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 of the Conquer Your Weight podcast. We are talking about Thanksgiving, which will be the day after this podcast episode goes live, and I just cannot help myself. We are going to talk about Thanksgiving. Interestingly, in many of the conversations with my patients, Thanksgiving is not the holiday that throws them most out of whack. Usually December is a bit more of a challenge because it's just the beginning of sort of Thanksgiving sets off the rest of the holiday season and then all of December they have end of the year parties and holiday parties and it's sort of Thanksgiving sets the stage for the rest of the year. So I want you to take some of the principles that we are going to be talking about specifically for Thanksgiving, and I want you to also think about how can you apply those for the next month of the year going forward. Because one of the things that happens very commonly for you and for most Americans is that as a society we tend to gain a couple of pounds every year during the holidays that can accumulate slowly over time. We've talked about this in other episodes as well, but when we look at weight gain trajectory, it tends to be this sort of slow and steady thing, two to five pounds per year for most people, and a lot of times that comes on during the holidays. So I would love to support you in not only maintaining your weight during the holidays, but possibly even losing weight during the holidays depending on what your goals are. So let's talk a little bit about Thanksgiving specifically. I'm going to go into some of the specific questions that patients and listeners have brought up with me and how to make game plans for some specific situations. Now, I have had a couple of Thanksgiving episodes in the past and I will stand besides all of those or behind all of those recommendations, and so definitely check those out as well. Lots of conversation about planning ahead for example, and all of that absolutely remains true, but I want to think about some of the things you can do both to plan ahead and to address some specific situations. So one of the things that has come up is just timing of meals throughout the day. So for someone who has one Thanksgiving that they're going to attend, let's say on Thursday, tomorrow, if you were listening to this episode live, it is common that that meal may be happening at a different time compared to your usual eating schedule. And I've heard this described a lot of different ways, but one of the things that pretty commonly happens is that families may have, let's say a mid-afternoon meal and that might be the only meal that happens during the day. And so the idea is that all day long we're just going to build up our appetite. We're going to be super, super hungry so that by the time Thanksgiving gets here or the Thanksgiving meal gets here that we can just indulge, maybe even overindulge because we have sort of saved up all of the calories for the entire day that we were going to eat in one sitting. Now you can absolutely do that. That is absolutely a choice if that is what you prefer and if that's in line with your goals. But one of the things that really commonly happens for people is that when a meal is later in the day than they would typically eat when they're sort of saving their appetite for a special meal, sometimes what will actually happen is that by the time the meal gets there, they are ravenous. And when we are ravenous, our brain clicks out of thinking planning mode and starts going to this danger mode of, oh my gosh, I'm going to starve to death. And our ability to really think rationally to plan to make the best decisions in line with our goals goes out the window. So the best advice I have for you is do not let your Thanksgiving meal be your only meal of the day. Now, if you are traveling and it's going to be challenging to eat another meal because people are like you're at someone else's kitchen or you're in a hotel or something like that, what I would recommend is that you actually bring some food with you. And this doesn't have to be anything fancy. This can be protein bars, this could be protein shakes. I'm a huge fan of traveling with tuna packets, so I always have those in my suitcase for example, but is there something that you can eat earlier in the day that is going to help provide some satiety? It doesn't have to be a gigantic meal. It can be just something small that, okay, by the time I get to my Thanksgiving meal, I'm not going to be just overly hungry. Now you'll notice with some of the things I mentioned, these are more protein forward options and I definitely would recommend to start your day off strong with something that is going to be higher in protein. It also helps to set our glucose into a GoTo regulation curve as well. If we start the day out with something sweet, particularly a processed carbohydrate like a pastry or some sort of bread product, cinnamon rolls, coffee cakes, that type of thing, what happens is we often spike our blood sugar up and then crash down, and that puts us just in the same situation as if we hadn't eaten at all and sometimes even a little bit more urgent because we feel crashy like we feel like our blood sugar is going low, we feel maybe lightheaded, a little weak, a little nauseated, maybe a little hangry. And so for sure do not start your day off with a processed carbohydrate or a sugary sweet carbohydrate if that is your family's tradition. Let's say your family starts a Thanksgiving day with cinnamon rolls, for example, that is awesome. You could absolutely participate in that. If that is in line with your goals, please just make sure to also pair it with a protein so that you're not going to get that crash down sensation after having done that sweet in the morning. So make sure that you are putting yourself in the best situation that by the time mealtime comes around, you are not just going to be ravenous and digging into whatever. Also, what really commonly happens is that when we are overly hungry, we overeat and so we eat beyond our normal satiety point and simply a lot of times because we just ate too quickly because we were ravenous, we started eating quickly and then we quickly passed that point of comfortable satiety into now uncomfortable like, oh, I ate a little bit too much or maybe, wow, I really overdid it. So making sure that you go into the meal with an appropriate amount of hunger and not ravenously hungry is super, super important. Another specific question that has come up in the practice is people who are navigating multiple families, so maybe they do one in the afternoon and then they turn around and walk out the door to the second family in the evening. And I think there's a lot of different ways that you can handle this and it's going to have to be what makes the most sense based on the timing there, based on what food choices are the favorite. And so you'll have to decide this a little bit for your own, but let me give some suggestions. If this is going to be a pretty quick turnaround, I think the best thing that I can recommend is really paying attention to what your hunger and satiety signals are. If you know how much food you would typically eat in a day, for example, or at a certain meal, how are you going to divide that up so you can enjoy yourself at both of these? Are there certain dishes that are going to be at one meal that you're really excited about versus at another meal? How can you make sure to really prioritize those? There's going to be some things that are the same, and so you might decide that like, okay, mashed potatoes are just mashed potatoes, and so I'm going to have them at one place or the other, or maybe I'm just going to skip them all together, or maybe your family makes the most amazing garlicy buttery herby mashed potatoes that you've ever had, and that's a priority. Excellent. Make sure that that's something that you decide to intentionally include on the list, but it may mean then foregoing mashed potatoes at the other side of the family, for example. So paying attention to what is my hunger, what is my satiety and how do I sort of divide out this meal? Now, one of the things that I will often recommend is if it is happening over two separate meal times, great, just plan it as two separate meals, but recognizing, like I said, how much food do you typically eat in a day and how am I going to divide that out accordingly? So by the second meal, I don't feel overly full. Now, a lot of times this is where we have belief systems about what it means to show up as a guest. Maybe even our family pressures us a little bit, especially at that second meal or maybe even at the first meal that we should be eating more. I can't believe you're not eating this much. I will remind you that this is your own boundary to draw. Other people may have opinions. It's annoying when they sometimes express those, but it is your own boundary to decide how much are you going to eat or not eat. That is going to be in line with your goals. And so if you know have a second meal coming up, you may not be eating as much at the first meal. And if someone makes a comment about that, you can gently remind them, thank you so much for offering me another serving Aunt Susie, I am leaving for another Thanksgiving meal in an hour, so I think I've been well served for now. It can be a simple, no thank you. It doesn't have to be a long in-depth explanation, but you can just say, thank you so much. I'm heading to another meal. Or if you're at the second meal, thank you so much. I'm coming from another meal at this dinner. I'm really focusing on dessert or I'm really going to focus on X, Y, Z, whatever it is that you are excited about. So make that plan, sort of think about your hunger, think about your satiety and recognize that it's really your own boundary to draw and then to enforce. And a lot of times, especially if we're on a weight loss journey, our family and friends, they just want to help. They just want to take care of you. A lot of families show love through food, and so I will also remind you that you do not need to invite a lot of drama. Sometimes we ourselves don't have a clear plan, and so that uncertainty ends up inviting. It sort of puts the foot in the door for the drama to come up. And so if you're like, oh, well, I don't know, maybe I should, but I'm going to this other Thanksgiving, I will tell you that your family member or friend, whoever is the food pusher in your family is going to dive on those words and great. Okay, you should just one more bite or just try a little bit of this. The best situation is to just no drama, like no thank you. I've been well served. You. Do not owe them an explanation. You do not owe them an entire narrative of what you're eating and why you're eating it. A simple yes, no thank you. Maybe later I'll see if I have room, I'll take it to go. All of those are perfectly acceptable answers, and so being clear on what your plan is upfront too can really save you because then you feel confident with saying, oh my gosh, thank you so much. That looks delicious. I'd love to take a slice to go, and you can just leave it at that. It doesn't have to be this whole back and forth about your weight loss journey and what you're trying to do. It can just be as simple. I'd love to take it to go, no, thank you. So starting to incorporate and recognizing where your beliefs are getting in your way, and if you run into a specific situation and it kind of goes wonky, no big deal. I will tell you, you will run into many of these situations again in the future. And so write it down, think it through. How could that go differently next time? Maybe you want to workshop that with someone like myself with another physician coach, a therapist. That can be really valuable as well because the good and the bad news is you're going to find yourself in similar situations again in the future. So setting those aside, I'm going to think about some other things. One of the things I think is really important is thinking about our food order. So when we look at a meal, thinking about eating our fiber first followed by our protein and some fat and then ending with carbohydrates, particularly those more processed or starchy carbohydrates, that is one of the best ways that we can promote a healthy glucose metabolism and to promote appropriate satiety, making sure that we're filling up with really nutrient dense foods, first, filling up with those low calorie vegetables, then moving on to meats or others versus the protein and then finishing the meal with starches and sort of any room that you have leftover, then going to the mashed potatoes or the bread rolls or the desserts or whatever it would be. That food order can make a really big difference in making sure that your body feels nourished after the meal and not feeling kind of overly full when we've started the meal with more processed carbohydrates, sometimes we're still hungry. Then for the more substantive I said that we are more substantial parts of the meal, like the proteins, for example, and so then we eat those and can feel overly full. So just make sure to emphasize any of those leafy grains or low calorie vegetables, that green beans, for example. Emphasize that early in the meal, then the proteins, and that can make a really big difference in how you feel after the meal as well. The other thing is slowing down the time over which you're eating. One of the things that's wonderful about Thanksgiving is because we're often surrounded by other people, there's a lot of conversation going on. Maybe people are standing up to go get food or food is being passed around the table, and I would encourage you to use that as an opportunity to really sit and savor your food, to participate in conversation such that you are having to set your fork down and the meal gets drawn out over 20, 30, 40 minutes. When we can eat over a longer period of time, we allow our natural satiety to kick in and we can eat more in line with our goals than when we eat quickly. And so luckily, thanksgiving is often a situation where eating slowly makes a lot of sense, and I'll encourage you to just lean into that, enjoy the conversation. So that's an excellent thing that you can do. The other thing I will say is choose the foods that you really enjoy. If you want to put a bite of everything on your plate, that's great, but if there's certain foods that are just kind of meh for you, I would say go ahead and leave them off. Pay attention to when you're choosing foods that are less in line with your health goals, how can you choose the ones that you're really excited about that your taste buds are just going to dance with joy that you know you're really going to love and savor and be super excited about. Save your food choices that are less in line with your goals for those type of options. You can also, we've talked about before, how to be a guest, and I will encourage you that if you want to bring a dish along with you that is more in line with your food goals, this is an excellent way too to make sure that you have foods available that you are going to enjoy and is going to be in line with your goals. So if you are traveling somewhere, it may be a little bit more challenging, but if you're local or if you're able to maybe pop by the grocery store and pick up some ingredients, how can you show up as a guest that's going to be a gracious and generous guest bringing in a dish, and then also making sure there is something or some things that are in line with your goals. I'll also recommend going for a walk after the Thanksgiving meal is one of the best things you can do, honestly after any meal, but just to get your blood flowing, get your body burning that glucose while it's active in your bloodstream. It can be nice for digestion just to get things moving through you. Great way to connect with people. So invite your family or your friends out on a walk with you. It doesn't have to be this huffing and puffing going for trying to build up a sweat and all of that. It can be something that feels pretty laid back, something we're just kind of meandering. Maybe people have started to put up Christmas lights or just enjoying the crisp air and fresh air after dinner, but taking some time, getting outdoors, getting your body moving, that is an excellent thing you can do as well. And lastly, I will leave you with thinking about fun ways that you can utilize leftovers, whether you're a host, whether you're a guest, if you are a host, I will recommend how many of those leftovers can you get out of your house. If you are a guest, maybe you can stake away with the leftovers that are most in line with your food goals. And then can you start to play around with recipes that are, how can you repurpose a Turkey into another dish, for example, that will be in line with your goals. We recently sent out a recipe for pasta that would be really good with Turkey, for example. So there are things like that that you can do to repurpose a meal to make it a little bit more in line with your goals possibly. And so how are you going to handle those leftovers and how are you going to repurpose those things? And are there things you need to just really intentionally either keep out of your house or get out of your house depending on if you are the guest or the host? Because many of us, if we have certain food things sitting around, they may be calling from the kitchen. And so really intentionally trying to, like I said, either keep those out if you were a guest somewhere or get those out. If you are a host is a really great way to make sure that we're not being haunted by those foods that are leftover from Thanksgiving. Recognizing too that the next day you might be feeling a little bit less hungry. If you've eaten more than you typically would the next day you might be waking up and feeling less hungry. Just lean into that. Lean into what is my body asking for and what can I give it right now? And that can make a big difference too, because even if one day did go maybe a little bit overboard, maybe you ate a little bit more than you intended to. Our body is naturally designed to send us less hunger signals the following day. So pay attention to what that looks like because we see these natural ebbs and flows. Alright guys, so that is what I'm going to leave you with for this Thanksgiving 2024. As if always, if you have questions, I would love to address those for you. You can always email me info@sarahstombaughmd.com. We would love to create a podcast episode just for you to address the questions that you have. Thank you so much for joining me today. Happy Thanksgiving. I'll see you all next time.