand themselves as body positive, right? We’re not yet at the point where body diversity is a given, and you would just be the influencer selling this brand of cute diapers because you had the platform and the metrics they wanted. You’d be selling cute diapers because they went about running a body positive campaign this one month and that’s it. That kind of thing is coopting the rhetoric of the movement rather than furthering the movement.MiaThis is such a pain point for me, too, because there are so many brands that will do a campaign about plus size clothes that they have, right? They will work with plus size influencers to market that campaign and use the budget to market that campaign for those clothes. And you walk into the store, you can’t buy those clothes.VirginiaRight. They’re not stocked.MiaSo, they’re using these campaigns to look good as a brand and you’re not actually given the access that everyday people can use to make their, their lives easier. Old Navy was one of these! They’ve changed. I forgot what they called their campaign, but they’re now have all sizes in stores except for size 30. That one is that one’s online.VirginiaSo close, Old Navy! Almost there.MiaBut for so long, they excluded plus size from coupons. They excluded plus size from stores. Not to make it about Old Navy, but they have such a huge customer base that’s plus size and they actually were excluding us from so many different things, yet doing campaign work with plus size influencers. The same thing happens within the momfluencer space with brands. I think there are brands that are doing great things, especially in the babywearing community. But some of the very popular websites and apps and things for pregnancy where pregnant people really need to see themselves represented to feel good in their bodies and to feel good going through this special time. We need to see more.VirginiaAubrey Gordon had a great tweet recently where she said when brands do that kind of thing, they’re really using plus size people as cover to make their thin customers feel better. This is a brand that’s trying to be inclusive without having done the work of talking to fat customers, of making things that that customers need. I think it’s important for all of us with any degree of thin privilege to think about. We might feel good that Anthropologie is carrying our size now, but who are they not serving? How much further do they need to go? And how do we hold them accountable? MiaWho’s not at the table with me? That’s something that I’m asking myself a lot, as I do this work. I gained weight after my pregnancy and that shift from a size 16 to a size 20 was so eye opening for me. Because I was either out of certain ranges for certain brands, fashion-wise, or I was like the last size, right? So I found that things I was sharing, people were like, “I wish it came in this size!” or “Oh, that won’t work for me.” It’s really hard to share something with your community and then realize that so many people are left out. So I try to share as many inclusive brands as I can that have an extended size range or have a very inclusive size range. I wish there were more of them. The same thing is true of the momfluencer space. Who isn’t coming with me? You have to look around.VirginiaI just love that you are using your role as an influencer so thoughtfully and raising these questions that are sometimes uncomfortable but that really need to be asked. It’s really important work, so thank you.MiaI try. It’s a lot of reflection and I’m certainly not showing up perfectly. But, I hope I’m getting better every year. Butter For Your Burnt ToastMiaClothes-wise, Universal Standard has some amazing pieces out, like these foundation turtlenecks. They have my favorite t-shirt, which is the Tee Rex, and they have the essential tee. I highly recommend those. They are pricier but they last and they are really worth it. You’ll be happy with the quality. VirginiaYou’ve been influencing me about this turtleneck the whole time we’ve been chatting. It’s very cute. I’m very glad that that was your recommendation because now I can go look it up. My recommendation is going to be pretty off topic, as they usually are. My recommendation is to go buy yourself some flowers. It is March. March is very long. I live in the Hudson Valley of New York where March is 19 months long every year because spring does not happen. This is when I’m just really grateful we have a very cool local flower store. So I go in once a week and buy myself some flowers. You don’t have to spend a ton of money on this, but the amount of hope I feel having like something green and pretty is worth it.Thank you so much for being here! Tell listeners where they can follow and support your work.MiaThanks, Virginia. Mia O’Malley and Plus Size Babywearing on Instagram and you can find me on TikTok on under Plus Size Babywearing, which is not just baby wearing—it’s a lot of everything.The Burnt Toast Podcast is produced and hosted by me, Virginia Sole-Smith. You can follow me on Instagram or Twitter.Burnt Toast transcripts and essays are edited and formatted by Corinne Fay, who runs @SellTradePlus, an Instagram account where you can buy and sell plus size clothing.The Burnt Toast logo is by Deanna Lowe.Our theme music is by Jeff Bailey and Chris Maxwell.Tommy Harron is our audio engineer.Thanks for listening and for supporting independent anti-diet journalism. This is a public episode. 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