• Providing Support (Alisa Karmel PsyD): We both grew up in the same household, dealing with fatness throughout our childhood. There were many ideas on how to lose weight—this diet, that diet—but no professional support or solutions to help us feel better. Nothing ever made me feel enough, healthy, worthy, or loved. It directed everything I did. So, I chose a career to provide that support and create a space for children, adolescents, and adults to process and experience what they wanted to feel, challenging all the messaging that surrounds them. Today, I provide that support, giving back what I was looking for my entire childhood. It’s amazing. My patients still feel the pain, even in 2024, it still happens.
• Comedy as Defense (Ian Karmel): I became a comedian because I wasn’t smart or dedicated enough to do what my sister did. My comedy initially served as a defense mechanism when I was a little fat kid trying to beat the bullies to the joke. I wanted to disarm their thoughts by saying what they were thinking first, giving me some agency. That instinct turned into a career in comedy, often writing for others, where I didn’t have to diffuse what people thought about me. Much of my standup comedy, though not all, operated on diffusing that tension.
• Processing Through Humor (Ian Karmel): Back in third grade at Bethany Elementary School, I used humor as a coping mechanism. Now, as a comedian, I found myself doing the same thing on stage in front of hundreds of people. I lost some weight and got to the other side. I think a lot of my ability to process what had been going on was sort of delayed until two things happened. I lost weight, and then there was some stillness, like in the quarantine. I looked back on what my career had hinged on in a lot of ways and realized, I was processing a lot of things through humor that are good to process through humor, but would also be good to process at length more with not just trying to diffuse everything with laughs but confronting it.
• Communication (Ian Karmel): The idea of communicating with others who had similar experiences, or who have loved ones dealing with these issues, really inspired me to write this book. Doing it with Alisa, someone who not only shares similar experiences but also has extensive education and professional experience, made it even more compelling. Together, we can talk about these issues in a way that is relatable and informative. We aim to provide both empathy and practical advice, helping readers feel seen and offering hard information to support them beyond just feeling understood.
• Identity and Feedback Loops (Dr. Robyn): One thing that stood out to me in your book, and from what Ian mentioned, is how his identity was tied to making jokes. In my recent book, How to Talk to Kids About Anything, I emphasize the power of our “I am” statements when talking to kids. Children and teens often create feedback loops with statements like, “I am ugly,” “I am lazy,” “I am fat,” or “I am stupid.” These identities get reinforced as they hear themselves and others repeat them, becoming stronger over time. As key adults, we need to disrupt these feedback loops before they become entrenched. Many listeners might think, “Wow, it’s already really strong. My kid says this all the time.” It’s crucial to step in and interrupt these negative cycles to help children form healthier identities.
• Childhood Struggles and Identity (Ian Karmel): As a child, even if you can’t articulate it, you’re smart and intuitive. You experience the terror of childhood, wanting to fit in and not be different. For me, this was about being fat. You don’t realize you’re different until you see other kids who aren’t like you, and then someone uses it to make fun of you at recess or wherever. What’s especially toxic is when one or two people make fun of you, it feels like termites – if you see one or two, you think they’re everywhere, in the foundation. So, my own psyche started bullying me too. I assumed that this identity, which a few insecure kids used to push me down the hierarchy, was my identity. My brain started telling me that everyone was thinking this behind my back, even if they weren’t saying it to my face. So, my “I am” became “I am the fat kid.” Then I decided to be the funny fat kid, the one who is okay with it and has self-awareness. Intuitively, I realized that self-awareness grants some cachet because it makes people comfortable, making you seem smart and funny.
• Conforming to Fit In (Ian Karmel): I had a core group of friends who knew the real me, the ones who would come over to the house, hang out, and were familiar with my family. These friends saw me for who I truly was. However, in high school, I wanted to fit in with the popular kids, go to their parties, and be part of that scene. To do this, I had to leave a part of myself behind and play a role. In those social circles, I felt the need to desexualize, debase, and make fun of myself. Even if those kids weren’t consciously asking me to do that, there was a pressure to conform in this way to be accepted.
• Coping with Insecurities (Alisa Karmel PsyD): It’s interesting because Ian was the funny fat kid, while I was the smart fat kid. I did everything to divert attention from my body to my brain by helping others with their tests or studying. But being smart didn’t make me popular, and I often wondered how Ian seemed so successful. As children, we just want to be liked and find our social group because humans are inherently social creatures. The struggles children face today are similar to what we experienced. Children inherently make mistakes and learn how to function socially through trial and error. Each child comes with insecurities, and once a few kids make fun of them, they believe their differences are the most significant.
• Parents as an influence (Alisa Karmel PsyD): In my practice, I work with both children and their parents. Parents are the biggest influence and can do more than they realize. When we were growing up, there weren’t many resources for parents, and they often thought the solution was to help their kids lose weight. Today, we understand that’s not necessarily the answer.
• Leading with Love (Alisa Karmel PsyD): Above all I say today, and I stand behind this strongly, is to lead with love in those conversations (at home). Children and adolescents encounter so much negativity—from social media, from school, despite caring teachers. There’s shaming everywhere. If parents can remove fear, judgment, and discriminatory words before starting these talks, they’ll connect better with their children and keep communication open. Many young patients I see feel uncomfortable discussing these issues with their parents because the door is closed. Keeping that door open with love in conversations is crucial. It’s possible to be direct and supportive simultaneously, contrary to what some believe.
• Childhood Support and Intervention (Ian Karmel): Looking back, I wish my parents had intervened more directly. My mom especially made an effort; we even tried Weight Watchers once, and I recall jogging with my older sister. But as Alisa mentioned, there wasn’t much dialogue about these issues back then. Perhaps what I needed was someone to address my emotional eating habits more directly. I used to consume large amounts of unhealthy food in isolation, spending hours playing video games. Our family dynamics didn’t provide much supervision; with our mom working nights and our parents separated, there wasn’t someone consistently monitoring my behavior or discussing its implications. In hindsight, I think having someone lovingly and supportively guide me, explaining the risks of unhealthy habits and their psychological impact, would have been beneficial. However, life sometimes doesn’t offer the space or opportunity to recognize these issues and intervene early enough.
• Balancing Support and Directness (Dr. Robyn): I think it’s important to dig into that because I think to your point, Alisa, when you were saying that there’s kind of idea that you can’t do one and the other, you can’t be supportive and be direct. Listening to Ian, he’s the struggle is obvious. I think part of it from what I’ve talked about with parents is this idea that everything is linked. That if I say something about eating, it’s shaming them (kids). I often say to parents, weight doesn’t have to have anything to do with how you’re operating at home and the information you’re providing because you want your children to be healthy. And these are the things we feed our bodies with because they are healthy for us, not because this is how it ends up on you.
• Internal Voice (Alisa Karmel PsyD): A great study just came out from a pediatric journal. Essentially, as a parent, you need to step back and examine your own internal voice before taking any action with your child. Consider the messages you have about your body and any baggage from your upbringing or current relationship. Also, reflect on your diet, the foods in your refrigerator, your activity level after work, how you manage stress, and how you talk to yourself in front of the mirror. These steps are crucial before addressing anything with your child.
• Food as form of love (Alisa Karmel PsyD): Food can be a form of love, but how can we integrate food, love, and health? How can we celebrate those three together? I think it’s possible. There are various approaches once parents achieve self-love, enabling them to have direct conversations with their children that aren’t focused on weight or driven by fear of being overweight. Then they can encourage moderation, celebrate vegetables, and enjoy treats like the cookies our mom brings on beach trips.
• Parallel Conversations (Alisa Karmel PsyD): I think parallel conversations can be powerful when you feel shut out by your child. Having those conversations that maybe aren’t directly at your child, but maybe talking with your partner, another caregiver, or a sibling and modeling the type of safe conversation that can be held. You can be on the receiving end of this, maybe not yet, and keep having those conversations. Even when you’re in the car and listening to Taylor Swift playing on the radio, and they’re all jamming in the back, you can turn down the volume and say, “Yeah, I wonder what Taylor Swift does, or your favorite podcaster does,” and kind of talk about it, not directly at your child, but with your child. And I think what that does is gently introduce them to the idea that you’re a safe space, that you care, and you’re not going to come at them. The more they see that modeled over and over, eventually you’ll extinguish their fear and replace it with curiosity. They might actually be willing to talk with you. I’ve found that to be really successful.
• Authentic Selfcare and Acceptance (Ian Karmel): The advice I’d want to give to a younger version of myself is to stop trying to cram all these other things into this hole that you need to fill with self-love, self-respect. That was the story of the first 35 years of my life—from when I learned I was fat and different until I actually started working on it in a positive way, taking care of myself authentically. It was about acceptance from the popular kids, right? There was a bit of that academic validation Alisa talked about in grade school, less in middle school. But it was like, “Oh, the popular kids like me, so I must be okay.” And what the bullies were saying, that’s not true because look, these are the coolest kids at the high school liking me. Then when I got into comedy, it was like, “Oh, what the mean people say must not be true because these audiences love me, the newspaper loves me, and this TV network loves me.” Once I started using that to gain acceptance from girls, it was like, “Oh, what they say about me must not be true because these beautiful women accept me for whatever reason.” And then that became its own toxic cycle.
• You are Someone Worth Saving (Ian Karmel): What I would want to tell myself is that reaching for all these other tools to fill this hole won’t work. They will just clank down to the bottom and never fill the hole up the way you need it to be. Because that can only come from being honest with yourself, working on your self-esteem, and having the energy that comes from being kind to yourself. It’s not just about eating well, though that’s a big part of it because that’s sort of what aided me, but actually believing that you are someone worth saving.
• Embracing Strengths, Enoughness and Self (Dr. Robyn Silverman): Not because others are telling you they like you, but because you like yourself. Yeah, because you are valid on your own. I think that was perfectly said and thank you for sharing that with us. Hearing that from you is so illuminating. This idea of trying to fill a hole with things that can never fill it is profound. It won’t happen until you turn to your strengths, embrace your enoughness, and embrace your authentic self. That’s when that hole starts to heal. When we try to fill it with external things, opinions, food, or whatever else, it doesn’t work. In fact, it can make us feel worse.
• Don’t Stick Your Head in the Sand (Ian Karmel): I guess the big takeaway is not to think the worst thing you can do, and this applies from kids who are fat to adults who are fat, everyone, including parents, loved ones, and friends: don’t stick your head in the sand. I feel like that’s the worst thing you can do if you’re the person who needs a little help. If you’re the person who feels like you want to help but you’re not sure how to do it, just don’t stick your head in the sand. I think trying, and maybe not doing it perfectly, is better. Yes, and more loving than not doing anything at all because you’re afraid of hurting someone’s feelings or afraid you’re going to do it wrong.

Keep the Conversation Going (Alisa Karmel PsyD): Keep the conversation going. Like, do not shut that door. Keep the child feeling safe and just talking with you. And I think that conversation can be on any topic. It doesn’t have to feel productive all the time. You know, as long as the words are coming out of their mouth and their ears are listening, I think that’s going to be their biggest support as they start to evolve and learn who they are and how you learn who you are. I mean, I’m a new parent, I’m like, what the hell am I doing right now? Like, yes, it’s really important to just keep talking, keep learning, and don’t shut that conversation off.