This post discusses eating disorders, mental health, adverse medication reactions, and hospitalization. If you’re struggling, please reach out to a healthcare professional. You deserve support.
Three months ago, I published “When Algorithms Forget You’re Human.” I wrote about my wife—recovering from an eating disorder, doing well (over a decade with no lapse), dealing with weight gain from disability changes—and how social media kept serving her GLP-1 ads. Skin removal surgery. Weight loss programs. Sono Bello showed up eleven times after she blocked them.
I wrote about how algorithms don’t respect choices. How Amazon Prime offers no way to mark content as problematic. How AI systems act as yes men. How platforms treat vulnerability as revenue opportunity.
Finding a job these days is a brutal thing. Artificial intelligence is doing the initial screening and the interviews. There are ghost postings that never lead anywhere. If you do get through, people are facing five, six, sometimes seven rounds of interviews, only to be left hanging, wondering whether there will ever be feedback. Recently I had several colleagues go through this entire process—screening, panels, take-homes, final rounds—only to be rejected and watch the company repost the same opening a week later.
I sat down with a couple of them to talk about their experiences. This is what they had to say. Names have been anonymized.
Don’t stop. The HHS Office for Civil Rights was due to implement rules enforcing WCAG 2.1 A and AA as the required standard for any digital asset from an organization receiving HHS funding starting Monday May 11, 2026. As expected following the shift for ADA Title II, HHS just delayed the rule.
Under the revised timeline:
Recipients with 15 or more employees will now have until May 11, 2027, to comply.
Recipients with fewer than 15 employees will now have until May 10, 2028, to comply.
Don’t Stop!
I said it before and I’ll say it again. This is not a time to let up and relax. Especially for groups receiving these funds. Inaction on your part will likely to real world damage to individuals in need of those resources. Much more so than some of the Title II efforts.
You also have to deal with state laws. Many states have enacted their own version of the ADA and what is required for digital systems. Then there is the fact that the DOJ and HHS have been using WCAG 2.1 A and AA when assessing accessibility for several years already. Lastly, there are still private lawsuits. These won’t stop. Keep doing the work, more time allows you to make this habit and process or dig deeper if those are in place.
Civil Rights
The current administration doesn’t care about civil rights. Disabled people have been fighting for generations to get equal access. It has been more than 35 years since the ADA passed and two generations grew up on the internet in that time. Yet, disabled people are still considered permissible to discriminate against.
Even though the administration doesn’t care, they do not make up the majority of this country. I hope you realize how wrong it is to deprive the disabled the same access to the world just because it took a little more effort.
Warning: This post discusses eating disorders, mental health, and how digital systems can harm vulnerable people. If you’re struggling, please reach out to a healthcare professional. You deserve support.
About 10 years ago I gave a talk called “Designing with Empathy” at Open Source & Feelings. One line I’ve kept coming back to: empathetic design makes badass users. It wasn’t just about accessibility checkboxes; it was about recognizing that people navigating our digital world are already doing the heavy lifting. They’re managing disabilities, mental health, trauma, and life circumstances that no wire-frame captures.
Then there’s Ethan Marcotte’s reflections on painful “memories.” His family went through tragedy, and then kept getting reminders of the tragedy from social media. His social media usage changed because of this, with significant effect. He writes about losing the people who taught him to see differently. The activists, artists, writers, and the ones who walked different paths and shared their perspectives. When those connections vanish behind algorithmic walls, we lose more than content. We lose humanity.
These threads converge on something uncomfortable about our current digital landscape: when systems stop respecting people’s choices, they don’t just annoy—they disable.
The Algorithm That Won’t Take No for an Answer
My wife grew up with an eating disorder. As an adult, with time, patience, and therapy, she has excellent control. She’s done well. Really well. But recent disability changes that reduce what she can eat and how much she can move of course led to weight gain. As a couple who’ve been disabled for years, we understand this is a natural, expected outcome of medical treatment and bodily healing.
Her YouTube feed? Serves GLP-1 ads every break from Ozempic, Wegovey, and others. Skin removal surgery ads from Sono Bello. Weight loss programs from Weight Watchers and Rovo.
She blocks them. Repeatedly. Every single time. Sono Bello has kept showing the same ad despite blocking it 11 times. And we shouldn’t need to pay for premium to save her mental health. Can she not watch YouTube? Sure. If the creator provides another way.
The algorithm doesn’t care. It sees a body, not a person. It sees data points, not dignity. It sees sales dollars, not emotion.
And it’s not just YouTube, Meta, or Twitter. Amazon Prime Video does the same thing. Amazon also has no way to mark content as problematic. No “stop showing me this.” No “this is harmful to me.” Just endless repetition of whatever the engagement metrics think you want. And if you go to the controls during the ad, it is still seen as engagement.
This isn’t just bad targeting.
This is design that actively works against people’s well-being.
A moment of rest during serious topics. Enjoy sleepy puppies.
The AI “Yes Man” Problem
AI systems contribute to the problem. And as Generations Z, Alpha, and Beta grow up they are relying more and more on AI as the “source of all truth.”
Generative AI is programmed to make users happy. That sounds nice until you realize what it means:
AI lies about idea feasibility to avoid hurting feelings. “That’s a great concept!” when it’s technically impossible or ethically questionable.
AI uses your data to encourage spending. You mention wanting to learn guitar? Suddenly there are ads for expensive gear. You share a hobby? Now it’s monetized. And you don’t need to tell the AI. It has access to that from the social & economic tracking that exists on you.
AI isolates us from friends and hobbies. Why go to a real community when the AI companion is always available, always agreeable, always there? Have rejection trauma from past relationships? AI doesn’t reject you.
AI inflates user ego. It’s a “yes man” that never challenges you, never pushes back, never says “this might not be the best path.”
Companies like OpenAI, Anthropic, Google, and Meta aren’t building tools to help us think better. They’re building tools to keep us engaged, spending, and dependent.
They train on our conversations. They learn our vulnerabilities. They sell access to our attention. And they call it “helpful.” Github is launching an opt-out policy for its AI to use your code (private or public) to train the AI. I’ve opted out.
I’m not exempt from this critique. I’m aware that even this conversation could be logged, analyzed, and used to improve engagement metrics somewhere. That’s the trap we’re all in.
How “Optimization” Creates Disability
I’ve spent years talking about how empathetic design recognizes users’ existing labor. They’re already managing so much. Our job as designers isn’t to add friction—it’s to remove it. But what happens when the friction is the product?
Social media algorithms optimize for engagement, not mental health. Depression correlates with doomscrolling. Anxiety spikes with infinite feeds. Each clip that makes you smile, laugh, sad, or click is a dopamine hit that keep you locked in. Just like gambling, “Just one more video!” The metrics reward exactly what harms the user.
Advertising systems treat repeated rejection as a puzzle to solve rather than a boundary to respect. “They blocked it, but maybe they’ll click this time!”
Platform designs make it harder to opt out than to stay engaged. Dark patterns everywhere. Amazon Prime Video doesn’t even give you the option to flag problematic content.
AI assistants agree with everything you say, even when you’re wrong. They don’t protect you from yourself. They empower psychosis and delusion in previously rational people.
When people with disabilities navigate these systems, the burden multiplies. Cognitive load increases. Mental health deteriorates. And somehow, we’re told to try harder, download another blocker, be more resilient.
The problem isn’t the user. It’s the design.
The People-First Gap
I spend my days working on web accessibility. I’ve presented talks on building interfaces that work for everyone. I’ve written about supporting both mouse and keyboard users, about making sure drag operations work with single pointers, about the grief I feel every time I see a design that excludes people.
But accessibility isn’t just about screen readers and contrast ratios. It’s about agency. Can people control their experience? Can they say no? Can they trust that their choices will be honored?
When my wife blocks an ad and it comes back anyway, that’s not just annoying. It’s a message: Your choice doesn’t matter. Your body is our asset. Your recovery is our opportunity. Your mental health is more profitable when it’s bad.
That’s not just bad design. That’s dehumanizing.
What Would Empathetic Design Look Like?
Hard topics take time to process. This is a photo of a forested river flowing over some rocks. It’s a longer exposure, so the rapids and splashes all smooth out as time does when looked on a broad scale.
If we actually applied the ideas I’ve been talking about for years:
Respect repeated choices – Block once, block forever. No “maybe they changed their mind” algorithms.
Prioritize well-being over engagement – Measure success by user health, not time on site.
Transparent controls – Make it easy to see what data is being used and how to change it. Give people the option to mark content as problematic.
Honest AI – Systems that tell us when we’re wrong, when something won’t work, when we should disconnect and talk to a real person.
Human review for edge cases – When algorithms fail, have humans who can actually fix it.
Marcotte’s grief over losing voices reminds us: platforms are supposed to connect us to people, not replace them with optimization loops. When we lose the messy, unpredictable, human parts of digital spaces, we lose something irreplaceable.
The Hard Truth
Technology should serve people, not extract from them.
When a system repeatedly shows harmful content to someone in recovery, that’s not a bug. That’s a feature of a business model that treats human vulnerability as revenue opportunity.
When disability accommodations become afterthoughts, that’s not oversight. That’s design that assumes able-bodied users as default.
When mental health deteriorates alongside engagement metrics, we need to ask: Who benefits?
When AI agrees with everything you say, we need to ask: Are you actually growing, or just being validated?
Moving Forward
I’m not naive. I know platforms need to make money. But there are ways to do that without treating people like data mines.
For my wife, I want her to see ads that match her actual interests. I don’t want her medical history driving her ads (HIPAA?). I want her to feel supported, not surveilled.
For all of us, I want digital spaces that remember we’re human. That respect our boundaries. That prioritize our well-being over their quarterly targets.
Empathetic design makes badass users. I’d add: empathetic design makes badass companies, too. Because when you treat people well, they stick around. They trust you. They come back.
Not because they’re trapped in an engagement loop. But because they choose to.
What would you change about how platforms handle user preferences? I’m listening—and I promise, unlike some algorithms, I’ll actually remember what you say.
Follow-up questions I’m curious about:
Have you experienced similar frustration with algorithms ignoring your preferences?
What would “honest AI” actually look like in practice?
How do you balance business needs with genuine user well-being?
Are you comfortable with AI challenging your ideas, or do you prefer validation?
We all navigate the internet and computers in different ways. Some use screen readers, others keyboard, and some people by voice. Success Criterion 2.5.3 was created to support these diverse methods. While it helps all users, it was created to address using voice control because typing is a struggle for the user. On the screen is a button that clearly says “Submit Order.” You speak the command: “Click Submit Order.”
Nothing happens.Or worse, it clicks the wrong thing.
If you’ve been following me you’ll know I lost my father six weeks ago. Today marks his 83rd birthday. Mine is tomorrow. He was 32 when I was born and we had a family joke that he gave up his birthdays for me, so he was only 32. We laughed that for the last 18 years, I was the patriarch – not him.
But for about 4 years now, I’ve had to be the patriarch. I lost my mother 3 years ago, but it was a slow process and my father needed to focus on her health. I needed to remind him of appointments and responsibilities as he declined without her.
But that isn’t what I want to talk about today.
The Grief Process
When we lose someone in our life things stop making sense in a lot of ways. There is confusion, you lose your train of thought a lot and have to deal with stress, anxiety, anger. The closer the person, the less makes sense.
For example, I weep for those killed over this past weekend due to the conflict with Iran. These are people who had their lives stolen from them. Some of them are children who haven’t even had much life. However, this motivates me to protest war. It doesn’t bring me to my knees for hour crying.
When I lost my 97 year old grandfather, I cried. I cried a lot. A couple weeks later I cried less. In a few months, even less. More than 10 years on, I don’t cry. I smile because I think of how much I love him, the good memories, the lessons he taught me.
When both my mother and father passed, I wasn’t really allowed time to grieve right away. As the eldest child, local child, I had to handle a lot of post-death administration. For my father, I have to do all of it. This required me to box up feelings before I could do those things. But they never stay in the box.
The Grief Ball
I didn’t come up with this. I learned it long ago from a therapist I had. And it wasn’t grief for a person, but an ability I lost.
However, I’ve since modified it with my own words, analogies and adopted it for a broader audience. Grief is a button in a box. Every time the button is pushed you feel the full power of grief. This never changes. Eighty years from now, when that button gets hit, it will hurt the same as it did day one.
Inside the box is a ball. I call it the grief ball (naming things is hard). It is what triggers your grief. When you first experience a loss, the ball is inflated to the maximum care size for the loss. Iranian school girls feels like its a ping pong ball to me, but for the parents of each child it is a gym ball. Every time the ball hits the button I get angry and grieve for them and their families. But this is a pretty big box and the ball hits the button maybe once a day.
The ball in my mother’s grief box is the size of a softball. Its hit the button many times during the day. On the day she passed, the ball was pushing out of the box.Over time it deflated and hit the button less.
When my father passed, I boxed it all up to get through the paperwork of it all. The ball was big and hitting frequently, but I didn’t have time to deal with it. Following the Buddhist philosophy, I would acknowledge the thought and let it go. But on this auspicious day, there is no letting go. It will be present all day, and March 4th and 5th will never be the same.
Grief is Hard, But You Can Get Through It
Don’t run away from it. You need to work through these feelings. But you also don’t need to grasp onto the thoughts. That’s when we get ourselves into trouble. Trying to hold onto something only brings more grief, anger, frustration, and suffering. When it hits, sit with it. Acknowledge it. Feel it. Then let it go. This will help you get through moment.
This takes practice. If I didn’t study philosophy, religion (especially eastern religion), and years of meditation practice, I wouldn’t have been able to get through the last 6 weeks as well as I have. If you have a local meditation center, I strongly recommend going and learn to really meditate. You don’t need to be a Buddhist, but Buddhism has some lessons that work well in any circumstance.
This is my journey. I thought I’d share in case someone else can gain something from it.
You can see in the photo our little pantry was quickly thrown up. Now we are facing winter weather in Wisconsin. We realized we needed a better structure. So we bought a small 22 sq foot shed. We posted that this was happening on social media and looking for assistance to install it as both my wife and I are disabled.
Times are tough, but we have a little extra. Instead of shaming people for needing help, we are sharing what we can. I have been a Buddhist for over a decade. I’ve read all the major religious texts as well as the major philosophy and ethics books as part of getting my degree in philosophy. My wife is a deacon at her Episcopal church. One thing we agree upon is that all humans deserve care, love, support, the right to food, clothing, shelter, and healthcare. Actually, we agree on a lot, but most of it is irrelevant to this post.
‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ – Matthew 25(40)
If you have the means to help your local community, I encourage you to do so. If you can’t provide a pantry like ours, find somewhere to donate time or money. Because our budget for this is coming out of our pockets, we have limits. If you’d like to help us support our community, please visit our page about the pantry and donate.
Ok, the title is clickbait, but what isn’t these days.
Today Americans from the United States of America celebrate our Independence Day from British rule. This annual celebration usually includes trips to the lake or beach. People often grill outside with friends and family. The day wraps up with fireworks. Growing up, the Fourth of July was one of the greatest parties of the year.
Hopefully those of you working towards EAA are breathing a little easier today. While some of you were pushing last minute updates, I attended my local Pride celebration.
Well organized and attended, it reminded me why I do this work. People from 1-99+. People with visible disabilities. People with disabilities only visible because they made it so by wearing a device to control the disability (hearings aids off, headphones, walkers instead of canes). This wasn’t a celebration of LGBTQ+, this was a celebration of people being people.
