Conquer Your Weight

Dr. Sarah Stombaugh: Before we get into the episode, I am thrilled to announce we are launching an online course, The GLP Guide. The GLP guide is a must have resource for patients who have been prescribed any of the GLP medications such as Wegovy, Ozempic, semaglutide, Zepbound, Mounjaro, tirzepatide, Saxenda, liraglutide. There are a lot of them and this course is available for anyone to purchase. We often hear from people who haven't been given much information about their GLP medications. No one has told them how to handle side effects, what nutrition recommendations they should follow, or what to expect in the longterm. And it can be really intimidating and simply frustrating to feel like you're alone in your weight loss journey. With the GLP guide, you'll get access to all of the answers to the most common questions for patients using GLP medications, not sure how to use your pen, struggling with nausea, wondering how to travel with your medications. We've got you covered for only $97 for one year access. This is an opportunity you do not want to miss. The course is launching on October 1st. For more information and sign up, please visit www.sarahstombaughmd.com/glp. You don't have to be on this journey alone. We are here to guide you. And now for today's episode, this is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight podcast. Announcer: Welcome to the Conquer Your Weight podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hello everyone, and welcome to this week's episode. I am really excited to bring you this topic. I am reviewing a book that I recently read and how it applies to our weight loss journey. The book is "The Gap and The Gain," and this book has been so instrumental about the way that I think about things in my own life and then even in the weight loss journey and how I counsel and support my patients. And so I'm really excited to share this with you. Before I do though, I would love to ask you a favor. If you have been listening to this podcast for a while and have not yet left me a rating or review, I would be so appreciative if you could do that over the last couple of years. It has been so fun to see how this podcast has been growing, getting into the ears of more and more people. And that is because of the ratings, the reviews, of course sharing it as well. But when we look at the algorithmic growth, looking at how Apple Podcasts or Spotify or how different platforms suggest new podcasts to people, it is often based on the ratings reviews. So if you have been listening, if you have found this podcast helpful, I would be so appreciative. If you took a minute and left me a rating and a review, that would be just awesome. So I so appreciate you taking the time to do that. And let's dive into today's topic. We are talking about the book, "The Gap and The Gain. This is a book that is written by authors Dan Sullivan and Dr. Benjamin Hardy. And they wrote this book together addressing this mindset of whether we are in the gap or in the game. So let me explain a little bit about what this is. I'm going to be giving an overview and how this applies to your weight loss journey. You might find that this in and of itself sort of does the trick and you don't need to read the book, but it is a book that I highly recommend. I first read it or listened to it actually as a audiobook. And it was really great in that context. There was a little bit of ad-lib between the authors, between chapters, which I found really interesting and some really good insights were offered there. And so the Audible audiobook version, which I listened to on Audible, but the audiobook version is just awesome. So definitely recommend that or the hard physical copy if that is your thing. But let's start with this overview and then you can decide if this is something to add to your nightstand. So this book is this idea of when we are measuring things in our lives, and this can be any sort of goal, whether it's a personal goal, whether it is a professional goal, how are we measuring that thing? Are we measuring forward looking at some distant goal and measuring the gap, the things we have not yet achieved in the direction of that? Or are we measuring backwards? Are we measuring the gains that we've had? So based on where we've started, where have we come so far? And let me explain with a little bit more specific examples, because this really resonated with me in honestly even my personal life. I keep seeing examples of it in my parenting and the way my children perceive things, for example. And I think that you're going to find this really insightful in your own life, whether it is for your weight loss journey or maybe you decide to apply it to other aspects of your life as well. So when we think about the weight loss journey, the gap, when we're thinking about, let's say we have a 100 pound weight loss goal, and we are at some point into that goal, the gap is measuring what we have not yet done. And so let's say we've lost 10 pounds and we're like, oh my gosh, I have 90 pounds to go and it feels like we're never going to get there and we lose 20 pounds, we lose 30 pounds, we lose 40 pounds, we lose 50 pounds. And we're like, well, I'm only halfway there. I still have 50 pounds to lose. The gain, however, is looking that from the exact opposite of as lost 10 pounds. Oh my gosh, I've lost 10 pounds. Maybe there's been some mindset shifts that have changed for me. Maybe I have adopted a new way of planning and preparing my meals. Maybe I've tried new foods and incorporated those into my routine. Maybe I've cleaned up my sleep and bedtime routine or started an exercise regimen or thinking about how I navigate a holiday or a family event or social gathering, for example. And even though only 10 pounds has been lost, you start to see, okay, I've lost 10 pounds. 10 pounds ago I was behaving as a totally different person. And now look at all these things that I've started to change in my life. And that starts to build and create this momentum that gives you confidence and shows you, oh my gosh, I'm doing this thing and it's moving you in the direction of your goals. Versus I've lost 10 pounds. Oh my gosh, I still have 90. That is forever. 10 pounds is nothing. I've done that before. 90 pounds. Oh my gosh, how am I ever going to do that? Am I going to meet that by this deadline I've set, for example? And so even though we're in the exact same place physically, our body has lost 10 pounds. We can look at it in two very different frames. Now, we see this in plenty of other places as well. And it's really interesting how slipping into a gap mindset can actually ruin something that's pretty positive. And so for example, that 10 pound weight loss could be a really positive thing as opposed to a month ago when you weighed 10 pounds more, you might've celebrated and have been excited about 10 pounds. So why are we poo-pooing that? Why are we getting so disappointed? It was interesting recently, my family was on a vacation and we were out and about and we decided that as part of our morning snack, we were going to stop at Dunkin Donuts and buy the donut munchkins, which are the donut holes if you don't know. And so they sell them in different increments. But we bought a box of 25 and there are five people in my family. So we bought 25 donuts or 25 little donut holes, and with the ideal that each person would eat five donuts. Now interestingly, my 6-year-old ate six donuts because he was six years old, was his logic. That was okay because my husband had less. So it allowed him to be able to eat those six donuts. But when he finished his six donut holes, he was so upset and he was like, why are they done already? I'm still hungry. I wanted more. Why did we just get 25? We should have gotten 50, we should have gotten a hundred. And I tried to turn it into a silly game and like, oh my gosh, what if we had a thousand donut holes? What if we had a million donut holes? Wouldn't that be silly? Wouldn't our tummies feel sick? And he just kind of rolled his eyes at me and was like, no, mom, I don't want a thousand donuts, but just like 50. Then I could have 10. And it was really interesting because half an hour ago, we had not yet made the decision to stop at Dunkin Donuts. We had not told the children that we hadn't stopped and gotten the donuts. And if I had told him, okay, you're going to get a donut, you're going to get six mini donuts, he would have been so excited. Now here he was having finished six donut holes and he was like, oh my gosh, why don't I get more? And it was so funny because he was even more angry after the six donut holes than perhaps if we had just never had the donuts, never mentioned the donuts, and just went about morning snack in the way that we typically do. And so it's really interesting, and this is such an innocent example of gap versus gain thinking. So now this example, he's living the gap. So he's like, oh my gosh, I've only had six donuts. I wanted 10 donuts, I wanted 20 donuts. I wanted so many more. And so he is measuring against some ideal that he's envisioned in his head versus the gain would be, oh my gosh, I got to eat six donuts. That's a really special treat. We don't necessarily eat that every day. I enjoy these, I savor them. They were delicious. And so this positive experience he has now taken and has made it into something that he is getting really frustrated with that he is worse off than before he even had the donuts. And so this is what I'm thinking about as well. Then when we look at really anything, a lot of times we have this ideal outcome. We have this goal weight, and we haven't reached that. And so every time we're thinking about how much left we have to do, it can be frustrating, it can be discouraging. It can take away from the wins that we have already had. We all of a sudden focus on the things that went wrong on why we haven't reached our ideal outcome, how it's going to take so long to get there versus the gain is measuring this progress based on where you started. So that a hundred pound weight loss example, for example, I've lost 10 pounds already. I have 90 pounds to go there, as I said, is likely a lot of progress that has already started to build up. It may be things like non-scale victories, but there are the things and the shifts in your behaviors, in your mindset on the foods you enjoy, on the people you surround yourself with about how you plan. All of these things are going to inevitably lead to your weight and health goal success. And the interesting thing is that there's a lot of people who have resistance to this like, well, yeah, but I just don't want to live in la la land all the time. And no, absolutely you shouldn't. Should be paying attention to where you are, to where you're going. It's okay to have a goal in mind. In fact, having a goal in mind is phenomenal. But the problem is when we say, I can only be happy once I've achieved my goal. And so I'll ask you, what is keeping you from being happy right now? Do you think that at one hundreds pounds less, that you will feel happier? You may believe that right now. But what I will tell you is I have had patients who have lost a hundred pounds and they get to a hundred pounds weight loss, and they're like, oh, actually, maybe I should have lost 120. And so now they're working on an additional 20 pounds or, oh gosh, my skin is really loose. I feel like my body doesn't look the same as I expected it to. Maybe I'm not as strong as I expected to if I haven't been doing resistance training, for example. And so they reach their 100 pound goal and all of the sudden because they are practiced living in the gap thinking, they stay in the gap thinking and they start finding other problems with where they're at right now. And so we hit the goal, yet it doesn't have the same satisfaction as we think it will because we're still practice living in this gap mindset. And so you can have your goals, you can even change your goals. You could lose a hundred pounds and realize, you know what, actually losing 120 pounds is more aligned with my goals. No big deal. I have patients who change their weight loss goals all of the time. In fact, a lot of times when we're setting initial goals in my practice, I will say things like, we'll know it when we get there. And that's because the weight loss goal that we set may be dependent on a lot of different factors. It may be dependent on your age, how long your body's been holding onto that weight, what your other health conditions are. Are you seeing improvement or maybe even resolution of those health conditions? And at what place are you doing that? How is your body functioning for you? Does your body feel strong? Does your body feel energized? Is your body working for you in the way that you desire it to? And you may be surprised that with, we're going to lean into this 100 pound weight loss goal, but with a 100 pound weight loss goal, you may find that at 70 pound weight loss, your body is feeling amazing. You've seen resolution of high blood pressure or pre-diabetes or other health conditions that you've been dealing with. Your body feels strong, your joint pain's improved, whatever it is that you're dealing with. And you're like, huh, actually, I really like the way my body is functioning for me right now. And you might decide to end your journey. And so that goal can be a fluid thing. And sometimes it's actually even harder to be fluid with those goals when we're so focused on a very specific goal rather than looking at the present. Measuring from where I'm at right now, from where I started, what are the wins that I've had so far, whether those are scale victories, whether those are size in terms of clothing or waist circumference, maybe that's body composition, maybe that's other non-scale victories in terms of the activities you're able to do or the way your body's feeling or functioning for you. And so it really starts to become something that because we're living in the gain, we can pay more attention to what's actually happening and what our needs are. So this gap can really sabotage our goals when we're constantly chasing an ideal body, constantly chasing a specific goal weight. Sometimes it feels like we never quite get there. And like I said, you may lose that amount of money or that amount of weight rather, and feel like, oh my gosh, why was that my goal? I actually need more, actually, my skin looks a certain way actually, I'm not as strong as I expected. And even though we've hit that goal that we thought was going to make us so happy, it ends up falling kind of flat and the excitement is not as significant as we expect it to be. Or we find that we're comparing ourselves to unrealistic standards. Maybe we're comparing ourselves to someone on social media. Maybe we're comparing ourselves to a celebrity. Maybe we're comparing ourselves to someone who just lives in a very different body. There are things about ourselves that are genetically predispositioned. Even things like our height. For example, I have a friend who's five foot tall and super adorable, and I am five six, a little more than five six, and I'm plenty happy in my body, but if I wish to be five foot zero and she's so cute and petite and little, and I'm just not ever going to be that, I'm just six inches taller, and that's just the body that I was given. So sometimes we have these literally unrealistic expectations of our bodies are not going to get taller, our bodies are not going to get shorter. There are things about us that are just the way that they are. And so are we even setting goals that don't make sense for where we are. Also thinking about our past selves, sometimes we're setting weights based on a number. We've never been based on a weight. We were in high school based on a time in our life where we had a really unhealthy relationship with food. I actually see this one happen a lot. And I'll say, there's no reason you can't set a goal that you've been at at some point a long time of goal. I often have patients achieve goals that they're like, oh my gosh, I could have never envisioned being here. But sometimes I've had patients who set goals of, okay, I want to be at this number the last time I was there was in high school. And they reflect on their behaviors at that time. And their behaviors are either A, not in line at all with what would help them achieve that goal at this time, or B, are really, really unhealthy. So for one, I often see people who during high school feel like they could eat whatever they want. They didn't struggle at all with obesity at that time or with any excess weight at that time, and they were eating literally a candy bar for lunch. And they're like, oh my gosh, I wish I could be the size that I was in high school. But when they reflect on what they were doing in high school, they were actually eating foods that did not properly fuel their body. And if they were to make those type of choices right now, it would maybe even worsen their health. It would maybe even increase their weight, for example. Or during a period of time, they're looking at a weight and they had very unhealthy eating behaviors where they were restricting. Maybe they were binging and purging or just purging. And their relationship with food during that time was really negative and was really at a place that was challenged. And so setting a weight that reminds us of how we got to that weight can really, really be difficult as well. And so when we think about what our weight goal is or when we're moving in the direction of our goals, thinking about the behaviors that are going to get us there, which is interestingly the gain thinking, thinking about the behaviors we've shifted, building that motivation because as we build and shift those behaviors that we start to see is moving us in the direction of a realistic standard versus something that feels very unrealistic when we're in the gap. There's often these feelings of failure, sometimes this all or nothing thinking, and it can create a situation where we're like, oh, man, just forget about it. Sort of feeling like I've fallen off the wagon, for example, and so you've had a bad day and you're like, oh my gosh, I can't believe I ate that thing. I don't even care about the rest of the day. And then just sort of letting everything go because of one bad decision or one decision that was not in line with your goals, and then realizing, oh gosh, a few more pounds have creeped on since I let that go. Finding yourself in a place of yo-yo dieting because we're either all in or we're all out. Now, this is not saying that we cannot reframe the setbacks that we've had in our lives. Things will go not according to plan. Let's say you set a goal of I'm going to work out four days this week, for example, and you ended up having three exercise sessions. So living in the gain is like, Hey, when I started this journey, I wasn't moving my body at all, or I was moving my body just when I absolutely needed to. I had no routine exercise, and now I've been routinely exercising up to four days per week. Isn't it amazing that even in this week that was really challenging, I was still able to exercise three days versus like, oh my gosh, I can't believe I didn't exercise that one day I was supposed to, but I was sick or my kid was up all night long or my car broke down, or whatever the reason is now, it's not saying you have to sort of forgive yourself and move on, and you can't rework that. Maybe the reason you missed that session was because you didn't feel like working out or a work meeting went too long. Great. How do you help yourself to find a solution so that next time you're not going to find yourself in that situation again? But let's celebrate the fact that you did work out three times this week, that you did make the priority to set that aside on your schedule for that to be something that you really wanted to accomplish. And okay, there was this one day that I was planning on working out, but I was not able to let me workshop that so I don't find myself in that situation again, that is living in the gain, that is allowing yourself to celebrate the victories that have happened, to reframe and workshop those setbacks so that as you move forward, you are constantly looking at progress. So this idea of progress not perfection is so, so important. We are going to make decisions, food choices, things that we do or things that we don't do that are not 100% in line with our goals. And sometimes we see these people on social media or we have these ideas in our head about what it takes to live in a certain body size or to have a certain health outcome in our life. And the interesting thing is that often either is pictured in this way or maybe we've just imagined it in this way that never again can you have a sweet, never again can you have a fried food. Never again can you have an alcoholic beverage or whatever the thing is that seems really off limits where it's interesting that looking at what our relationship has been, let's say with sugar and our cravings for sugar, how we've handled those in the past, how we're handling those now, deciding that we're not going to have any, is often setting ourselves up for a place where we're constantly focused on it, we're thinking about it, we're craving it more and more and can give us a sort of we're all in or we're all out. If we set ourselves a goal of previously, I would've had dessert every single night of the week. Let me see if I have dessert five nights of the week, how my body feels with that, for example. And at the end of that seven days to check back, okay, I've had five desserts over the last seven days. How did that feel? How was my body functioning for me on those two days where I chose not to have dessert? Was I missing it? Was that good? Was it bad? How did that help move me in the direction of my goals? How am I going to shift this moving forward? And so if you look at where you've come from versus where you are versus where you're going, oftentimes we have made huge strides in the direction of where we've come from, whether it is mindset shifts, whether it is behavior shifts. We start seeing that there's these huge shifts that have happened. And if we think about just continually building on that progress, that over time we are going to evolve into an unrecognizable version of ourselves. And that cannot happen overnight. You cannot snap your fingers and all of a sudden become a new person. It is a progress thing every day finding, Hey, am I 1% better? Am I 1% more in line with my goals today than I was yesterday? Am I constantly moving in the direction of my goals, recognizing that there may be setbacks, and then workshopping those and moving forward because that progress not perfection is so, so important. And maybe the most important mantra that you could have as you think about what it looks like for your overall future and your overall goals, progress, not perfection. Am I moving in the direction of my goals? And then as you're doing those things, your goals become inevitable, which is really, really exciting. Now, I'm not going to say that you're never going to find yourself in gap thinking. For one, it's likely something that you've practiced over and over and over again. Two, we find it coming up sometimes in silly examples like the mini donut example or the donut hole example that I was sharing with my 6-year-old. We find it coming up where we're really disappointed about something and we recognize with reflection that, oh my gosh, it's kind of silly that I'm upset that I only got to have six donuts when previously I had zero donuts and this is better than the alternative universe where I had none of them. And recognizing that that's a childish example. But even as adults, we do that type of thing all of the time. We do that type of thing all of the time where we're looking at the thing that has not happened rather than the thing that has happened rather than the positive things that have happened in our life, the direction that we've moved in our goals. And you can look forward, you can set goals. That's absolutely a healthy thing to do. But make sure that when you measure your goals and you measure how far you've gone is often so much more valuable than where you're going, how far you've gone. Building that confidence, building that motivation of what you've already done gives you the fuel to keep moving forward because you have evidence that what you're doing works. And if you are a patient of mine and you're feeling like you're getting into a sort of a gap rut and feeling really frustrated, please reach out. I love, love being able to support patients with that. And for everybody else, I want you to spend time thinking about the gain, thinking about how do I reflect on where I've come from? How do I spend time practicing being in the gain? This can look like things like daily gratitude, for example, where you're reflecting on one or multiple wins from the day that can be done really well in a journal or done with a accountability partner or maybe with your family. It's a really lovely family activity around the dinner table. Let's all share one positive thing from our day. One thing we really enjoyed about our day, for example, and helping to frame our day with the things that have gone well. We often have this negativity bias as humans, such as it's easy for us to focus on things that haven't gone well. So it is important to turn, look at the things that have gone well. Now, there's days where it feels like, oh my gosh, I have just, nothing has happened this day has not gone in line with my goals. Sometimes what I will have you reflect on is not just sort of in the context of today, but looking really far back. So let's say in the context of a weight loss journey. Let's say you started this journey six months ago or a year ago, or five years ago, for example. Or maybe you're just reflecting on a lifetime of yo-yo dieting and you're like, how do I make and tails and heads of this situation reflect on what are the things that I'm practicing in my mindset? Are there things that I'm doing right now that feel really good for my body, that feel really good for my mind, that are helping me to achieve my goals? Spending that time to reflect on the mindset shifts that have happened is such a big deal. What I often find is that when we think about our emotional weight, losing that and working through our emotional weight is required to proceed the weight loss of physical weight. And so our mental shifts will always proceed the physical shifts in our body. And if you are someone that's like, oh my gosh, I wish I had support like this in my weight loss journey, if you are in Illinois, Tennessee, or Virginia, I would love to see you as a patient. In my medical weight loss practice, I see patients in person in Charlottesville, Virginia, and throughout the states of Illinois, Virginia, and Tennessee by telemedicine. You can reach out to us on our website at www.sarahstombaughmd.com. You'll find that link in the show notes, show notes. Thank you so much for joining us today. We'll see you all next week. Bye-bye.