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 today's episode. I'm really excited to share this episode with you. Honestly, as I say that, I think I probably say that every week because I just love sharing my thoughts and my experiences with you all. So thank you so much for being my listener. We are talking today about how not to screw up our children. This is a conversation I have with my patients very often because they are parents, maybe their grandparents, and they are worried that their behaviors will impact their children or grandchildren or other children in their lives in a negative way. And on the flip side of that, a lot of times they see how our own parents have messed us up, if you will, and they are really cognizant about making sure that they don't want to do the same thing for their own children. They want to teach their children how to have a healthy relationship with food, and they want to make sure that they are really being a good role model and being their ideal role model in this situation. So I'd like to talk about a couple of overarching principles, thinking about honoring our hunger and satiety, what it looks like to build a meal and thinking about the different rules of different foods in our body and thinking about when we eat, whether that's in response to hunger or whether that's in response to an emotional state like stress or even as a reward. For example. What is the reason that we're eating and sort of break down each of these things and talk a little bit more about them. Now, I've done an episode similar to this a while ago. It's actually been about two years ago that I most recently did an episode like this. And just a couple of weeks ago, my children and I went out for ice cream on a Wednesday afternoon. It was nothing particularly special except that I get out of work early on Wednesdays. So I picked the kids up from school, we get ice cream, and then we went to the Children's Museum and we live in Charlottesville, Virginia. While it's a lovely town, it's a very certain times of year, there's a lot of tourists. And so we're coming into one of those times. The fall is lovely. We have a lot of tourists. And so a group of older women walked into the ice cream store to get ice cream for themselves. And my kids were sitting in a booth with me eating ice cream and my kids and these women were smiling at each other and making eyes at each other and it was really sweet. And one of the women walks over to our table and says, oh, you children must've been so well behaved for your mommy if she brought you out for an ice cream treat. And it was really funny because I see examples of this type of language and this type of behavior very often in our society where we look at food as a reward. And it took me just a moment, but I was like, Nope, actually just having a fun Wednesday afternoon, just moving right past that. They didn't do anything special. It wasn't any sort of reward. I mean, it's not like we go out for ice cream any day, but it was just, it's just a Wednesday, we're going out for ice cream and we're having fun, and that's it. So with that, I started thinking a little bit about how I would share this message with you all. So let's start and talk a little bit about hunger and about fullness. Now, I have a handful of episodes talking about the hunger scale, thinking about our hunger, thinking about our satiety. And it's really interesting because this is something that generally speaking, we are all born with, yet many of us really lose sight of what our hunger and what our fullness or satiety signals are. One of the first things I do with every single one of my patients is help to support them in paying attention to that, paying attention to physical hunger, to satiety, paying attention to when that's coming up, what types of foods are more likely to create satiety, are there foods that make us feel hungry more often? This is something that we are doing to just start to rebuild that relationship with ourselves and understanding what it is that our body needs. Now, if you haven't listened to some of the episodes on the Hunger Scale, I have some of the very, very beginning. And then just a couple of months ago I did an updated version about recalibrating your hunger scale. So those are excellent resources if you want to look a little bit more into that. But the idea of the hunger and the fullness scale is that we're taking something that is qualitative. We're taking something that is innate to us that we may be out of touch with, and then we're bringing it to the forefront of our minds to start repaying attention to it and start rebuilding that habit that we are acknowledging what it is that our body needs. So often we in modern culture eat for reasons beyond hunger, beyond satiety. We eat because the clock, it's eight o'clock in the morning and I eat breakfast at eight o'clock every day. We eat because of our work schedules, we because of our family schedules. If the whole family's going to sit down for dinner at six o'clock and you're not hungry, well, you're probably going to sit down anyway. And that is okay. There are external pressures in our lives. We don't live our lives in a vacuum. We need to be paying attention to these other things and make sure that we are acting in response to those and also in response to what our body needs. And so what those looks like on the hunger scale, for example, is if typically living in a vacuum, there were no other people, there were no other schedules, nothing else we had to consider. My recommendation is that we start eating at a negative four. We're just a little bit hungry, sort of appropriately hungry. There's nothing ravenous or urgent about the situation. And then we eat until we hit appropriate satiety at a plus four. And at a plus four level, we're also feeling appropriately full. Our body feels comfortable, our body still feels energetic. There's no sluggishness, no, oh, maybe I overdid it. There's no unbuttoning of the pants or changing into sweatpants. It is. I feel like I've had really sort of just enough. This feels really good in my body and I know I don't need to eat anymore to meet my goals. So when we're thinking about eating between those points, what is going to happen is that there are times, for example, your family is sitting down to eat dinner. It is six o'clock at night, you're not super hungry. Maybe you had a late lunch, maybe you had an afternoon snack, and let's say your satiety is zero, your hunger is zero or negative one. She's like, maybe I have the early earliest signs of hunger, but I wouldn't normally eat no big deal. That just means that you would need to eat less food in order to hit your appropriate satiety. And so we can utilize these factors in order to start building our meals based on what it is that our body needs. And when we look at children, particularly young children, they are masters of this. They don't need to be thinking about a number on a scale. They don't need to be writing it down or saying it out loud or really formally acknowledging it. They are just so in touch with what is their hunger and what is their satiety. And I've given these examples many times, but it's wild to me just how in touch my own children are with this. And if you have children in your lives to take a look at their relationship with food and how in touch they may be as well. And so days where very commonly my kids eat pretty small amounts of food at dinnertime, and then by breakfast time they're just starving. So at dinner time, sometimes it's literally 2, 3, 4 bites of food. I mean, other times they might eat a full meal, but sometimes it's just a couple of bites of food and they're like, okay, I'm done. I'm full. And they excuse themselves from the table and we leave it at that. And they're perfectly satiated. We have a relatively short window of time from when the kids eat dinner to when they go to bed. So there's not that opportunity. Two hours later they're like, oh, I'm so hungry, or anything like that. And if that's coming up with your kids, you're certainly going to want to make sure that you're helping to build and create a meal that is promoting satiety for them. But many kids can eat a few bites of food and feel perfectly good. And then on the flip side, on the day where they're feeling a lot more hungry, I mean, there's days my kids are two, four and six right now. There's days where each of my kids, even the 2-year-old, may eat more than me in a single meal, which is wild because she's like this 25 pound little being. And that's just how the metabolism of young children is amazing. And she can sit down. She ate four scrambled eggs the other day, who eats four? I don't eat four scrambled eggs. And so it's just wild because they are totally in tune with what it is they're hungry for when they're feeling full. And if we just lean into that and allow them to pay attention to, okay, I'm full and I'm stopping my meal. But what so often happens is that we put a lot of external pressures of, oh, you haven't eaten enough. Aren't you sure you're not hungry for more food? I know you're going to get hungry in the middle of the night or before bed. Make sure you finish. You finish your plate. There's children that are starving elsewhere in the world. Whatever the language is that we're seeing, if your child is eating, your child is not complaining of hunger, your child is sleeping well, great. Do you need to be making adjustments to that? Or can you allow them just to lean into what it is that their body is naturally telling them? And so paying attention to our hunger, paying attention to our fullness is so, so valuable. And our children do this naturally and let them do it and then pay attention. And maybe we can learn from them as well. How can we incorporate these things into our own lives? Now, next, I want to think about building a meal and what this looks like honestly for any human, but especially for children and especially thinking about what it is that we're putting in a meal. When we look at the foods that are readily available to us in 2024, one of the things that comes up very consistently is the amount of processed food that is available to us. The amount of food that is very heavy and processed carbohydrates, foods that are maybe have a lot of preservatives in them, and food choices look a lot less like whole real food compared to even a few decades ago, we've seen this evolution of food where it's become more and more processed. Now, one of the things, whether we're talking about children, whether we're talking about adults, is that when we think about creating satiety, creating fullness, and not just in the short term but in hours that follow a meal, making sure that we're building meals that are actually promoting fullness for us. So if a couple of minutes ago I was talking about, okay, if you're kitties three bites of food at dinner and they're great, just let them be, and you're like, she has no idea what she's talking about because my kid is ravenous before dinner. Here's where I want you to pay attention though. What is it that your kid is eating three bites of food of? Because when we think about satiety, when we think about the foods that naturally create fullness for us, are we building meals for our children that are naturally going to promote fullness and satiety? Again, both in that short term initially after a meal, but also a couple of hours later, such that they're not just sort of snacking on processed carbohydrates, crackers, and fruits and chips and cookies and muffins, and a lot of the kids' snack foods are really carbohydrate heavy. And so even when some of those are fruit based, making sure that they are paired with proteins and or fats in order to create satiety. So when we think about lasting fullness, the best things we can do to get lasting fullness are to eat foods that have protein, to eat foods that have fiber, and to eat foods that have some fat in them as well. Now, foods especially that have naturally occurring fats, so meats, for example, fish, for example, dairy products. Those are honestly when they're naturally occurring, that makes a lot more sense to eat those compared to added fats. So fats in very highly processed meats, fats in fried foods, for example, where that fat is added is very different than when that fat comes in naturally as part of the food. And so thinking about and even starting to talk to your children about why we eat different foods. And so if they are wanting to eat goldfish crackers for a snack, fine, and that's probably not doing a whole lot for them nutritionally. So are there other things that we can add to that that are going to help us nutritionally? So when we think about fiber, for example, so my four and 6-year-old are both boys. We love a good potty joke in our house. And so when we talk about fiber and we talk about the fact that fiber makes us poop, my children are very into that. We're able to talk about the role of fiber in keeping our tummies full and helping our bodies to poop regularly, and they love poop. They think that that's awesome. And so that message really resonates with them. And so can you create a similar or a variation of that message for your own children? When we think about fruits and vegetables, now certainly those have fiber, but they also have a lot of vitamins and minerals in them that can be helpful in making our bodies healthy and keeping us from getting sick, even in keeping us from getting colds, for example, like vitamin C is one of the best things we can do to reduce or to improve our immune system, to reduce the chance that we're getting a cold. And so we talk about what is it that when you're eating an apple, when you're eating an orange, what are those foods doing for your body if you're having protein, we talk about, my husband in particular does a lot of weightlifting, weight training. And so my children see that they see how strong their daddy is. And so we talk about protein, we talk about muscles, we demonstrate, we hold out our big bicep guns and look at how strong our muscles are, and we talk about the role of protein in building our muscles. And so when we think about the way that we're talking about food, it is our responsibility as parents to put good food choices in our house, but also not to be overly restrictive. And so when they're at parties, when they are at places where there are opportunities to eat foods that are not healthy foods, how do we just build that into a more comprehensive meal where they're going to get some fiber, they're going to get some protein, and so even if they have Doritos or a cupcake or whatever the thing is, how do we just make this a more well-balanced meal and talk about the foods and the roles that those have in our health and in our bodies, helping them to create that such that as they get older, there's no foods that are off limit, but they just know how to build a more broad meal for their bodies. The other thing is this eating and response to emotions. So as we talked about the very beginning, the sweet older women who came up to my children at the ice cream store to say, oh, you guys must have been really, really well behaved if your mommy took you out for ice cream. Thinking about how and why we eat is one of the most, and honestly, maybe the most critical point when I think about our relationship with food, there's plenty of kids who are super picky, and I get that. And if your kid is picky and you're like, oh my gosh, I am just doing my best, then just keep doing that. Just keep doing your best and think about how are you teaching them to eat in response to hunger or satiety, or are they eating for a lot of other reasons like their emotions because they were well behaved, because they were sad because they had a bad day? What are the reasons that we teach our children to eat? If I could do anything for the entire world, reteaching, this is honestly one of the things that I find so important and that in so many of my patients who struggle with their weight, it's their relationship with food where they're eating for reasons unrelated to their hunger and satiety and eating in response to their different emotions. And so being cognizant of this as a parent. Now, this doesn't mean that every food has to only be eaten in response to hunger, but for example, let's say you're going out to celebrate a birthday while there are foods involved in it, the conversation is, is this about celebrating together, being together as a family, or is this specifically about the foods that we're eating when I took my kids out for ice cream? Is it about spending time together, enjoying the afternoon together, or is it about every time we do something special that is going to involve an ice cream? And while that example did, there's plenty of times where the afternoon involves going to a playground and spending time together, going to, there was a book sale in our town recently at the library and going there and spending time together and picking out some of our favorite books. And so do every time you're enjoying your time together, every time you're celebrating, does that always involve food? And if so, are there ways that you can create celebrations that don't involve food or special time together that doesn't involve food so that we're not always tying, okay, something good in my life has happened, I need to celebrate with a sweet treat. Or even if it's eating, can it be eating at a restaurant that is really, maybe it's really expensive, but it has high quality food that's also healthy food that's more in line with your goals, for example, so that it's not specifically I feel an emotion and I'm responding with a dessert, or I'm responding with a specific food type, for example. And on the flip side, learning how to acknowledge our negative emotions and teaching our children not to eat in response to our negative emotions, because this is super, super common as well. We learn this in our childhood from our parents, from our friends, from our culture, and we have something to us. We learn to eat to make our body feel good, and then that behavior continues with us for the rest of our lives. And so I've given some of these examples in previous episodes, but we think about, oh my gosh, you had a bad day at school. You didn't make the sports team. I'm going to take you out and we're going to get ice cream after school because you're feeling so sad and the ice cream will make you feel better. Or the kid falls down and bumps their knee and like, it's okay. Let's go get a cookie. Or your boyfriend breaks up with you and one of your friends brings over a bottle of wine. We over time have developed this relationship sort of subconsciously, where when we feel bad, we know that food or alcohol, plenty of other things too, but that these things make us feel good and we start to eat in response to those negative emotions. And those negative emotions sometimes are just the daily stress of life, of work, of family, of other things in our life such that we enter into this relationship where every evening maybe we're unwinding into dessert and or alcohol in response to some of the challenges that we've had throughout our day. And it's really interesting to start to chip away at that and pay attention to, okay, it does make me, I mean, there's a dopamine hit that happens in your brain when you eat sugary processed foods, when you have alcohol, those things make you feel good temporarily. And so there is a chemical response that happens there, and oftentimes it's this very subconscious thing. So how do we, and I often work with my patients of bringing that to the forefront so that they're aware that it's happening and then starting to work at identifying the emotions that are triggering that behavior, identifying and learning to process that. A lot of times that may be really well done with the support of a therapist, for example, but starting to pay attention to acknowledge awareness of the emotions that are happening and processing those rather than jumping away from those and responding with a food item instead. And I see this all the time in children, in my own children, the comments that other people make to them, whether that's friends or family or neighbors or random women at the ice cream store, people have a lot of beliefs around food that they openly share. And so as parents, it is our role to protect our children, to teach our children and help them to establish this really healthy relationship with food. And if you were listening to this and you're someone who's like, oh my gosh, I wish I wish I wasn't at in adulthood dealing with some of these things, I want you to know that it is absolutely possible to relearn your behaviors, whether that is with the supportive medications, whether that is support with a program like mine, with coaching, with therapy. There are many people who have an unhealthy relationship with their food. They eat for reasons beyond hunger and fullness, and that is something that can change. So even if you're like, oh my gosh, I'm old, old dog can't learn new tricks, I will tell you, you absolutely can if that is important to you. And so if you're someone who's listened to this episode and wondering, what does it look like to work with an obesity medicine physician to work in a weight loss program, where we're addressing not just the medications, not just the medical component, but also some of this thought work, and what are the things that lead us to make the decisions that we do? That is something that is so important to me and is a crucial part of the program. We work with all of our patients to support them and also in groups in order to make sure that they get the support that they need. If that is something that's interesting to you, I would love to support you in your weight loss journey. I'm seeing patients in the state of Virginia, in the state of Illinois by telemedicine and in person in my Charlottesville, Virginia office. If you're interested in working with us, you can reach out to us at www.sarahstombaughmd.com. Thank you so much for joining us for today's episode. We'll see you all next week.