Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast, episode number 65. 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 podcast episode where we are talking about a topic that is very sensitive, yet I know I just knew that I needed to share this with you today. This is an episode that has been weighing on me for a long time, sort of floating around my mind and I had to share it with all with you all, see how it resonates and think about how we take ownership of our weight without taking blame. And that is such a fine road to walk, but that is what we are going to talk about today. So today's episode is titled, "It's Not Your Fault, But It is Your Responsibility." So I want to be very clear that as I say that I am not here to shame or to blame. So I want to spend some time talking about why obesity is not your fault and treating it will require taking ownership, taking responsibility in order to figure out how to solve that problem. What do I mean? It's not your fault if you are someone who has struggled with your weight for any period of time in your bones as I do, from working with hundreds of patients who have struggled with their weight, that it is often so challenging. People who have never had weight struggles, truly have no idea really just how complicated our metabolic systems are. Our cravings are our belief systems. And so what I'd like to do today is take a step back and talk about what are all of the things that create overweight and obesity, and then how can we move beyond those to start learning, to start having curiosity about how we treat our bodies regardless of where our weight came from, how it got there, whatever the journey was, let's start today and look forward to how we can help you in that journey of a healthier weight and really just healthier life for yourself. So when I say obesity is not your fault, you may want to believe me, but you may not believe me. And so let's just explore this a little bit. Especially in 2024, when I think about people who have lived in the American culture over the last 2, 3, 4, 5 decades. We know that we are surrounded by food that is highly processed by fast foods, by frequently eating more sugar, more processed carbohydrates, and that has quickly become something that was not that common to something that has really become the norm. And so for anyone who is on a journey to health, the wild thing is it means often sort of taking a step away from the norm to be able to address your health, to eat foods that are serving your body rather than to just go along with the status quo because the status quo in our culture is eating lots of takeout, lots of fast foods, even if it's not drive through McDonald's, thinking about convenience, foods, quick foods, things that are prepackaged, things that are easy, things that are full of sugar, full of flour, full of ingredients that you don't even recognize because we are in the society that is busy, busy, busy and is always looking for quick fuel. And so stepping away from that is often very challenging. We often grow up in an environment where we're not even taught what healthy food behaviors are, and it's because our parents don't know and it's not something that we teach in school. And so we have these ideas. Sometimes there's very fundamental things like the food pyramid I remember being taught as a childhood. But the wild thing is is that the food pyramid that I grew up with in the 1990s we now know was completely wrong. The food pyramid told us to have six to 11 servings of processed or maybe not processed carbohydrate, but of carbohydrate, sometimes processed things like pastas and rice and breads and that that should be the foundation of everything that we're doing. Then emphasizing our fruits and vegetables, then emphasizing our proteins, then our fats and sweets at the very teeny tiny top of that pyramid. And so the wild thing is that all of that information that was taught to us is not even accurate. So if you went through your entire childhood with being taught either no information or inaccurate information, and then your parents also maybe not having a full understanding of how they could best support our health needs, of course you grew up with those behaviors. And so for some people they found that and they find that they've been struggling with obesity for many years dating back into childhood. More frequently though I find that people are sort of protected against obesity in their childhood because for one, children's bodies are so amazingly resilient and two, many children were very, very active even through high school and even through college. So it's common that I have conversations with patients where they're talking about really having lifelong eating habits that haven't been the healthiest, but those didn't catch up to them until they were in their thirties or in their forties because in high school, or maybe even in college, especially if they were a college athlete or maybe they went to a really large campus where they had to walk thousands and thousands of steps every day, they didn't find that their dietary habits caught up with them. So they had this foundation of dietary habits that were not really ever the healthiest, but their hours of exercise and movement were able to offset that, such that now in adulthood when they've started to slow down and maybe they have a sedentary lifestyle or even just sort of a normal lifestyle where they're a normal amount active, but they're not really exercising a crazy amount or anything like that, they're just in this place where they have food habits that were never really ideal. The other thing now is that we as a society have become so sedentary and it's interesting to think about the result of the pandemic, for example, the result of working from home. And even though when we start to look at our children and seeing, I remember growing up and having gym five days per week. There's a lot of schools where students have gym one day per week, and then maybe they come home and they're on the tablet or in front of the television or on their cell phones and people are simply not moving as much. As some of you know, I work from home a couple of days per week. On those days, I have to be really intentional about making sure that I do get movement in because otherwise my commute is literally from my first floor down to my basement where I sit and see patients all day long. And so creating those movement opportunities is really quite important. And I compare that even to when I was working in a busy primary care office, I was commuting by public transportation. That represented a really major shift for me. And so when we have those shifts, we need to make sure that we are aware of those and accounting for those. So that role of movement for a lot of people was not taught to them or isn't something that's sort of naturally part of their lives. Another thing is thinking about all of the beliefs that have surrounded us that we've adopted from our childhood, from our culture, that really become part of our belief system that we can continue to have into adulthood. And if you don't stop and think about them, you may not realize that some of them are there. And I've touched on some of these before, but I want to step and talk about them for a little bit because things like finish all of the food on your plate, that is a food belief that often does not serve us when we are struggling with access to food. When I think back generations to my grandmother who was raised in the Great Depression or my grandparents, all of whom were raised in the Great Depression actually, but I think specifically I spent a lot of time with my grandmother, and that belief system was so pervasive that she would almost chase us around the kitchen with the last bite of something on a spoon saying, who's going to eat the last bite of whatever? Because God forbid you waste it. And it's so easy to understand where belief systems like that come from. And in 2024 when we have access to all of the food that we need, belief systems like those are not often serving us. And so when we eat every single bite of food on our plate, even though we're not hungry for it, it doesn't help us at all. And especially because portion sizes have become larger and larger. If you're eating at home or if you're preparing food on your own, it's easy to control your own portion size, but especially when you go out to a restaurant and you're being served a portion of food, we are often served a much larger portion of food than we actually need. So when we have that thought in the back of our mind that I need to finish all of the food on my plate, it's wasteful if I don't eat my food when those type of thoughts are coming up, yet you've been served a portion that is really true or even three times the amount that you really need, you are consuming food that your body doesn't need. So that belief system of don't waste your food isn't helping you at all. Or for example, when you think about the emotional relationship that we have with food, we are often taught to use food in order to support our emotions. So when we've had a bad day, we didn't make the soccer team and our mom takes us for an ice cream cone or your boyfriend breaks up with you and one of your girlfriends brings over a bottle of wine or a pint of ice cream. These things which are kind gestures of empathy and love and support are actually also teaching us that food can be the solution to our negative emotions and those type of things when practiced over and over and over again, really become part of our belief system such that it makes sense that when we've had a stressful day at work or our children are driving us totally crazy at bedtime, that we want to unwind into snacks at the end of the day. Of course it makes sense when we think about medications that we take. It's very common that either short term or long term, when you have had a medical condition that requires you to be on a medication that can be weight promoting, that can be very, very challenging, such that even if you are eating well, even if you are moving, there may be underlying mechanisms at play that will promote weight gain and that can be so challenging. And here is where the real problem comes in is that when you have struggled with chronic excess weight regardless of that amount, our body has these protective mechanisms that make it very challenging to lose weight, especially in the environment that we're in right now where we have access to food at all times and where the access to food that we have is often convenience foods and processed foods, for example. It is very, very, very challenging to lose weight. And I don't mean psychologically of just like you have to tough it out, you have to get through it. I mean that for a patient who has had chronic excess weight, their body is not going to let that weight go in the way that someone who has had that weight for a couple of months or a year has for example. And so when we have weight throughout our excess weight throughout our childhood into our adolescent years throughout college, the longer that weight sticks with us, the more likely that weight is going to continue to stick with us and could be more and more challenging for our bodies to lose that weight. And so that's where this, it is not your fault, but it is your responsibility. If you were raised in an environment where you weren't taught the healthiest beliefs, you had access to foods that maybe your parents even thought were good, but now in retrospect you realize they weren't actually as good for you as you thought you have all of these belief systems, you're not as active as you'd like to be if you came into adulthood with that setup, of course, that's not your fault. How could it be, right? Been in this environment where we surround ourselves with food that is not serving our bodies. We use food for so many reasons beyond hunger. We have all these complex relationship with our food beyond that. And then we tell people when they fail to be a thin body size that it is their fault. And I am telling you that that is just simply not fair. And when I think though about reversing obesity, it can be very challenging. And so this is the part where taking responsibility is important. And I want to be very clear. Again, I am not saying to take the blame or to take the shame or to feel guilt about that, but to look at where you're at right now and think about what is it that I could do in order to promote better health for myself? And you may not know the answer to that question, and I'm telling you that that is okay because there are a lot of people who do know the answer to that question and they are happy to help you. People like myself who are board certified in obesity medicine, a lot of primary care physicians, people who are certified in preventative type medicine like lifestyle medicine for example, or integrative medicine, there are a lot of people who are trained in this who would absolutely love to help you. And so when you come to work with someone or when you start exploring even just in an internet search or looking at books, just starting to think, I wonder if this is possible. And when you can take that curiosity mindset, there is nothing better that will serve you because all of our bodies are unique. Different people respond differently to different diet plans or exercise plans. People have different food preferences. People have different lifestyles, they have different stressors. And so when we think about what is the answer moving forward in order to support someone in their healthy weight and in their health journey, there is not going to be one answer that is the right fit for everyone. And so that's where taking this responsibility comes in. When you eat food, when you log your food, when you look back at it, instead of saying, well, I did the best I could. Everybody else I know eats like this and they don't have a weight problem, you can absolutely say that It's just not helping you to find the solution. I will tell you, I know that there are so many people who are thin who eat absolutely terrible, and it is so frustrating if you are someone who is in a larger body who is eating well, trying to do your best and still not seeing that weight loss you want, and then you've got that skinny friend who just eats candy all day long and continues to be in a thin body, I totally hear you. And it's totally unfair that there are people who wear their weight on the outside of their body where some people are really, to be honest, much more genetically protected against weight gain. And so it totally sucks, and I hear you. And if you want to sit there and compare yourself to that skinny friend who eats candy all day long, it's really not going to help you. In fact, it's probably just going to make you feel even worse about yourself and wondering what's wrong with you. And the reality is there is absolutely nothing wrong with you. Your body is amazing, and your body is doing really what it's designed to do and store away excess energy for later for times where there's not food available to it. And so how do we work with your body rather than fighting yourself? Work with yourself to reconnect with what is your hunger? What is your fullness? What are the foods that you enjoy that also nourish your body? Are there foods that are really rich in fiber, rich in protein, maybe rich in healthy unsaturated fats that help us to feel fullness, to feel that fullness for longer, to feel energized, to not make us feel bloated or to cause migraines or to cause GI symptoms and foods that just feel really good in our body? And what are the movements that we enjoy and can we walk or can we train weights or can we throw our children in the air or can we swim or can we do yoga or Pilates or any of number of things that may be interesting to you and just to you? Because this is simply about what is going to work for your body. And so when you start to bring that curiosity and start to wonder, stop the comparing, stop the shame, stop the blame, but just start to ask, what could I do? Is there someone who could help me? Because for most of my patients, they have been on numerous diets, they've been on numerous different plans, they really feel like they've tried everything. And that is such a frustrating place to be. And so often when you're in that place, it can be really challenging to see the next step because you feel just so darn defeated. And so if you are someone in that position, I want you to know that while it is important to take responsibility, to learn about how you can best support your body, it doesn't mean that it has to be something that you do alone. It can be something you do with a friend. It can be something that you do with a physician or a health coach or someone that's able to really help support you in your goals. And that is really okay. Reaching out for help is not a sign of weakness. In fact, I see it really as a sign of responsibility and of someone who knows that I don't know the answer. And so I know that I need to ask for help, and that is okay. And so if you are someone who has found yourself in a situation where you really feel frustrated and you feel like you have done everything and realizing all of these things throughout my life have led to this place where I'm at right now, and I just don't know how to move forward, that's okay. And the next step is reaching out to move forward with someone, with a book, with a resource that you feel comfortable with. And it doesn't have to be right now, it can be something that's happening in the future, but just know that there are resources that are out there for you. It is possible for you to really achieve your health, to achieve strength, and to feel strong and powerful in your body. So thank you for listening to this message. As I said, it's something I've been thinking about for a long time, and I just want to invite you to let go of the shame and the blame and the guilt, and recognize that our society does not set people up for success and moving forward into that position. It's not going to be easy. It can be simple, but it's not going to be easy, and you can totally, absolutely do it even if you don't think you can, even if you've had lots of frustration in the past. I'm just here to encourage you that it is absolutely possible. So please reach out to a trusted resource, whether that's me, whether that's another physician in your life, and I would love to support you in achieving your optimal health and weight. Thank you so much for joining me today. See you all next week. Bye-Bye.