Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast, episode number two. 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: Hey everyone. Thank you for joining me today for the first real episode of Conquer Your Weight. Today we are going to talk about learning how to trust yourself. And this is a theme that you are going to see coming up over and over again throughout the podcast. It's going to take some work, but I wanna start challenging you to do this right from the very beginning. So the things we're going to address in the podcast today is understanding how to start trusting yourself again, how to bring awareness to what you're doing, how to be honest with what you're doing and how to learn how to listen to your body. One of the things that drives me just totally crazy about the diet industry is that it teaches you that you don't know what's going on with your body. You have failed, you are at a higher weight number, and now you need to turn and look to someone else. Someone else is the expert who's going to help you solve your problems. And while you may not know a hundred percent of what you need to know, we have learned to feel completely incompetent about our body and our choices and what feels good for us. And so I want you to turn inwards and use information, the signals that your body is sending you and combine that with what we are going to talk about to help make the best plan for you going forward. And so we're going to address some really general food principles. Talk a little bit about logging your food as well as paying attention to hunger signals. When we think about food principles, the biggest thing I want you to think about right now are foods that serve your body. We are going to, at a later date, get more into nitty gritty of different food plans and what may or may not make sense for you depending on your medical conditions. But I want you to think about what are your food preferences, your likes and dislikes. Are there medical conditions for which you need to be treating with food? And are there other factors to consider like cultural or religious dietary plans? When we think about food choices, it's so important that you enjoy the food that you're eating. I am never going to tell you to choke down something that you are not going to enjoy. So for example, I love salmon and Brussels sprouts. I gladly would eat salmon and Brussels sprouts for dinner once a week for the rest of my life if you asked me to, maybe even twice a week. I love it if you prepare the salmon, right? If you roast those Brussels sprouts, little salt, a little pepper, little olive oil and garlic, literally, I could eat that all of the time. But if you hate salmon and Brussels sprouts, it doesn't serve you to put that on your dinner plan because when it comes time to eat that you are not going to, who wants to eat food that they don't like? Ultimately, to have success in the long term, you need to find foods that both serve your body as well as foods that you really enjoy eating. And so I want you to keep that in mind both today, but as we move forward so that you can make the best decisions for yourself. I wanna talk a little bit about food logging as well. When we look at studies of people who have had success with long-term weight loss, one of the biggest things that all of those people have in common is that they log their food. And this can be done in a lot of different ways. I'm sure you've seen a lot of different apps that are out there that allow you to do that. I try to encourage people actually, not to get too overboard with it, I recommend to use a really simple app like the notes app on your phone, which is basically just a blank notebook paper, or to use a real like hard copy pen and paper in order to write down what you're eating. And you'll find over time there may be things that do or don't make sense to you. Like if you forget to bring your hard copy journal with you, maybe it makes sense to have something in your cell phone instead. But I want to encourage you to start really paying attention to what you're putting in your body and without making any changes at all to just bring an awareness to the foods that you are eating. And I'm surprised, one of the things I do with my patients at their very first visit is something I call a 24 hour diet review. And that means that from when you woke up yesterday morning to when you went to bed yesterday evening, what are all the foods and drinks that you put into your body? And I approached medicine and weight loss from a completely judgment-free zone. I talk to my patients like, "Hey, no judgment here at all. This is just us, us gathering information." And even with that in mind, I'm surprised how many of my patients literally can't remember what they ate yesterday. They will sit there racking their brains for like five minutes because they just weren't really even paying attention. And so to start to bring awareness of the food choices that you're making allows you then to start making food choices that are going to better serve you in the long run. And so what I recommend is writing down each day and just a very kind of general list of what you had to eat that day. So you'll write for breakfast, I had a slice of toast with smashed avocado on it. For lunch, I had a bowl of soup with a side piece of bread. I had an afternoon snack of cashews in the afternoon for dinner. I ate chicken and rice. And then after dinner I had two cookies before bed. And it can really be at that level of detail where you're writing down just enough information that it can help recall those memories. But you really, I don't necessarily recommend writing down like, I had two tablespoons of this, or the food weighed, you know, this amount of grams or anything like that. When you start looking at those really detailed levels, you start getting into calorie counting and starting to look at external factors for deciding how much food you need. There are a lot of different calculators and estimators of metabolic rate and how much food that you should be eating, but I don't recommend just a strict calorie restriction or strict calorie counting. I recommend really turning inward to see what you need for your body. And we can make adjustments based on how that food feels in your body, both now and then over the long term. So you can certainly do any of the apps that are out there. There's a lot of great ones like Lose It or MyFitnessPal. Those apps are going to be a little bit more geared to specific measurements. And so you can certainly do that, but just recognizing that may not necessarily be information that you need, you know, now or even long term, although it, it may be interesting data as well. And you might like to see how things are evolving over long term. So I'm totally fine with you doing that, but I don't want you to feel like you have to do it because sometimes that adds a layer of complication that then makes it hard. You're like, oh my gosh, it's gonna take me 15 minutes to sit down and enter all the food that I ate today. And so I, I don't end up doing it where just jotting it down really quickly. You can literally do the whole thing in a minute, you know? So that's the very first thing I want you to do, is just start writing down what you eat. And even when it's like, I walked into the break room and there were cookies and I had half of cookie, or I had one bite of candy, or I had the leftovers off my kids' plate, whatever it is, anything that goes in your mouth, food or drink, write it down. Because that will start to make you realize, wow, like I thought I was making really healthy decisions, but it turns out I actually grab food from the break room every day at work, or I routinely, you know, grab food as I'm walking through the kitchen, I'm not even hungry, I'm just grabbing these things out of habit. So you start to see those awareness, you start to give yourself that honesty and it allows you to understand. So all of this is done from a place of no judgment. And so I can certainly promise you that there is no judgment coming from me. The most important thing here is that you don't judge you. You're gonna write down what you ate, what you, when you ate it, and maybe just a general estimation, like two slices of toast or something like that. Everything that goes in your mouth, you write it down. And then ultimately that helps us give information to where we can tweak things for you and the foods that are serving your body. I've also had a lot of patients who use this in the context of their medical conditions. So patients who have migraines or who have irritable bowel syndrome or something like that, they can also use this in order to give themselves that information of when I eat x, Y, Z food, I notice that it gives me these symptoms. And so it can serve you in different ways as well. So definitely, especially if you're just writing it in a notebook or in the notes app on your phone, you can even include some information there about physical symptoms that you're having in order to help serve you medically as well. So that's the very first step of things I want you to focus on. The other thing I really want you to focus on is what are the signals that your body is sending you? We are each born with innate hunger signals that are biologically ingrained in our bodies, yet we learn from a young age how to ignore those. Our body has this really complex system for neuro hormones that help to tell us when we're hungry and when we're full, when we stay tuned into this system, we're able to eat exactly when and how much we need. And if you've ever watched a toddler or a really young child eat, you can see this to be true. So for example, I have a one and a half year old and a three and a half year old, and you can watch us in action. There are times where they eat so much food. My toddler weighs 31 pounds, my year and a half year old, and there are times where he will literally eat like three eggs, two dozen raspberries, a cup of milk for breakfast, and I'm like, oh my gosh, where do you put this into your teeny tiny little body? And then there's other days where he eats like a bite of chicken and two carrot sticks for dinner and then he calls it quits. And as a parent, it can be really hard not to intervene in that situation, especially when they eat like literally three bites of food. It's like, "Hey, aren't you sure you want to eat more?" But as a parent, my goal is to teach my children how to recognize and then pay attention to the signals that their body is sending them. And as your doctor, my goal is to help my patients to start paying attention to and relearning these signals. And so we're gonna start by just paying attention to the hunger scale. This is adapted from the Life Coach school as well as Katrina Ubell, MD. And it's a scale, a numerical scale that helps you to assign a number to what you're feeling. And I want you to start putting this in combination with your food log so that you can have an awareness of what's going on in your body. So this scale ranges from negative 10 to plus 10. So negative 10 is going to be like really empty, really hungry, where plus 10 is going to be like the most amount of food that you can possibly imagine in your body. So let me just review how some of these things may feel in your body. So again, that negative 10 is ravenously hungry like I am on a deserted island. If I could eat my own arm because I knew how to cook it and prepare it properly, I would literally eat my own arm off of my body. I am so hungry. Negative eight is I am very hungry. I will eat anything in sight. Negative six. Ooh, I'm feeling pretty hungry like I probably should have eaten or I better eat soon. Negative four is a tolerable amount of hunger. This is the point where you want to start eating is when you're feeling a negative four. Like your body's empty enough, it's sending you signals, but you haven't gotten to the point where you're in any sort of panic. Negative two is just that like very early sign of hunger. I think of this as like, yeah, I could eat right now, but you don't necessarily need to eat right now. Zero, completely neutral. Then we start moving into the positive side, which is as your body is starting to fill up. So number two or plus two is starting to fill up like, hey, I could go for a jog around the block right now. I'm not feeling full at all. Plus four, I'm feeling comfortably full. I could go for a brisk walk around the block. This is where I want you to focus on stopping eating. Plus six is that feeling of, hmm, like maybe I ate too much plus eight. You're like, oh yeah, I definitely ate too much. You're like unbuttoning your pants. Or changing into comfy sweats. We wets where plus 10 is, oh my gosh, I have eaten so much food that like right now I feel physically ill and you're wanting to excuse yourself to just like lay in bed because you feel terrible after this meal. So in combination with your food logging where you're writing down everything that you're eating, I want you to start writing down a number that makes sense to you as well in terms of how hungry or how full you are. And at first we are doing this from a complete place of no judgment. You're just writing it down, you're paying attention and you're like, huh, that's interesting. I walked by the break room and I ate a cookie even though my hunger scale was a plus one, like I was feeling a little bit full 'cause I had literally eaten lunch an hour ago, yet I still eat the food anyway. And just starting to bring that awareness of, "Am I eating because my body is telling me to, or am I eating because of some other external factor?" So it can be a little bit easier to write this down in terms of starting a meal. I also want you to pay attention to, as you're eating to stop eating when you're actually feeling full. And so one of the things that happens is that because we are distracted while we're eating or we are like just really not paying attention, we may end up eating a larger portion than our body actually needs. And so all of a sudden you found yourself at a plus six and you're like getting pretty full and you're like, oh shoot. Like how did, how did that even happen? And so there's a lot of different things that you can do in order to pay attention to your fullness signals as they're starting to happen. So the best thing you can do is always to serve yourself. So if you have, if you're eating at home or eating with friends or family and you have the option to control how much food goes on the plate, choose how much food goes on your plate because you're going to do a better job of deciding that compared to anybody else. Now, if you're at a restaurant in particular or probably at other people's homes, you may not always have the option to do that. And so I want you, when your plate is very first set down in front of you to look at the amount of food with a completely logical brain and say, how much food do I think that my body needs? And to literally take your fork and your knife and to cut that portion or to separate out that portion so that you have decided how much food you're planning on eating. And then you can eat that amount of food and check in with yourself. Hey, do I feel full right now? Am I still hungry? If you're still hungry, keep eating. But if you're starting to notice that you're filling up, you can realize like, huh, I thought maybe I needed all this food, but it turns out I ate this smaller portion and it was actually just the right amount for me. The perfect example I always give of this is the Chipotle label. Um, if you go to Chipotle and order really any of their entrees, but I always order the bowl. So this is the one I think of. It is a huge amount of food and it is certainly way more food than my body or most people's bodies actually need. Yet our brain plays this trick on us where when a portion of food is set in front of us, it automatically becomes one serving size, even if it's way more food than we would have ever chosen for ourselves in that circumstance. And so I would encourage you to cut that in half and you might find that you can literally eat half of it and then save the next for a completely separate meal, which both saves you feeling uncomfortably full in the moment as well as saves you money. So you're welcome on that. But paying attention as you're starting to fill up to stop eating when your body is feeling fullness, and to actually be engaged and paying attention to your meal so that you're able to start recognizing these signals. And so if you're eating food with friends or family, that's great. It naturally slows you down in your eating process. So it allows your fullness signals to be sent from your stomach to your brain, so you're able to recognize, Hey, I'm full. It's time to stop eating. But anytime that you're eating by yourself, I really want to encourage you to just sit and eat your food, not to be watching television, not to be scrolling on your cell phone, not to be doing work at the same time, but just carve out time and just focus on eating lunch or dinner or whatever it is so that you can really pay attention to what's happening in your body. And as you start to pay attention, then we'll be able to start making changes so that you can acknowledge these signals over time. So a couple of big goals for you on this very first week, but the biggest thing is to just start paying attention. What foods feel good in your body, what foods serve you, what foods do you enjoy? What are you actually eating? Logging that and writing it down. And then what are the signals that are happening in your body? So I want you to pay attention to that and we'll check back in next week. I look forward to seeing you soon. If you are enjoying my podcast, leave me a review wherever you subscribe to podcasts. Take care. Bye-bye.