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:
Every single day in my practice, patients will ask me the question, “What should my goal weight be? How do I know when I’ve lost enough weight?” And this can be a really tricky thing to answer, but do not worry today, that is exactly what we are going to dive into. How do I know when I’m at my goal weight? What should my goal weight be? Because what happens when you reach that number and realize that you don’t actually feel that different? Or what happens if you have a goal and you’re not getting there but realizing, “Wow, actually my body’s feeling good. It’s working well and I’m not yet to that number. Why should we have a weight? How do we determine that weight today? I’m going to give you some ideas and some questions that you can ask yourself to help decide what your goal weight will need to be.

Now I want to make sure that you stay till the end because we’re going to go over questions that you should ask yourself to reflect on if you’ve met that weight and how you know if you should keep going or not. So let’s dive into this because people are asking, okay, what should my goal weight be? That is a question, of course, that we are thinking about and I want to ask this question as well. I’m wanting to understand with my patients what are their goals? Is there something that they have in mind and what is the reason that they’re coming up with it? We as humans, I think we love these numbers because it gives us something to really anchor to. I think a lot of too, that diet culture of calories in versus calories out. You’ve probably heard some of the formulas. If you eat this amount of a caloric deficit, it equals one pound of weight loss.

You could lose that over a certain amount of time and it feels like it becomes this very clear math equation of if I eat a 500 calorie per day deficit and I do that for a week, then I’ll lose a pound. And then if I want to lose 50 pounds and after a year I’ll be at my goal. It’s really fun for us and easy for our heads to wrap around what that would look like if it was that simple. Now the challenging thing is that human bodies are not mathematical equations. And while there is some truth to calories in versus calories out, the biggest problem there is it’s a very incomplete story. There are so many other factors that drive our appetite, our fullness, our body’s propensity to gain weight or release weight that calories in versus calories out becomes just a very small piece of the picture.

And even when we think about weight loss goals, a lot of times you’ll hear people say lose one pound per week or two pounds per week or whatever it is. That never plays out either. A lot of times week to week, our weight loss is very like up and down type thing. And even if over time we see a trend, it always looks like this, whereas this up and down thing that happens. But we love as humans to anchor on that number and it gives us an idea of how close we’re getting to that goal. So it makes a lot of sense. A lot of times too, we have these anchoring times in our lives. We think back to, okay, when I was in high school, I was this weight or when I got married I was this weight or before I had a baby I was this weight.

We have these weights that stick in our head for whatever reason, maybe a weight that our body was at for a period of time, maybe a weight that we got to after some sort of previous weight loss attempt. So we have these anchoring points and we hold onto them. A lot of times too, we have this idea of we don’t really know. People are asking, “Okay, what should my goal be? ” And I think one of the most annoying things that I say in practice literally every single day is we know it when we get there. Now one of the things that’s really interesting is that when we think about whatever your current weight is and whatever your goals are, a lot of times we will start to see health improvements long before someone has hit their goal weight number. And even if someone has 20 or 30 or 40% excess body weight, what we know is that losing sometimes even 5% of their body weight starts to have really significant clinical differences in their health.

After 5%, 10%, 15%, people notice really significant changes in their blood pressure, in their blood sugar, in their cholesterol, maybe in pain. So as they’re losing weight, they might notice that there’s less arthritis or joint pain, especially in the lower part of the body, in their hips, in their knees, in their feet. And this does not require getting to “goal weight,” whatever that number is, does not require getting all the way to your weight loss goals before we start to see some of those health metrics change and starts to help us think about, okay, when we’re thinking about a goal weight, what is the reason for the goals? And so this comes back even to asking yourself, what is your big why? Why do you want to lose weight? And it is okay to lose weight for a variety of different reasons and multiple different reasons.

You might want to lose weight to improve your blood pressure, to improve your joint pain and you may want to lose weight for aesthetic purposes and that is okay. I think we’re living in a time where there’s a lot about body acceptance, which is important. You need to learn to love and accept your body and you can learn and accept your body and want your body to be in a different size as well, but it’s all going to be wrapped up together. We’re not going to get to a smaller body size and suddenly start loving our body. It’s that learning to love your body, learning to nourish your body, learning to fuel your body, to move your body, to distrust your body. All of those things are going to work together, but it is okay to want to lose weight for reasons beyond just your health goals.

Now certainly this is something that I think a lot of people may hear this and feel concerned about of like, okay, are we just losing weight for aesthetic purposes? Absolutely not. There’s so much more that goes into why we want to lose weight, but it’s often multifactorial for people and it’s okay to recognize that there’s lots of different pieces that we’re going to be tracking and that we’re going to be thinking about. So a lot of times I say we know it when we get there, but I still like to have an idea of is there a weight that you’ve been at previously for a long period of time? Is there a number that you have in your mind of why you’d like to get to a certain number? Because I want us to be thinking about that and tracking that as we go. And then as we’re in the weight loss journey, as we’re thinking about nutrition, as we’re thinking about movement, as we’re thinking about sleep, as we’re thinking about medications, if you’re using medications as part of your weight loss journey, we want to be checking in and assessing, is your body still willing to release weight?

So if you look at as your weight loss journey is going, are you still losing weight with what you’re doing right now? Does what you’re doing feel sustainable? So if you imagine, okay, the way that I’m eating right now, this feels really sustainable. If I imagine five years from now, 10 years from now, 20 years from now, if I can imagine eating in this type of way for a long period of time, that is a great sign. Now, if it has taken a lot of white knuckling to get where you are at, that is not a great sign. It is not very predictive of long-term weight loss. But if you imagine the way that you’re eating, you’re fueling your body, you’re getting protein, you’re getting fiber, you feel energized and feeling physically well throughout the day from the foods that you’re eating and thinking about, “Hey, could I do this long-term?” That is great.

You’ve not needed to eliminate foods or entire food groups. Now you might be cutting back on those. You might be very intentionally consuming sugar on very special occasions. That is okay, but if you imagine, “Okay, could I do this forever?” That is a really important question. I also want you to be paying attention to some of those health markers. We talked about recently those non-scale victories and why the scale does not tell the entire story and this is where those health markers are really important. Understanding why are you wanting to lose weight and then as you are losing weight, are we seeing those improvements? Because sometimes even before we see the weight loss, we see metabolic health improving, we see blood sugars improving, we see blood pressures improving. We see these other signs that things are shifting in the body even if nothing has moved on the scale.

And even when the scale does start to move, like I said, it’s not always these huge amounts of weight loss. It’s 5% or 10% where we start seeing really significant differences in terms of other health markers. So if you’ve had resolution of prediabetes or type two diabetes, you’re off of your blood pressure medications or cholesterol medications, how does that align with your weight goals and with where you’re at? You want to think about how your life is day to day in terms of your availability to do things or your ability to do things. When you think about, has your life expanded? Are you able to do more things, experience more things in your life? Is there anything that would be particularly different if you continued to lose weight? And then really thinking about those trade offs. Sometimes we think about, okay, we’re treating sleep apnea with a CPAP machine.

We’re on a nutrition plan that feels really good. We’re on an exercise plan that feels really good. You’re on a dose of medication that’s well managed in your body, you’re not having significant side effects, it feels really good. In order to create more weight loss, what would we have to do? And if the trade-offs there become more significant than any potential benefit, I think that’s a really important part of thinking, okay, what is my body size right now? Am I happy at this number right now? Have I resolved the things that I set up to resolve and does it make sense for me to push it even further? And there may be instances where it’s like, yes, absolutely. We’re still working on reversing type two diabetes and we’re going to be continuing to work towards your weight loss goals. But what if everything has changed and it’s just the number on the scale that’s not exactly where you thought it would be?

How do we work to feel good in your body to accept and love your body to cherish your body at this stage recognizing that pushing the weight loss further may be incredibly challenging. It might require another modality of weight loss. So maybe we’re going from thinking about GLP medications to thinking about bariatric surgery, or we’re thinking about that the diet may need to be more intensive or that the exercise regimen may need to be more intensive. And it’s like, “Hey, is that doable? Is that worth it? Are these trade-offs just not worth the potential benefit that I could get here?” And so asking, “Okay, have I crossed a point where it’s no longer simple and it’s no longer happening seamlessly and what would be any difference from here?” And this is where we really start to think about how are you defining success. Certainly we cannot argue that we live in a society that values thinness and when thinness and being thin is the ultimate currency, of course it is totally understandable that many people have a goal of getting fully down to like a BMI of 22 where they’re at this “normal body weight.” And if you’re listening to this, not seeing the video like major, major air quotes there, because normal body weight is going to be this wide variety and there’s a lot of things that are going to help us determine if you were at an ideal place for your body.

But in the society that values thinness where being thin is the ultimate currency that we can have. It is easy to understand why we feel pushed to continue to lose weight beyond just all these other health metrics. And so I really want you to think about success and what are we defining as success? Because if you are anchoring success on a very specific number, you may either A, never reach that number and feel like a failure despite seeing huge other wins in your life, or B, you might reach that number and realize that you don’t actually feel as good as you expected to feel at that number. And that is incredibly frustrating and disappointing when that happens. And so when we think about what is the definition of success, I want you to be thinking about these things. How comfortable does my life feel? How easy is it for me to live in this place of maintenance right now?

How can I preserve my health? How can I live fully? How can I decrease the mental burden of this experience that I’ve had? And this is where a lot of times at this point we might be starting to think about maintenance, but what’s true is that how you lose weight is how you keep weight off. And so a lot of times weight loss and weight maintenance do not look that different from one another. And so we’re thinking about this transition. How do we help to maintain our weight? I have a really great episode on this just a couple of weeks ago about how do you maintain your weight? And I want you to be thinking about this honestly throughout your weight loss journey, but then as you’re transitioning into that maintenance place as well, feeling really confident about how you’ve gotten there and that continues to be a sustainable thing.

So as we wrap up this episode, I want to leave you with a couple of questions to ask yourself to think about, am I at my goal weight or would I like to continue pursuing a lower body weight? And one, this current lifestyle that I’m living, is this sustainable for me? If your current lifestyle is not sustainable or if pursuing a further weight loss goal would not be sustainable, that is a major red flag. Why am I pursuing further weight loss? Is it for pursuing health or is it pursuing a number on the scale, really pursuing perfection? If that is the case, there’s a lot more work that can be done with coaching, with therapy to really understand and learn to love and cherish your body. What am I hoping that 10 more pounds of weight loss would change in my life and what additional weight loss would that meaningfully improve my life in any way?

And so if you ask yourself, if I lost five more pounds, if I lost 10 more pounds, what would be different about that? Would it make any sort of meaningful difference compared to what I’m experiencing right now? And then if you think about, okay, what about my weight at this number? If my weight were to stay exactly where it is right now, I stayed this way forever. Would that be okay? Would I be happy? Could I be content at that point or do I need to continue to lose weight for another reason and really getting clear about what those reasons are and there is not one number that is going to be perfect. Our bodies change over time. So many things change from our muscle mass, our age, our body composition, our energy, how close fit. All these things will change as we age, as we grow.

And so when we’re anchored on very specific numbers, it may not always be the best thing for us. So I want you to think about why do I want to lose weight? What is changing as I lose weight and is this something that I can keep up long term? I’m Dr. Sarah Stombaugh. I would love to support you if you are looking for help in your weight loss journey. I see patients in person in Charlottesville, Virginia and by telemedicine throughout the states of Illinois, Tennessee, and Virginia. You can learn more at www.sarahstombaughmd.com. Thanks for joining me today. See you all next week.