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Fitness Doesn't Have to Be about Denial and Shame

Fitness Doesn't Have to Be about Denial and Shame

Rachel Feltman: For Scientific American 's Science Quickly, I'm Rachel Feltman. Just to give you a heads-up, we'll be talking about physical fitness today. We'll touch on topics such as disordered eating and intentional weight loss.
Social media is full of fitness influencers promising 'bikini bodies' and hawking fat-burning cardio routines, especially for women and femme-presenting people. But if you know where to look, you can find folks who are doing things differently: exercising slowly, lifting heavy and getting strong—a process that often involves fewer workouts and a lot more calories.
One of the most popular figures in the femme lifting space is writer Casey Johnston. Her book A Physical Education: How I Escaped Diet Culture and Gained the Power of Lifting just came out, and she's here to tell us more about how strength training can change our relationship with fitness, body image and even our own minds.
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Hey, thanks so much for coming on to chat.
Casey Johnston: Hi, thanks for having me.
Feltman: So I would love to start by asking: What misconceptions did you have about lifting and strength training before you got into it?
Johnston: I think a lot of the same things that a lot of people have. I thought that if I started lifting weights, it would make me bulky instantly, and I thought it was only for people who really needed to be strong, like, in a professional way, like if you were an Olympic athlete or an NFL running back, or you have some sort of strength-oriented job. And the other misconception I had was that muscle is always just sort of there on your body, waiting for you to lose all of the body fat in order for the muscle to suddenly show through. And I didn't know that your body can sort of consume muscle or your—the amount of muscle in your body can fluctuate based on what you're doing and it is possible to diet too much, for instance, and lose muscle mass ...
Feltman: Mm.
Johnston: As you do that.
Feltman: Yeah, so what changed your mind?
Johnston: The big event in my life was that I found a post on Reddit where a woman was talking about her strength-training progress, and she was having what looked to me like a very sort of unusual to me at the time relationship with lifting ...
Feltman: Mm.
Johnson: Where she was only going a few days a week. She was eating a lot of food, and she wasn't that strong; she was, like, strength—she was clearly not the type of person that I thought of at the time as somebody who lifted weights. But she was having a great time. She was feeling so much better. She was enjoying eating. And what was most important to me at that time was she was getting these physical results that I had always been pursuing with all of my weight-loss activities, where she had lost some body fat and she was looking more, quote, unquote, 'toned,' as we might say.
And after all my years of running and dieting—and I was putting so much into this, so many hours ...
Feltman: Mm.
Johnston: So much effort—I was like, 'What, what the heck?' that this lady is doing this with, you know, half the time investment, she's eating way more, she's committing all of these, quote, unquote, 'sins' that I thought were impossible for me to do as a woman in the world, and here she's doing them all. And not only is she doing them all, she's getting all of the results that I was never able to get.
Feltman: Mm. So I've been following your work for a long time, but for listeners who aren't familiar with you yet could you tell us a little bit about the trajectory that followed after that?
Johnston: Yeah, after that I decided I had to try this magical set of activities that I had no real awareness of before. And so I got into lifting weights, started eating more, and I was like, 'I feel like I've tried everything else. Nothing else is really clicking for me.' And pretty quickly I realized I love this style of workout. I love how I feel when I eat [laughs] and then when I go to the gym and I'm fed and I have all this energy and I can do my workouts and I'm getting stronger, like, steadily. It just felt incredible.
And from that point, after I lifted a couple of years, I started writing a column about strength training for other people, an advice column called Ask a Swole Woman. That column has been published by a few outlets at this point, and then I started a newsletter based off of that column that was a little more expansive, and now here I am: I'm writing books and writing a newsletter and talking to you and all this good stuff.
Feltman: You've done a lot of research on lifting, nutrition, fitness and diet culture in general. What things have you learned that have surprised you along the way?
Johnston: I think the biggest surprise to me was: there were so many things about my existence before getting into lifting that I thought were just sort of par for the course of human existence, where you have cravings for food, but you have to, like, work really hard to deny them. You have to be always pursuing weight loss in order to be healthy. And I learned that not only are those things not true, but that constant sort of chronic dieting is bad for your body in the way that I—your muscle can be dieted away, and that can become a vicious cycle: the more muscle you lose, the less ability your body has to burn calories and maintain all of your sort of biological equilibrium and—but the harder you're going to try to lose weight because of that.
Feltman: Mm.
Johnston: So it can become this yo-yoing cycle. It's not just up and down in weight; it's that your body composition is changing in such a way that it makes it harder and harder to do each time ...
Feltman: Mm.
Johnston: Which is a little different than I had thought of things or how I was made to understand it, which is that, 'Oh, you lose weight, and then you gain the weight back.' It's like there's a more insidious cycle going on there.
Feltman: Yeah.
Johnston: The other thing I learned: I had these cravings, and I thought just denying cravings, having to work really hard to not eat food or to really want food, be thinking about food a lot but having to push it away was just part of how things are. Later I learned from this experiment the Minnesota starvation experiment is how it's colloquially known—where they put a bunch of men on a diet for a few months and found that, among other things, their mental state was very badly affected. They became really rigid, attached to rules, very fixated on food. And I found in my own experience that when I started eating more—not just, like, endlessly more but a modest amount more to support my lifting—that the cravings just went away. So much of the mental difficulty that I was experiencing was likely a downstream effect of not eating enough, not sort of taking basic care of myself, and I had never really made that connection between my mental state and the sort of input of food.
Feltman: What do you think is missing or wrong in the way that most people frame fitness and wellness?
Johnston: I think that there's a big emphasis on hard work ...
Feltman: Mm.
Johnston: Which is par for the course of American culture. It's sort of like: 'You earn everything that you deserve'—big quotes around all of this—'by working really hard, bearing down.' And sort of conversely: 'If you don't work hard for it, then you don't deserve it,' which is interesting because in our culture a lot of things come from different privileges [laughs] of different kinds. But laying that aside there's a lot of emphasis on—or at least, especially when I was getting into lifting—'no pain, no gain,' and 'sweat is your fat crying,' and these kinds of things that are focused on: if you're not enjoying it, if you're not in pain, you're not working hard, and you're not gonna get anything out of this ...
Feltman: Mm.
Johnston: That pain and suffering are one-to-one with 'results,' quote, unquote, and being deserving of the things that you're doing.
And I subscribed to this ...
Feltman: Mm.
Johnston: With my running, where I was always pushing myself harder and harder, running farther and farther, eventually getting into half-marathons, hoping to sort of reach a point where everything was, like, a little more balanced, that I didn't even have to think about it all so much, and I only felt like I had to think about it more and more.
When I got into lifting I found that the workouts were such that—there's a lot of emphasis in lifting on recovery. If you lift on one day, you need to rest enough the next day in order to be able to lift again the day after that. Your muscles are built in this time when you are resting, really; your body is sort of gathering its resources, repairing your muscles, making them a little bit stronger for the next time that you lift weights. So if you don't give your body those resources to repair the muscles, if you don't give it the time to repair them, it's a waste of a workout. Like, there's no point in lifting but not doing those things. So I had never thought of things that way—that all of these things could exist in balance—and that was not the emphasis that I had been taught about exercise.
Feltman: What are some of the most interesting things you've learned about the human body over the course of doing this work?
Johnston: I feel like I learned that there's so much more interplay between the brain and the body than I ever considered. I mean, it's—it feels, in one way, a bit silly to say because it's like, 'Obviously, your brain is part of your body; of course there's interplay. Your brain controls everything.' I learned that there's sort of messaging that goes back and forth between your muscles and your brain. Your body informs your thoughts in so many ways.
There is some research that I got into while writing the book about the experience of interoception, how our almost unconscious processes in our body influence our feelings and our ability to perceive those feelings. A really good example is: let's say you get jump-scared online ...
Feltman: Mm.
Johnston: By one of those, like, creepy thing jumps out at you and screams. Before you even have the thoughts to interact your body is reacting: Your breath is quickening. Your heart increases. Your muscles tense up. This is all feedback that gets passed back to your brain and informs your emotional state, and over time that can become its own vicious cycle of—it's sort of how trauma happens—the interplay between your brain and your body and how you're able to perceive those signals, or in, in certain cases of trauma you learn to tune out your body because the signals are so threatening and you are kind of like, 'I'm not gonna survive unless I sort of push all of this away and down.'
So reattuning to those signals is a whole process but one that I found lifting was super helpful with because it was this really focused almost practice in a way that I didn't think of, where it's asking, 'You did a rep, you did a set, you went to the gym, and you ate more—how did that feel? How does your body feel when that happens?' And I was so used to pushing away how my body felt and trying to tune it out, but in lifting all of that is necessary information that informs how you kind of do everything else in the gym. And that taught me to attune to my body in all of these other situations where my body is telling me something about how I feel and I need that information [laughs] in order to make decisions that are helpful to me.
Feltman: Yeah. What advice do you have for people listening who think this all sounds interesting but, like, really don't know how to engage with strength training or, you know, get off the endless cardio train?
Johnston: Well, I would say read my book because it will explain all of this. I think, genuinely, this book is for people who maybe have never known how to approach this stuff or even why you would bother with it if you're not somebody who is sort of oriented towards ...
Feltman: Mm.
Johnston: Sports already. It's like, 'What does physical activity and strength training, in particular, have to offer someone where that's not their thing, it's not their job?' There's a whole slew of things that are interesting, and even if you never put a foot through the door—I'm not trying to, like, indoctrinate anyone—but it's all good information to know and you can bring it into the rest of your life in lots of ways.
But I have another book that's more specifically about getting into lifting, a beginner lifting program called Liftoff: Couch to Barbell, that's for people who have never lifted weights before. So you start with body weight and just stuff in your house, and it's very easy—starts easy and works you up to using weights.
But in general I think it's worth acknowledging that it is difficult; a lot of us have unacknowledged history—hang-ups or issues or a lot of things that have affected us with our bodies that are difficult to unpack or confront. And so it's worth acknowledging that with yourself: that there's so much that we absorb over the course of our lives into our bodies and brains that are affecting how we think about this stuff.
It's the marketing world that wants you to exist in this tension: 'Oh, it's simple, it's simple, and if you can't make it simple, there's something wrong with you.' There's not anything wrong with us; it's that our bodies need this consideration and space and time, and it's worth it because your body is literally where you live—you will never escape your body, and your body is not easy to ignore in the way that I often hoped that it would be, but once I was able to give it a little more room I found that there was this whole relationship with myself that I was missing out on.
So I think these things aren't gonna come all at once, and so much of it is just about having curiosity and openness and focusing on your experience of these things and not what someone else says you should be doing. I have my suggestions, but they're just suggestions; it's take or leave. If it works for you, good. If it doesn't, something else might. But the whole thesis of this is that your physical experience matters—and not just in a abstract way but in a way that's very important to each of us.
Feltman: Thank you so much for coming on to talk today. This has been great.
Johnston: Yeah, thanks for having me.
Feltman: That's all for today's episode. Don't forget to check out Casey's book A Physical Education. We'll be back on Friday to take an exclusive look at a particle collider.
While I've got you I have just a quick favor to ask: We're running a listener survey to find out what people like about Science Quickly and what we might be able to improve. If you complete it this month, you'll be entered to win some sweet SciAm swag. Go to ScienceQuickly.com/survey to help us out. We'll also include a link in this episode's show notes.
Science Quickly is produced by me, Rachel Feltman, along with Fonda Mwangi, Kelso Harper, Naeem Amarsy and Jeff DelViscio. This episode was edited by Alex Sugiura. Shayna Posses and Aaron Shattuck fact-check our show. Our theme music was composed by Dominic Smith. Subscribe to Scientific American for more up-to-date and in-depth science news.

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People Are Revealing The Worst, Most Unprofessional Thing A Doctor Has Ever Said To Them, And I'm Absolutely Furious
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People Are Revealing The Worst, Most Unprofessional Thing A Doctor Has Ever Said To Them, And I'm Absolutely Furious

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I'm so embarrassed for you that I'm not even going to put it in your chart.' A year later, I finally saw an endocrinologist. When he looked at my bloodwork, he was shocked. I was post menopausal. 'Why didn't you tell anyone?' It took a few years, but it turned out to be a flare of psoriatic arthritis that killed my ovaries." —Dessertcrazy 3."I was having dizzy spells so bad that I couldn't stand without vomiting or falling down. Like, I woke up one day and couldn't walk in a straight line. I saw an ENT and had an MRI on my ear. Turned out I had a physical anomaly in my ear. I'm missing a bone/some tissue that would normally separate a main artery from my inner ear. As I age and things sag, the artery pushes straight against my inner ear, causing tinnitus and making me dizzy. While explaining the results of my MRI to me, the ENT then said, 'And guess what we can do to treat it?' all full of glee and with excitement. Dumbfounded, I stammered before he exclaimed, 'NOTHINNGGGG!!!!! Hahahaha.' I literally just started sobbing. I was 28 and suddenly couldn't walk, and this man was laughing at my diagnosis." —sabdariffa 4."While half-asleep at around 6 a.m., I stepped out into thin air halfway down the stairs and fell about six feet directly onto my right ankle. An emergency room doctor, the only available doctor in town, said 'You've probably only sprained it. You need to walk on it to get it to heal,' after a visual inspection from six feet away. He didn't touch it or even bend down to get a closer look. He refused to call the X-ray tech in for something so minor. I had to wait until the following morning to get one of my staff to drive me to the next town over (an hour away) to see another doctor who immediately had me X-rayed for my broken ankle and torn ligaments. I was off that foot for like four months." "My intellectually disabled sister had frequent vomiting and fever, and her skin turned yellow. The ER doctor said it was a tummy bug. 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27 Unprofessional Ways Doctors Dealt With Patients
27 Unprofessional Ways Doctors Dealt With Patients

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27 Unprofessional Ways Doctors Dealt With Patients

A Reddit user recently posed the question, "What's the worst thing a medical professional has said to either you or someone you know?" While most healthcare workers are compassionate, hard-working, and brilliant, many flaws in the system cannot be ignored. Bias, differences of opinion, lack of research, hubris, and other factors can interfere with a patient's ability to get proper care. Here are 27 stories from people who felt dismissed by the professionals they turned to during their time of need: "A psychiatrist told me my depression would go away if I just 'smiled more and wore prettier clothes.' I was literally there because I couldn't get out of bed for weeks. Still makes my blood boil thinking about it." "I told the doctor I was not having periods anymore, and I was having hot flashes. They said, 'You women are always fantasizing about health problems. Are you really trying to say you're experiencing menopause in your 30s? I'm so embarrassed for you that I'm not even going to put it in your chart.' A year later, I finally saw an endocrinologist. When he looked at my bloodwork, he was shocked. I was post menopausal. 'Why didn't you tell anyone?' It took a few years, but it turned out to be a flare of psoriatic arthritis that killed my ovaries." "I was having dizzy spells so bad that I couldn't stand without vomiting or falling down. Like, I woke up one day and couldn't walk in a straight line. I saw an ENT and had an MRI on my ear. Turned out I had a physical anomaly in my ear. I'm missing a bone/some tissue that would normally separate a main artery from my inner ear. As I age and things sag, the artery pushes straight against my inner ear, causing tinnitus and making me dizzy. While explaining the results of my MRI to me, the ENT then said, 'And guess what we can do to treat it?' all full of glee and with excitement. Dumbfounded, I stammered before he exclaimed, 'NOTHINNGGGG!!!!! Hahahaha.' I literally just started sobbing. I was 28 and suddenly couldn't walk, and this man was laughing at my diagnosis." "While half-asleep at around 6 a.m., I stepped out into thin air halfway down the stairs and fell about six feet directly onto my right ankle. An emergency room doctor, the only available doctor in town, said 'You've probably only sprained it. You need to walk on it to get it to heal,' after a visual inspection from six feet away. He didn't touch it or even bend down to get a closer look. He refused to call the X-ray tech in for something so minor. I had to wait until the following morning to get one of my staff to drive me to the next town over (an hour away) to see another doctor who immediately had me X-rayed for my broken ankle and torn ligaments. I was off that foot for like four months." "I have a genetic condition that (among other things) causes my joints to spontaneously dislocate or sublux. This is extremely painful, obviously. For me, the first joint this started happening to was my shoulder. It's a very shallow joint, and if the head of the humerus moves out of place enough, it starts to wear down the cartilage and make it easier for it to slip out again in the future. Before I got diagnosed, I just knew that I had a fucked-up shoulder that was really painful sometimes. I'd seen many doctors about it, and one had finally referred me to an orthopaedic specialist. I remember being so excited about the appointment because I was finally going to get some answers and stop being in pain all the time. He was an older guy, and after listening to my story, he just said: 'I think you should consider a breast reduction.'" "A doctor told me a particular problem I had was my weight. I said, 'It's been there when I was underweight, overweight, and everything in between. If you can tell me the magic number on the scale where it won't be a problem, I will try my damndest to get there.' Lost the weight again, and it was still a problem. He's not my doctor anymore, though." "I was in the ER after months of unknown stomach pain. The doctor told me it was 'probably just a virus' and that 'teenage girls tend to exaggerate their pain.' A few months later, I ended up needing emergency gallbladder surgery, which fixed the issue. Thanks for nothing, loser!" "My gynecologist looked at my chart and said, 'Oh, you're 32? Better hurry up and have kids before your eggs turn to dust.' I switched doctors that same day." "I was told by an ER nurse that 'God only gives what he knows you can handle.' I have multiple chronic illnesses. Another time in the ER, a male nurse said I had an obstruction in my pelvic area after a scan. I said yes, I'm wearing a menstrual cup. This confused child looked me in the eyes and said, 'Well, there shouldn't be any obstructions. I can check it out if you like.' I screamed at him that if he didn't know what a menstrual cup was, he sure as shit wasn't going anywhere near my vagina. The patient on the other side of the curtain cracked up at the exchange." "I was exhausted, kept getting sick (colds/flu), and just didn't feel right. I was told, 'I don't think anything is wrong except that you're a mum and they're always tired.' I pushed for blood work and was low on vitamin D, anaemic, and needed an iron infusion. I had a history of poor iron levels, but apparently I was just 'tired.'" "I went in with complaints of severe abdominal pain, and the gyno told me, 'Well, good news. At least pain won't kill you.'" "'No, I'm not going to redo your PAP. It's not unusual to have an abnormal test once in a while. Come back in six months, and if it's still abnormal, we will look into it.' I didn't like that, so I got a second opinion. I had endometrial cancer with a bonus ovarian tumor. The ovarian tumor could have metastasized quickly if I hadn't had surgery as soon as I did. Thankfully, all was caught in time and I didn't need chemo or radiation, but I can't help but think of the people who trusted this doctor's word and got a different diagnosis." "When my brother was born, he was unable to swallow. He was in the NICU; they had him on a feeding tube and were suctioning him regularly to keep him from aspirating. On Mother's Day, my mom asked the head of the NICU what his odds were of surviving, and without even looking at her, he said, 'Your son can't swallow. People who can't swallow eventually choke on their secretions and die.' And then he walked away. My brother just turned 40. Fuck that doctor." "I was newly married and went to the doctor to get back on the antidepressants I had been on in the past. I've had awful anxiety and depression my whole life, but I had to get off my meds since I lost insurance. I got insurance again after getting married. The doctor wanted to try me on some new meds, and I told her I just wanted to be on my old ones, and she said, 'Well, since you're newly married, you might want to try something new and stronger since depression and anxiety normally cause problems in marriages. You wouldn't want to ruin your new marriage, would you?' I never went back to that doctor again." "The guy really WANTED my symptoms to be fake because that was the conclusion he'd already drawn and he was really pissed off when a few things in my tests turned out to be slightly elevated enough that he couldn't deny me care. He gave this big, frustrated sigh and said, 'Look, you're [blah blah] levels are slightly elevated, so I'm going to admit you, but...' and then he trailed off because I think he realized he'd get in trouble for whatever he planned to say next. It's good he did too because it turns out I was totally right and we caught something that could have been VERY dangerous very early." "'Migraines aren't a real thing.' This was after I'd just had a bad one that lasted three days with me in bed, unable to tolerate lights or sound. Yep, I found a new doctor." "When I told my pediatric psychologist that I was seeing things that I was pretty sure weren't real, she told me, 'Well, some people are just more attuned to the other side.' When I moved, I finally got a new psychologist who recognized that I was having manic episodes with hallucinations and put me on a mood stabilizer." "Over the course of 20 years, I've often had my pain dismissed as period cramps. The last doctor told me he'd send me to a psychiatrist if I came back because he didn't think my pain was real. By the time they found the issue, I had an ovarian mass the size of my head in my abdomen and pelvis. It had already developed into cancer. Had any one of the dozens of doctors I went to over the course of 20 years even done a simple ultrasound, this would have been caught before it was cancer." "Someone I know was explaining that she has an iron deficiency but was afraid to watch her diet too much (to manage this deficiency) because it could make her fall back into anorexia (for which she's had hospitalizations in the past), especially at the moment when she was very stressed (new job, break-up, etc.). The doctor looked her up and down and said, 'Oh, it's okay. You don't seem to be at risk of anorexia.' Not only is this a ridiculous remark (and very dangerous given the situation explained), but she was just at her ideal weight and was a size 8 (US size). I can't imagine what it must be like for people with eating disorders who are actually overweight." "I went to see a specialist about my endo (diagnosed via laparoscopy) because I was having some worrying symptoms. My MRI scan came back normal (pretty common for endo not to be visible on the scan). He told me I should think myself lucky I didn't have something like cancer, and that he didn't want to refer me on until I was in 'real' pain. Turns out my deep infiltrating endo that was left untreated had now caused adenomyosis and spread to my bladder and bowels. I WISH I had made a complaint at the time." "'Seven weeks of bleeding is normal. Our first availability is in another seven weeks. Come back then.' He also rolled his eyes at me and huffed with annoyed exasperation, like a bratty/moody teenager does. I had been bleeding for over seven weeks already. As this provider told me the above statement, blood had started literally gushing down my legs. It was summer, and I was wearing white shorts, so he could very clearly see blood pooling down my legs. I waddled off to the closest bathroom, cleaned myself up, and called my primary care doctor to explain the circumstances. My primary care usually doesn't handle gynecologic issues, but he was (literally) stunned into silence when I explained to him what had just happened at my usual gynecology clinic, so much so that he responded: 'I've got a buddy on duty at the ER at [hospital across town]. I'll contact him directly and let him know you're en route.'" "I once had a cardiologist tell me he didn't recognize me with my shirt on." "'It must be caused by what's between your ears.' That's what a doctor said when my girlfriend's kidneys were literally failing. This went on for years." "I was living in two rooms with two small children, going through a stressful and unpleasant divorce at 25. I went to the doctor, saying I thought I was depressed, and she said, 'You don't look depressed.' I was too depressed and defeated to argue." "During a routine women's wellness exam, including a breast exam, a male doctor told me, 'You know, you can fix your asymmetrical breasts with plastic surgery.' He then proceeded to tell me what all the options were, including different-sized implants, fat transfer, etc. The young female medical assistant who was required to be in the room looked absolutely horrified." "I was trying to get a referral for a new OB-GYN for a hysterectomy after bleeding nearly every day for two years, and my female PCP says to me that I didn't need one. Since I had not had kids, my uterus was 'hungry' and I just needed to drink celery juice instead of coffee." And: "I was having severe pain and digestive issues, undergoing a lot of medical tests. It turned out I had gall bladder disease, and a gallstone was cutting into the duct. I was hospitalized for the third time, and my kidneys were shutting down (along with other systemic failures), and they sent a psychiatrist to talk to me. He accused me of making everything up, not having friends, and generally causing problems. The next day, they did an exploratory surgery and found the problem with my gall bladder. I was angry and hurt that the doctor accused me of basically lying. For the record, I'm female. My story happens to a LOT of women." Have you ever dealt with a condescending or dismissive doctor who ended up being totally wrong about your condition? What happened? Tell us in the comments or share anonymously using this form. Note: Submissions have been edited for length and/or clarity.

Spellements: Wednesday, June 11, 2025
Spellements: Wednesday, June 11, 2025

Scientific American

time6 hours ago

  • Scientific American

Spellements: Wednesday, June 11, 2025

How to Play Click the timer at the top of the game page to pause and see a clue to the science-related word in this puzzle! The objective of the game is to find words that can be made with the given letters such that all the words include the letter in the center. You can enter letters by clicking on them or typing them in. Press Enter to submit a word. Letters can be used multiple times in a single word, and words must contain four letters or more for this size layout. Select the Play Together icon in the navigation bar to invite a friend to work together on this puzzle. Pangrams, words which incorporate all the letters available, appear in bold and receive bonus points. One such word is always drawn from a recent Scientific American article—look out for a popup when you find it! You can view hints for words in the puzzle by hitting the life preserver icon in the game display. The dictionary we use for this game misses a lot of science words, such as apatite and coati. Let us know at games@ any extra science terms you found, along with your name and place of residence,

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