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:
If you have lost weight before and regained it and maybe that’s happened multiple times, it is very common for people to have the experience like they are totally disconnected from their body. They don’t know that their body is working with them. A lot of times they’re often feel like they’re fighting their body and in this constant state of resistance and it is simply exhausting when you feel that way. And if that sounds familiar at all, I want you to stay tuned and share this with someone else that you know who may have experienced this also in the past because chronic weight cycling diet culture breaks down our relationship with our body and today we are going to talk about how to build that back up. If you’ve ever felt like you don’t trust your body, you feel disconnected from your body, today’s episode is the episode for you.

Now, if you are new here, I would so appreciate if you like and subscribe. I’ve been working on growing my YouTube channel. So for people who are listening to this on the audio version, definitely check this out on YouTube as well. I’ve realized that I sometimes really talk with my hands, especially for those episodes. Sometimes I’m making a lot of hand motions or trying to demonstrate something and so it’s really fun to have the video as well. But I so appreciate everyone who is here today. But let’s talk about this. What is happening when you’ve lost weight, when you’ve regained weight, when you’ve been through these ups and downs, you’ve been in diets before and you feel totally disconnected from your body. How do we help to heal that? And we’ll talk about this both in the context of with medications, but even then just on our own, how do we help to heal that relationship with our body?

And when we think about it, it really makes sense how diet culture can create the situation where we feel like we don’t understand our body, where we feel like we have to restrict ourselves or not all foods are allowed. It can create a really challenging relationship with foods and with eating environments. So when we think about a very traditional diet, there may be entire food groups or certainly foods where it’s like, okay, these are bad foods, these are good foods, you should eat these, you shouldn’t eat those. And while I think we can all agree that there are certain foods that will fuel our body better, foods that are more nutrient dense, foods that have really important roles in building and supporting our body, while other foods may be playing more of a emotional role and that’s okay. We can eat for reasons that aren’t hunger.

We can eat for celebration. We can eat certain foods for comfort. It’s normal and common in our society for that to happen, but it can take on the sort of life of its own, especially when we enter into any type of restrictive diet program. So when you are told, do not eat this type of food or this group of foods, what’s very common is that we enter into this cycle of restriction and we are restricting certain foods and we feel really deprived. And so psychologically we’re feeling deprived, but then even physiologically, a lot of times we’re starting to feel hungry. So we’re starting to feel these intense hunger signals and this is not psychological. Even as we tip into cravings territory, a lot of cravings are very much physiologically driven. So if you think about the experience, for example, of being hungry and going to the grocery store and you look at your cart as you’re leaving and you’re like, “Oh my gosh, why?

Why did I put these type of food items into my cart?” It is because you were hungry and when you were hungry, when those hunger hormones like ghrelin are just screaming at you like, “Hey, buy food.” It’s not just like, “Hey, get the most healthy food that you possibly can. ” We’re actually a lot of times looking for really energy dense foods. So foods that are very highly processed, foods that are sugary, foods that are fatty, those are the foods that our body is more likely to crave. So we take this back to a diet, for example. We’ve been restricting, we’re feeling deprived, now we’re feeling hungry and our body starts screaming at us literally with hunger hormones saying like, “Please go eat some food.” And then you’ve got this psychological and this intense physiological argument that’s happening in your body and it leads to a overeating or overindulging type of cycle.

And we see this happening over and over again and this can happen over the course of a day. So maybe you have a day of really bad eating. And again, for anyone who’s listening, there’s big air quotes on that bad eating, but you have a day where you’ve overindulged and then we sort of sometimes very consciously or sometimes a little bit more subconsciously it’s like, “Okay, I was really bad this weekend so I need to make sure that I’m really good starting on Monday morning. I’m only going to eat lettuce and protein or whatever.” And so we can have these cycles that are short days at a time, but they can also be longer weeks at a time, months at a time. And we can see a lot of times I’ve worked with patients who’ve had really significant weight loss attempts in the past where they’ve lost 50 pounds or a hundred pounds through diet and exercise alone, but then they found that that weight has come back sometimes and that weight plus more.

So we have these really intense cycles that happen and our body, we feel like we’re fighting our body, but the reality is when our body is sending those signals of ghrelin of like, “Oh my gosh, you are so hungry, go seek food right now.” This is actually a very protective mechanism. So your body is trying to help you. Your body’s like, “Hey, I feel like we must be in a famine right now. There’s not been a lot of food that’s been available to us. So I’m just going to help you out, remind you that you need food. I’m going to yell at you that you need food. And the longer that you go without eating, your ghrelin is just screaming at you now to go get some food. And this is, like I said, your body is trying to help you. So sometimes we feel like our body is fighting back.

We feel like, why won’t my body listen to me? I’m just trying to eat healthy or not eat this much right now. And I just feel this overhunger and this overcravings. That is actually a very, very protective mechanism. So I think even understanding your body is not trying to fight you. Let’s figure out how do we work with your body. Now, one of these ways might be through the role of medications and we’ll talk about how those medications are supportive, but even setting this aside, I really like to think about the role that food is playing in our body. A lot of times we take food and put it into all these different categories like these are foods that are healthy or these are foods that are unhealthy. These foods are good, these foods are bad. These are workday foods or weekend foods or vacation foods.

We have these different ways that we categorize food. And one of the things I really want to encourage you is to ask yourself, how is this food fueling my body? I want to think about food as fuel. I also want to think about food as nourishment. So these words like fuel, these words like nourishment, fuel sounds very neutral. So it doesn’t have this positive negative connotation to it. Fuel feels like a very neutral type of thing and something like nourishment feels like such a loving word. When I think about food as nourishing my body, it feels like giving my body just a big hug. What does my body need right now? What would really nourish me? And that then when we think about the types of food choices that we’re making, nourishing our body sometimes builds in space for foods that are traditionally not considered as healthy.

Nourishment can look like a lot of different things beyond just true physical hunger. So asking, how do I fuel my body? How am I nourishing my body right now? These are the types of questions that are really powerful and can start to rebuild that trust. So I want to encourage you to think about those two questions. How is my body being fueled? How is my body being nourished? Now, when we think about fuels our body, this is one of those reasons that they eat less and move more, doesn’t work, is that food is both a package of calories as well as a signal of how is our body supposed to use that food. When we simply eat less, our body often responds with this really intense hunger because our body is not feeling adequately satiated. Foods that are very carbohydrate dense, for example, especially those that process carbohydrate dense do not create a lot of natural satiety or fullness.

So when we think about what are the types of foods that make our body feel full? We’re really looking at fiber, we’re looking at protein and we’re looking at fat. And when we can combine all of those together, that can be a really powerful way to help fuel our body in this way that feels very even and sustainable. When we’re eating a very carbohydrate forward meal, we often feel that our blood sugars is up and down. We’ll feel this rollercoaster of … A lot of times we don’t feel the spike, but we’ll feel the crash. I don’t know if you’ve ever had that sensation of eating a really sweet, for example, like if you’ve eaten candy or a cookie on an empty stomach, you feel that crash coming down from it afterwards. That is very common because our body doesn’t get this lasting satiety from those type of foods.

But when you have, for example, something that has fiber, something that has protein, you think about the way that your body feels after having some whole grains with vegetables and a survey of meat, for example, you are likely to feel sea shaded for hours later. And so that feels really fueling in the body. So thinking about and paying attention to, even just if I look at what am I doing right now and how are these different foods feeling, paying attention to, okay, on that day that I had just a muffin for breakfast, oh my gosh, like an hour later I was ravenously hungry versus on the day that I had a piece of whole grain toast with some avocado and an egg on top of it, like, oh my gosh, I felt sea-sheated for four or five hours. Noticing the difference in how different foods feel in our body is really incredibly powerful.

And you can start to feel like, oh man, instead of just like, oh, I’ve been bad this weekend, I need to eat healthy. Sometimes it’s like, oh, I traveled this weekend and I’m feeling a little constipated. My body could really use some vegetables right now. And not even in this frontal cortex human way, but in this like, okay, my body is asking me like, “Hey, let’s get our bowels back in check. Let’s get things moving again.” Some vegetables would feel really good in my body. So really paying attention to how am I fueling my body and noticing the way different foods feel in our body can help to rebuild that disconnection that has happened in the past. Now medications may also play a really powerful role. I think one of the reasons that the GLP medications have been such the blockbuster that they have been is that they help to regulate those hunger signals so that our body is not feeling overly hungry, that when we eat, we feel like we’re able to eat an appropriate portion, that in between meals, we’re not constantly thinking about food.

And it’s amazing when we compare these medications with some of those lifestyle changes like the way different foods feel in our body, pairing those things together is absolute magic. I think there’s a lot of misinformation about the way that GLP medications are utilized. They’re not meant to suppress appetite to the point where you can’t eat anything or you can only sip on protein shakes. Now sometimes that can be someone’s experience as the very first starting a medication or titrating the medication. If that experience happens for you and it’s temporary, no big deal. But long-term, we want to use the dose of medication that allows you to feel appropriate hunger, to feel appropriate fullness, and to eat foods that feel good and fuel your body. And those two things, like I said, when partnered together are just absolute magic and it helps us to start to rebuild that trust so that we’re not thinking about food all the time.

We’re not planning our vacations or our days around food. It becomes just part of the day rather than the focus of the day and this is where the magic really starts to happen. And this is one of my biggest passions is helping people with reconnecting with their bodies, whether they’ve been through lots of diets in the past, whether they’ve had eating disorders in the past and feel like they can’t trust their body, but now maybe they’re really struggling with weight in a way that’s been challenging. I love supporting patients who’ve been through those type of journeys. And if you are looking for someone to support you in that way, I would love to see you as a patient in my clinic. 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 for today’s episode. See you all next week.