Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight podcast, episode number 10. 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: Hi everyone. Welcome back. Thank you so much for joining me today. It is the last night of our vacation, and I am coming to you from the condo closet again, so hopefully those 11 throw pillows did the trick for some decent sound quality. I'm also about 90 to 95% recovered from my cold, so hopefully my voice is all right for you tonight too. Today we are going to talk about making a food plan. A food plan is so important because you are bringing intentionality to the food choices you're making. A food plan is a lot different than a diet. When we usually think of a diet, it's a short-term change to our food habits. With the goal of weight loss, diets will vary vastly in what they recommend, but there are usually pretty strict guidelines about what you can and cannot consume when you're on the diet. My goal for you is that you can come up with a food plan for yourself that you can honestly follow for the rest of your life, that you listen to your body and learn what feels good, what nourishes you, what satisfies you, what meets your nutritional needs, and it will be one of the key factors for long-term success with both weight loss and later weight maintenance. Before we dive into making a food plan, I want to review some of the information we talked about last week regarding blood sugar, insulin, insulin resistance, and weight gain. Last week, I was telling you about my experiment with the continuous glucose monitor, and overall the experiment proved exactly what I expected, which is that sugar and flour and other highly processed foods cause a really high spike in our blood sugar. While foods like more complex carbohydrates, especially if they're balanced with high-quality fats and proteins, lead to a much more rounded response in our blood sugar. And this is really important information because while blood sugar is only an approximation of our blood insulin levels, the two generally mirror one another When the blood sugar goes up, the insulin also must go up in order to store away that extra blood sugar for energy for later. When the blood sugar goes down, our insulin levels go down as well because that hormone is no longer needed. Then when our bodies need fuel for energy, we can either obtain that fuel from food or from our own stores. When we obtain that fuel from food, we're entering back into that same cycle of increasing blood sugar and increasing insulin in order to store away that energy when we don't eat and instead obtain our fuel from our own stores, we're burning the stored fuel sources like glycogen from the liver or fat from our fat stores like we talked about in episodes five and six. Generally speaking, our bodies are either in energy storage mode and or energy burning mode, and that's gonna be really important information for what we think about for creating your food plan. Similarly, of course, all foods are not created equally. When you eat a processed carbohydrate, like a bowl of sugary cereal and a cup of juice, your blood sugar spikes very high, and as a result, you must also have a high amount of insulin in order to process and store away that blood sugar. On the other hand, if you have a more complex carbohydrate like a bowl of steel-cut oatmeal topped with berries and nuts, a more moderate amount of insulin will be required to process and store away that blood sugar. Then an example of very few or no carbohydrates in your breakfast, like a three-egg omelet filled with veggies and cheese, maybe meat would acquire a very low amount of insulin in order to process and store away the blood sugar. Or alternatively, you could skip breakfast altogether. For example, if you're practicing intermittent fasting, and then of course no insulin is required because you're not eating at all. And let me be clear, there's nothing wrong with insulin. It's honestly one of the most important hormones in your body. If your body is secreting insulin, it means you have a healthy and functioning pancreas, which is great and important, super, super important. But just because your body is capable of releasing huge amounts of insulin in order to process your blood sugar doesn't mean that it should. Our bodies weren't really designed to consume high amounts of sugar and processed carbohydrates. When you look at naturally occurring foods that have sugar in them, things like fruits or certain vegetables or grains in their whole form, they all contain sugar, but relatively low amounts compared to their manmade processed counterparts. For example, an apple contains a moderate amount of fructose, which is fruit sugar, and while that's still sugar-eating, a whole apple also contains significant amount of fiber, and so therefore your blood sugar response and your insulin response is much more rounded. But you know, as humans, we had to take apples. They weren't good enough as they were, and so we had to juice them. Sometimes we add extra sugar to that juice, and when you eliminate the fiber from the apple, and especially if you add additional sugar, you're getting a huge head of sugar that will spike your blood sugar just through the roof. So eating a whole apple has a very different response in your body than drinking a glass of apple juice. And over time, as our bodies release high amounts of insulin, our insulin receptors start to ignore the signal and we have to release even more insulin in order to process the sugar and carbohydrates we consume. This is the beginning of insulin resistance, and for many people, one of the first signs of insulin resistance is weight gain. And if you're struggling with extra weight, it means that your body has stored away more energy than it needs, period. And there's so many things that can contribute to this, but one of the most important things which is within our own control is the foods we choose to eat and the timeframe in which we choose to eat them. When we make a food plan for ourselves, we have to consider both the foods as well as the timeframe. If you eat foods that are full of processed or simple carbohydrates like breads, pasta, cereal, instant oatmeal, granola bars, crackers, cookies, cakes, pastries, fruit, juice, soda, any other sweet sweetened drinks like teas or coffee, your body will need to excrete high levels of insulin in order to store away that energy for later. And when we eat foods like this regularly, we're experiencing regular spikes in our blood sugar and thus also spikes in our insulin. Often there's a crashing sensation afterwards because the blood sugar has gone up quickly and then goes down quickly as well, and that crashing sensation feels terrible. It's that like, oh my gosh, I have to eat or I'm going to die sensation that maybe feels like nausea or dizziness or hanger. And ironically, eating another processed carbohydrate can bring the blood sugar up quickly and help resolve this feeling. If we instead eat foods that are more complex like whole grains or high-quality fats or proteins, our body has burned them much more regularly, which leads to even blood sugar numbers throughout the day and none of that terrible crashing feeling. And you can see how consuming simple and processed carbohydrates can be a factor in needing to eat frequently throughout the day. The timing and frequency with which you eat is really important. The more often you eat, the more time you're spending in that energy storage mode. If you eat breakfast, then morning snack, then lunch, then afternoon snack, then dinner, and maybe a bedtime snack, you're literally spending your entire waking hours in that energy storage mode and your body never even has a chance to start burning its energy because you're constantly choosing food for fuel instead of using fuel that's already stored on your body. In terms of glycogen or fat stores. On the other hand, someone who eats less frequently spends more time in energy-burning mode. When our bodies need more fuel for energy, we have that choice. Do we choose it from food or do we choose it from our own stores? And when we choose it from our own stores and we, because we're not eating, we're instead getting to burn those stores and use up the energy instead of just consuming more and more of it. One way of doing this is intermittent fasting. Intermittent fasting is like intentionally choosing to eat our food during a shorter window so that we can spend more time in an energy-burning mode and less time in an energy-storage mode. And if you think about it, we all practice intermittent fasting naturally while we sleep. When we have breakfast, we are quite literally breaking our fast. So for example, when I look at my current schedule, I usually wake up about six o'clock in the morning. I have breakfast around 9:00 AM I eat lunch at midday and dinner around 6 or 6:30. I'm always completely done eating by 7:00 PM and I'm pregnant right now. So therefore, I'm not trying to practice any sort of intermittent fasting. This is just my usual eating schedule. But even so, I'm only eating from 9:00 AM until 7:00 PM which is a 10-hour window. Therefore I am not eating or fasting for about 14 hours of the day. And some of you listening to this will think, Hey, that sounds pretty normal, but others of you are gonna wonder like, doesn't she get hungry before or after then? No, not at all. When I first wake up in the morning, I'm not hungry. It's usually only after a couple of hours of being awake that I actually start to feel those hunger signals. And practicing intermittent fasting is not one size fits all. It's going to look a lot different for every single person. So someone who's been having that snack between every meal and a bedtime snack, you know they're eating from when they wake up at 7:00 AM until when they go to bed at maybe 11:00 PM they probably think that my current eating schedule looks like intermittent fasting. And for them it would be a really good start to practice eating during a shorter window like my 9:00 AM to 7:00 PM for example. And commonly, people choose to eat during even shorter windows. So one of the most common intermittent fasting regimens you'll hear is 16 hours of fasting and eight hours of eating. For people who practice this window, it often looks like eating between 11:00 AM and 7:00 PM or maybe noon to 8:00 PM. Other people might eat in just a four-hour window, and some people eat just one meal per day. Some people even do longer fasts, and what's right for someone else may not be right for you. And it's so important to note intermittent fasting is not starving oneself. It's intentionally eating during a shorter window in order to maximize the amount of time you're spending in that energy-burning mode. And when you're in your eating window, you can and should eat a normal amount of food. You should eat enough high-quality foods during that window to be able to sustain you throughout 24 hours. And when you're choosing complex carbohydrates and high-quality fats and proteins, you can be satisfied eating during a shorter timeframe and not feel those wild swings and blood sugar that make you feel like you need to eat every couple of hours throughout the day. And I want you to use all of this information to help make a food plan for yourself. People are always asking me, what is the best diet for weight loss? And I struggle with the answer because the reality is it's not really clear that there is one. Some people will swear by a vegetarian or vegan diet, others by a Mediterranean diet or a ketogenic diet, or honestly, any other number of diets. There's so many out there, probably plenty I haven't even heard of. Every single person is going to tell you up and down why their diet is the best. But do you know what? There really is no diet that is the best. Like how could you follow a Mediterranean diet if you're allergic to fish and you hate olives? How can you be a vegan if you enjoy eating meat and other animal products? And why would you follow a ketogenic diet if you eat whole fruits and vegetables and feel great and have a healthy body weight? Different diets are going to work for different people. Now, certainly there are some diets that make more sense than others, and there's some diets that might make more sense for you, but ultimately, you need to come up with a plan that's yours and just yours to come up with the like insert your name here food plan and doing this has to be a very intentional process. You can certainly do this on your own, and I encourage you to do that after listening to my episode today, but it may make sense to do it with the help of a doctor, a nutritionist, or a health coach as well. Your food plan is simply about you and your body and your needs. You are going to make a food plan that includes both the foods you are choosing to eat and an eating window, and you're going to stick for it for at least two weeks. The reality is long term, we wanna come up with a food plan that you can follow lifelong. After two weeks, you're gonna reevaluate though and you're gonna see what's working, what isn't working, and I'm gonna say this a handful of times, but right off the bat, you are not gonna make the magical food plan that's perfect for you. It's going to take time. You're going to learn what feels good, what satisfies you, what helps you to achieve your weight loss goals. And what's perfect for you when you begin this process will likely be a lot different than what is perfect from you three months from now, or six months from now, or five years from now. It can and should evolve over time. You want to make a food plan that you can and will stick to for at least two weeks. And when you read your food plan, you should feel satisfied and confident that this plan makes sense for where you are right now. So when you sit down to make your food plan, I want you to first identify foods that you can't or won't eat. There may be foods you're allergic to, foods that you choose not to eat for religious, cultural, ethical, or other reasons or simply foods that you just don't like. I would write down each of these foods and write down the reason why you aren't eating it. Think about these and question them just a little bit. Certain foods will likely be a strong no. So for example, if you have an anaphylactic allergy to a food, obviously you aren't going to eat it. On the other hand, if you had a mild allergic reaction to a food when you were five years old and your mom told you you should avoid it for the rest of your life, well, maybe it actually makes sense to get allergy tested. Or if you have an important religious or cultural reason for not eating a certain food, it makes sense not to eat those foods either. But there are times where it might make sense to reevaluate your food choices. So for example, I have one patient who still identifies as vegetarian, but she eats red meat every so often because it's been so crucial for her for maintaining a certain vitamin and mineral levels for her, specifically her iron. And she looks at it like a prescription she needs to take, which I think is such a fun way to look at it in such a cool way to have a good perspective of what she needs for herself. And so she chooses high-quality, organic grass-fed red meat. Often she'll choose a really lean cut of meat such as bison, or other times she buys meat at a local's farmer's market. So think about this for yourself, really question why you were choosing to exclude some things from your food plan. I especially want you to consider foods that you don't like. If it's just one or two things on the list, fine, you can weigh those two foods. But if you're a really picky eater and you have a lot of foods that fall into the don't like category, I want you to stop and consider each of those foods. When was the last time you tried it? Have you ever liked the food when it was properly prepared? Is it possible that you could ever like the food? Are you willing to try it again, thinking about those things and starting to question, there may be foods that you don't even realize you may like because you had it 20 years ago and it was prepared really poorly. Next, I want you to think about all of the foods that you will eat. So considering what are the high-quality foods that will make up your food plan, you should break it into different categories and then brainstorm all of the foods that fall into this category. And those should be foods that you like, but also foods that serve the nutritional goals for yourself. So kind of broadly speaking, I would break it into proteins, fats, and carbohydrates or macronutrients. So for proteins, thinking about poultry, fish, shellfish, red meat, pork, legumes like peanuts and beans, soy, whole grains, dairy in fats, thinking about some naturally occurring fats in meat or fish, baby and dairy products, nuts, avocados, olives, different oil products, carbohydrates in the form of fruits or vegetables, whole grains, nuts. Again, legumes like peanuts and beans. And then I want you to consider what are the foods you are going to limit? These are going to be foods that you are really intentional about when you choose to eat them and not something that will be part of your daily routine. This should be really anything that has sugar or flour or is heavily processed. So it's those breads, pastas, cereals, instant oatmeal, granola bars, crackers, cookies, cakes, pastries, fruit juice, sweetened teas or coffees. You also need to decide how you'll handle sweeteners, anything from naturally occurring sweeteners to artificial or non-nutritive sweeteners. In addition to considering the foods you will and will not eat, you should plan during which timeframe you plan to eat every day. If you're currently someone who is eating from that 7:00 AM to 11:00 PM maybe the first step you make is to eliminate bedtime snack. So you're just eating from 7:00 AM to 7:00 PM and maybe later you reduce it even further. If you're someone like me and presently eating from 9:00 AM until 7:00 PM maybe you consider pushing it back. So your breakfast is at 11:00 AM and then you're eating from 11:00 AM till 7:00 PM or you may decide that whatever your current eating window is is just fine and you're first going to focus on foods and later add in an eating window as you need to. Remember, this is really just about you and your body and your needs. You're gonna set this food plan and you're gonna stick for it. Stick with it for at least two weeks before evaluating how it is or isn't working for you. And like I said, it's going to evolve. You're not going to come up with a perfect food plan on the first try and have long-term success with weight loss, and it's all gonna be butterflies and rainbows. It's going to take some experimentation, it's going to evolve over time. And what's right for you right now will not always be right for you in the future. And after you've sat down and made your food plan, I want you to really critique it. Is it filled with the foods you like and will actually eat with foods that serve your body and your nutrition goals? I want you to feel nearly a hundred percent confident that you can stick to the plan you're reading or that a plan that you've made for yourself. Because if you're reading it over and thinking, yeah, this totally looks great, but no way am I going to eat this, then you need to adjust your food plan. Because initially your goal is to learn to trust yourself, to learn that you have your best interest in mind, that you can make decisions that reflect that. And this is going to be your guideline for your day-to-day eating. Next week, we'll talk more about how to use your food plan to make daily decisions for yourself. We'll also talk about how to make exceptions to your food plan. And as you follow your food plan, you're going to notice that all of the thoughts and feelings and cravings come up, and we'll need to practice managing your mind so you can be in charge of your food rather than feeling like your food is in charge of you. If you live in Illinois or Virginia where I'm licensed to practice medicine and you want some help making your food plan, let me know. I'd love to see you as a patient. Sometimes having another set of eyes, especially a non-biased set of eyes, can be really helpful for making a food plan. And then especially later, as you're evaluating if it's working for you and kind of critiquing and making tweaks to it. So if you're interested in working with me, fill out the form on my website. It's www.sarahstambaughmd.com, S-A-R-A-H-S-T-O-M-B-A-U-G-H-M-D dot com, and we'll get connected. If you've enjoyed today's podcast, please subscribe and leave me a review. Wherever you listen to podcasts, please share this with anyone you think might benefit. Thanks so much for joining me. I look forward to seeing you next week. Bye-bye.