Conquer Your Weight

Dr. Sarah Stombaugh: 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 today's episode of the podcast. I'm so excited to bring on a guest health coach and the newest member of our team, Caryn Ranney. She is a phenomenal resource, learning a little bit about how to better connect with yourself, understanding your health goals. So we're going to talk a little bit because we've been getting the question, and I'm sure Caryn gets this question all the time of what is a health coach, what do they do? How can they support someone in their health goals? And so I'm really excited to dive into that conversation. Caryn, why don't you tell us a little bit about yourself and how you came to be in this health coaching role that you do? Caryn Ranney: Thank you for the intro, Dr. Stombaugh. Well, that's a long story. Of course it is. So I've always wanted to be in the health and wellness field. I've always wanted to help people just make whatever changes they're wanting to make for themselves. So whenever I went to college, I pursued a bachelor's in nutrition and exercise science, and I got my personal training certification through the American Council on Exercise. And within my bachelor's I already was learning about motivational interviewing and how to help people work through the changes that they're wanting to make. How do you talk to somebody who wants to make changes in their life? And from there, I didn't realize that health coaching was a thing, but once I found out about it a couple of years later in my career, then it was exactly what I was looking for. It is a board certification through the National Board of Health and Wellness coaches that teaches people how to partner with other people to talk about health behavior change using health behavior change, psychology. Dr. Sarah Stombaugh: I love that. And so tell me a little bit when someone is working with you, how do you work with them? What does a session look like? Caryn Ranney: Great question. So first I'll have an initial consult, which is for free for everybody so we can talk through what are you looking to work on, can we partner well together for that? And then anything else that has to do with working together, schedule and pricing from there, we've already laid a groundwork of what the person's wanting to work on, but from there we start with, we explore the big motivators that are behind why a person is wanting to make these changes. And that's very the thing that actually matters to the person. What are the big motivators outside of just I should be doing this. From there we can explore what are the specific actions and we try to boil down based on the big picture, what are the specific actions that I'm wanting to start incorporating into my life. So that's when we talk about the behaviors, what are the behaviors that we're wanting to develop? So again, it's just a conversation. Why is this thing important to you? What will it give to your life? Another big question I like to ask is how would you measure progress or what would progress look or feel like is a question that I like better. Some people are data oriented and they want to measure with data and other people aren't as much. And other people, one of the things they're wanting to get is more energy, and that's something that you feel. So the energy, how can we track your energy if you're getting more energy or not? So again, if you have a goal, how do we measure whether what we're doing is working or not? So we'll talk about how to measure progress and the kind of general goal at the end of each session is to clarify a realistic, reasonable goal that also can be specifically measured so we know whether we tick that box or not. So that's the goal by the end of the session. And another thing that I didn't point this out yet, I can't believe I did, but it's client led. All health coaching is client led. That's one of the biggest pieces of it is we want to help people find whatever the goals are that they're wanting to incorporate into their life. So again, by the end of the session, the goals to find something that people feel is realistic and doable and measurable and they agree that they want to work on that, it's not something that I'm telling them they should do. Dr. Sarah Stombaugh: Well, and it's interesting because you didn't outright say it at the beginning, but you sort of implied it with a lot of the things you're talking about. We think about motivation, for example, and it's really interesting when we start to explore those things with our patients or with our clients. Everybody's motivations are really quite different. And so as a physician or as someone looking in from an outside role, we can bring our own biases and make assumptions about how, I'm always talking of course, with people about their weight, but thinking about how that's impacting their life and their goals may be completely different. Are there goals to have less joint pain? Are there goals to feel more energy? Are there goals to bring down their blood pressure? Are there goals to be able to run around with their grandchildren? Everybody has very different goals, and so stopping to ask that question, it takes time and it takes exploration. And so I love being able to have this health coaching piece to sort of balance. There's this very clinical medical side of what we're doing and how do we apply that to the individual? And so that's where that coaching piece can really come in. So I love the way that you described some of that. So tell me a little bit, I think patients who, or people who are listening to this may be thinking, okay, but what exactly does she mean? What are some examples of that? So tell me maybe from past sessions with clients or just example sessions that you've had with people, what are some of the goals that people might come with and how you would support them in working towards those? Caryn Ranney: Great question. That is a really cool thing about health coaching is it can be about any area within wellness. And we even have a wellness wheel that says that there are multiple different areas outside of physical health, physical wellness, physical wellness being like, I want to exercise. I want to support my physical body. I want to improve my nutrition, I want to sleep better. There's also emotional wellness, which is stress related or emotion related. There's also occupational wellness, there's intellectual wellness, there's environmental wellness. Social wellness is a big one that we got a spotlight on during the pandemic, how important our social structures are to our health and wellness. So that is a really cool thing too, is goals can look very different person to person. And sometimes someone might come in, I'll try to think of a specific example. So this client came in wanting to reduce their medications that they're on, so like medications for cholesterol, medications for blood pressure, and I don't think blood sugar was in there and this specific example, but that was the overarching goal. And at first it was hard to figure out why do I want to do this versus why should I be doing these things? And I can't remember. I think the first specifics were, and I can't give too many specifics, that of course will identify this person, but they're someone that travels for, they're a musician. So they had this specific, they struggled with eating around the time that they would be doing their show, because I didn't know this because I'm not a musician or a singer that you can't really eat within a certain time period before singing because of the, I guess your diaphragm is you're singing, you're pushing upward and just a bolus of food in your stomach, then you're not going to be as productive. So that was the challenge, was food around whenever they had shows to travel to and from. And they'd also be getting out of the show later at midnight whenever all that's open is a Sheetz or a Wawa. So we were first talking around how can we make sure that you have a good food option available for you after your show? And if you don't have a good option, then what are some good options at places like Sheetz or Wawa? Dr. Sarah Stombaugh: Which to clarify, are gas stations locally? I have a lot of listeners all over. So like a 7/11, like a convenience store, a gas station. Yeah. Caryn Ranney: I'm just talking gobbledygook. Dr. Sarah Stombaugh: Yeah, no, no. I think most of the listeners are local to here, but for those who aren't, they're like, what is that? Yeah, convenience store. Caryn Ranney: Store, yeah. So that was one of the places that we started. And then other things like packing a cooler so that they had food with them for the show. So that was one of the examples of where we started with the goals. But what I do want to point out with this person specifically is something that was really cool that we started meeting together more and more. They had this kind of this, how would I describe this kind of view of themselves? Like they're saying that they had a voice on one shoulder and a voice on the other shoulder and the voice on the tempting voice, they called skinny name. Let's say the name is Dylan, like Skinny Dylan will tell me I can eat whatever I want and I'm hungry, so I should just do it. And so as we progressed and as we talked more and had more sessions, this person said that the Skinny Dylan voice started going away and he wasn't doing it as much. Dr. Sarah Stombaugh: I love that. Caryn Ranney: Yeah. Dr. Sarah Stombaugh: Well, and that's such a good example of meeting people where they are, because you can imagine if this person was in a medical clinic, for example, and just got advice of need to eat three meals a day, or you need to eat at these specific times, you need to practice intermittent fasting or which is given some very broad guidelines or specific guidelines that are for maybe a more broader audience that that person comes home and is like, okay, cool. But I have no way to apply that to my life because my life involves travel, it involves shows. I have to be careful about the timing of things. And most people are in similar, I mean, not that exact situation, but situations where there are nuances that end up making a difference of do I have to think about my kids? Do I think about my spouse? Do I think about my meeting schedules at work? Or I'm traveling on an airplane or I'm traveling by car and I'm stopping at road stops. And all of those things end up playing such a really big role. And when we're kind of locked in a very standard, this is what a person should be doing if they're trying to lose weight or achieve a certain health behavior that it doesn't compute a lot of times like, well, that doesn't work. And so it kind of all goes out the window. So meeting somewhere where they're at to be able to explore, okay, how can we support you, Dylan, or whoever the person is, how we can support that specific person and not just give these really general recommendations that just don't really land for someone. Caryn Ranney: Exactly. Dr. Sarah Stombaugh: I love that. Well, and it's interesting when we think about some of these end behaviors or end results, really, we think about weight, for example, the weight on someone's body is never about, it's never just about the food. It's never just about, it's like it's this whole complex, what is their sleep? What is their family? What are their stressors? What are their triggers? What are all of the environmental things and how do we support someone in aligning their goals with what makes the most sense for them so that they can take these skills and really apply them in a longterm way? Yeah, go ahead. Caryn Ranney: And then also understand too that we cannot always predict life is unpredictable. So week to week, to also partner with somebody and help them reframe negative thinking, let's say whenever it's like, well, I wasn't able to do my goal because my child was sick. Well, of course your goals changed. Then I like to talk to people about how it switched to then a social wellness focus. Then you're taking care of your family. So then it took a little bit away from the physical wellness. Dr. Sarah Stombaugh: Absolutely. Caryn Ranney: Yeah. It just helps people. It gives, yeah, go ahead. Dr. Sarah Stombaugh: No, no. I think using that sometimes those learning opportunities of you'll be in a similar situation before. And so when you think about you sort of found yourself in this situation, your kid was sick and you weren't able to make the health decision that was most in line or you weren't able to make the previously decided decision, okay, but what did you do? Was it most in line with your goals given the situation that you found yourself in? Maybe yes. In which case, amazing. And let's applaud your on the toes thinking, and if not, no big deal. Let's workshop that because going to find yourself in similar situations again where life changes and you need to be able to adapt. And so how can we support you in that? Caryn Ranney: Mm-hmm. Dr. Sarah Stombaugh: Excellent. Tell me one of the things, it's amazing. Sometimes people come to visits with me and we're talking about so many different things that we get to the end of the visit. I'm like, oh my gosh, I haven't asked their blood pressure, I haven't asked their weight, and I'm a doctor. I should be doing those things. Of course. And certainly in telemedicine, in person, obviously I do those things at the beginning of the visit, but in a telemedicine encounter it's like, oh gosh, we should probably adjust the medical aspect going on here. And there's so much focus on this behavior, and I've had patients say, gosh, this almost feels like therapy. And so I think that's a really important clarification to make is when you think about health coaching versus therapy, what are some of the differences there? Caryn Ranney: I love that you asked this question that is, it's easy to confuse, and I remember thinking about that whenever I was going through training for health coaching is how do you make the discrepancy? So health coaching uses psychology, so it's similar to therapy because it uses psychology, but it uses health behavior change, psychology. So that's the big piece. I feel like it stays within that realm. However, we can still explore these other things. So sometimes somebody comes to a session and as we start talking more and more, it ends up coming up. That's something within the childhood is actually still been affecting somebody to where it's now affecting their behavior and their adulthood. So let's say that we uncovered that piece at that point, then what I can do, my scope of practice is to help them determine specific actions to work with that circumstance. I cannot then dig deep into the emotional side of things that a therapist would, if that makes sense. Dr. Sarah Stombaugh: Yeah, absolutely. I often think of health coaching or coaching in general, sort of looking forward. And so with all of the information that we have, how can we apply that to our behaviors in the future where a lot of times I think of therapy as looking backwards as exploring things and how that has come to build us and readdressing and reframing things in the past that may certainly affect us and does affect us in the future. But with that sort of license to explore that past. And there's overlap as you can certainly imagine. But I think recognizing where we're delving into like, oh, this is trauma territory, for example, if you think of a lot of patients, for example, we'll share food traumas that they've had. For example, maybe food insecurities early in life or almost emotionally abusive behaviors that have been experienced with parents or other adults in their life about how themselves as a child, how they were interacting with food or engaging with food. And so recognizing where, okay, this patient, I can still support them and they may really benefit from the support also of a therapist if they're not already getting that. Caryn Ranney: Absolutely. Yeah. So that's whenever I would refer out, and I do actually have a referral network set up with a therapist, and in her words, what was really useful about being able to refer her patients to me for health coaching was she can uncover and work through those deep emotional things, the past, so to speak, those deep emotional things that are affecting the behavior to uncover them, especially if it's, I forget the specific word, but whenever we can kind of hide and Dr. Sarah Stombaugh: Like repressed? Caryn Ranney: Yes, repressed, especially if we have repressed memories or repressed traumas, she can help to uncover that stuff. But then she found health coaching be really helpful because I can kind of do not, and this isn't a bad thing, but the handholding, let's figure out during a day, let's say you're going through something and you have a trigger, then what are the actions that you can take or the things you can do for yourself in that moment to help. It's like where the rubber meets the road, so to speak. Dr. Sarah Stombaugh: Yeah, absolutely. And providing that really specific support when you have a concrete situation working through those either in the present or for the future. I love them. I really enjoy that description. So tell me when we think about, and we haven't talked about this too much, but Caryn of course is the newest member of our team, and if you're listening to this podcast when it's released in August, well, it'll probably be released in September of 2024. You are working with our patients and all of the new patients who come into our practice are getting this balance where they're working both with me from a medical side, and we certainly do behavior change as well, but then having also visits with you in order to target, okay, let's really focus on the behaviors and focus on setting these goals that help align best so that you're moving forward in the direction that's most in line with your health and wellness goals. So we're seeing this more and more where medical clinics are starting to incorporate health coaches. And so tell me a little bit about what you've seen more broadly and how you feel that that can really support someone's medical health. Caryn Ranney: Another great question. So again, if we just kind of go back to what does a health coach [do]? A health coach, helps a person talk through change. So from that standpoint, there's multiple areas within the medical field. There's physical therapy, there's dental work, there's the eye doctor, there's psychology, there's general practice. Almost always there's a conversation about telling their patient, we need to do this thing, right? Dr. Sarah Stombaugh: Mm-hmm. Caryn Ranney: Not always this simple as, okay, I'm going to go do it now. Right. Sometimes it's even said than done. So that's where the health coach comes in to actually partner with people to help them figure out how to do the things that then their medical provider is asking them to do. Dr. Sarah Stombaugh: Absolutely. Caryn Ranney: That's a physical therapist or the dentist or the eye doctor. Dr. Sarah Stombaugh: Absolutely. I think there are, you think about the healthcare field right now and just how busy it is and how stretched it is, and whether someone is talking about an insurance based model in which visits tend to move really pretty quickly. But even in a private practice model, sometimes I feel like I could sit down with a patient for two or three hours even and we could just explore everything. And that's not possible. It's not possible for a clinic to function in that way. And so how can we really spend the time and dedicate to those behaviors and make sure that a patient is really getting this well-balanced perspective. And so I love that patients are able to get the support in both ways, Caryn Ranney: And that's where health coaches come in. They're there to spend that time, but sometimes it is a short amount of time. Some health coaches will spend just 10 minutes with people, but now you can be very productive in 10 minutes. Yeah, and I think it also is a health coach is a key piece of bringing autonomy into healthcare where people do have some, not that they should have all the say, there's always a balance with this. Of course, a lot of times medical providers have more of the knowledge that, well, then they can recommend their patients to do X, Y, Z. However, there should still be a conversation of, is this what you want for your health? So I feel like helps to bring that autonomy in. Dr. Sarah Stombaugh: I love that. Well, lemme ask you, Caryn, as we wrap up our conversation today, are there things that we haven't talked about that you really want to share and make sure that my audience understands about health coaching? Caryn Ranney: I think we did a really good job of covering it. I just want to emphasize again that it is always client led. In other words, even if I'm thinking that it would be a good point to educate something about someone, about a topic, I'm still going to ask permission about if they want to hear that or if they've already heard about it. It's very much so person focused instead of trying to just demand that somebody do a thing that they don't want to do. Dr. Sarah Stombaugh: Absolutely. I love bringing that clarification and helping the patient to really feel empowered in that situation. That's really neat. Well, thank you so much for joining us today. If patients or listeners are interested in learning more about you, finding you working with you, where can they do that? Caryn Ranney: So I have a website. It is my last name, Ranney, R-A-N-N-E-Y, coaching.co, not com. Co. ranneycoaching.co. And that's the website. And I have an area on there where you can fill out form to schedule initial consult, and those are free. So if anyone's ever interested in working with me or even just talking with the health and wellness professional and picking their brain, they can always go on there and schedule an appointment for free. Otherwise, I also have an Instagram, which is also Ranney Coaching, R-A-N-N-E-Y coaching. Dr. Sarah Stombaugh: All right, excellent. And as I mentioned, you are working with our team right now. So all of the patients in our practice who are working in our membership model, see me monthly, see you monthly, and it's great. They kind of have this back and forth where every two weeks they have a touchpoint with someone in the practice. And our patients love how personalized our care is and how easily they're able to get in touch with us to address any questions and concerns and really make progress in their goals. So we're so happy to have you as part of the team. If you're interested in learning more about our medical practice, you can visit www.sarahstombaughmd.com. All of the links both for Caryn and her coaching, as well as my practice will be in the show notes. You can see them there. Caryn, thank you so much for joining us today. This was really fun. Caryn Ranney: Thank you very much, Dr. Stombaugh. I enjoyed it. Dr. Sarah Stombaugh: Yeah, absolutely. And we will see you back actually in a couple of weeks. She's going to be back to talk a little bit about pain management and movement. Caryn also does personal training where she helps people with chronic pain. And so look out for that episode. That'll be coming in a few weeks. Everyone have a nice day. We'll see you soon.