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.. 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 of the Concur Weight Podcast. I'm excited to bring a guest on today, Dr. Aalia Al-Barwani. She is a physician like myself and also a coach who focuses on obesity medicine. She is board certified in obesity medicine, but what her specialty is is really helping on the mindset piece, which I love. I think that the mindset piece is absolutely the crucial piece to being able to have long-term success, not just with the number on the scale, but what is the overall measure of our health. And so thank you so much today, Dr. Al-Barwani, for joining us. I'm really excited to talk about mindset. Dr. Aalia Al-Barwani: Thanks for having me, Dr. Sarah. It is such a privilege and I agree with you. I think the mindset piece is really the piece that I've focused in on my career as I develop and figure out parts of obesity medicine that I'm learning to love. And the mindset is most definitely a big chunk of that. Dr. Sarah Stombaugh: Yes, absolutely. Well, tell us a little bit about yourself. How did you come to be interested in obesity medicine and practicing in this way? Dr. Aalia Al-Barwani: Yeah, that's a great question. So my story, my background is in family medicine and primary care, and I've been doing that for over a decade. And I noticed that I was having similar conversations over and over again with patients related to their weight. And so it wasn't necessarily, oh, you just have to lose weight. It was like, Hey, let's talk about what you're eating. Let's talk about how you're moving. So it was similar conversations over and over again, and I was like, there has to be a better way than just squeezing in two to five minutes at the end of the visit where they're here for diabetes and high blood pressure and all these other things that they were coming in to really address what I felt was the root and the core of what could really help them make a difference to their health other than medications and being in primary care, we love our plans. We love, okay, if somebody comes into us with us, excuse me, come in to us with diabetes or high blood pressure, or they want to quit smoking, we have a whole plan laid out for them. This is what I want you to start taking. This is what I want you to do. These are some behavioral changes. But for my patients particularly that came into me and were like, Hey, I want to lose weight. I felt very restricted in what I had to offer, and it was a lot of what we're still hearing now, unfortunately, which is eat less and move more. And when it came to medications, it was like phentermine, and even then people were scared to use it. And so it was just very, it felt like underdeveloped field to me, and I felt like again, there has to be a better way. And so learned about obesity medicine and then it really opened up my eyes and my whole world in terms of how I practice and understanding the complexities of obesity and how to treat obesity. I just fell in love. And so yeah, that's what brought me to obesity medicine and I just felt like I could really help people in a more meaningful way and get to the root of a lot of their medical health issues. Dr. Sarah Stombaugh: Yes, absolutely. I will say I feel that so much. My background is also in family medicine and primary care, and I think a lot of us who are drawn to this space, we're looking for how do we help at that root? And so thank you so much for sharing that. Tell me about the coaching piece and how you came to integrate that in. Dr. Aalia Al-Barwani: Gosh, again, I learned from my patients by serving patients. And so again, I started my practice. Once I got obesity medicine certified, I decided to start my own practice because I felt like again, those two to five minutes, I wasn't going to get anywhere. I wasn't going to really be able to meaningfully help people. So I started my practice and it's obesity only focused. And in so working with my patients and I focus on helping women, I was like, okay, now I'm ready to go. I have everything. I know how to help people. I know what advice to give them. And I was sharing that education, people were taking that in, but then it was like there was this gap still between education and execution. I was running into the same wall that I was hitting in primary care, which is patients know what to do, but they're still not doing it. And so on a personal level, I underwent something similar in terms of my business. I knew what I needed to do, but I wasn't able to execute. And I had the beautiful experience of working with an NLP coach, and that changed my whole belief system. That changed my identity, that changed how I viewed myself and the world around me. And it was such a profound shift in how I was as a person and then how I showed up in my business that I was like, this is so powerful. And then it clicked. I was like, oh my goodness, this is exactly what my patients need. How do I expand their world so that they're able to see beyond what they've grown up learning or believe about themselves so that they do believe that that bridge, that they can traverse, that bridge, that they can cross that bridge between knowing and doing. And so I decided that I wanted to get into it and learn all of the things about coaching and specifically neuro-linguistic programming or NLP coaching because that was what I was exposed to and absolutely fell in love. So decided to learn and then help my patients in that way. Dr. Sarah Stombaugh: Yes, I absolutely love that because the mindset piece really, so many of my patients, as I'm sure you experienced too, they're like, I know exactly what to do. I could write a book on nutrition, people who I've been through every diet, I have all these experiences. And it's not about knowing what to do, it's not even about being told. It's about having that buy-in and understanding how does this serve a role in my own life? What are the things that are, you mentioned like the beliefs from childhood that are serving me. What are the ones that are not? What are the things that are sneaking in even subconsciously? So tell me this mindset piece, I couldn't agree more. Mindset is absolutely at the core of so many of our health behaviors, including weight. And so tell me how you incorporate that work in with patients. Dr. Aalia Al-Barwani: So when patients come to work with me, I let them know the three main things we're going to focus on is going to be mindset is a must, and then there's nutrition, and then it's the medical management. And so with the mindset piece, so I will either weave it into my visits with my patients, which last anywhere from 30 minutes to an hour, or it's just a dedicated mindset visit only. And we are addressing resistance and beliefs and a negative coming up for patients. And so the work that I do with my patients, I ask them to do a lot of reflecting. And I think that we are so busy that oftentimes we are just our automatic behavior. We don't kind of reflect on our automatic behaviors. And I would argue that it's these automatic behaviors that build up and stack up to paint the world and the life that we have currently. And so by addressing what we're doing on a day to day and how we're approaching our lives, our eating, our movement, all of those things, automatically we can have success. So what I mean by that is if your every day is I have to eat this kind of food as opposed to I love eating foods that give me energy or I love feeling how energetic I am after eating a protein rich meal and focusing on that part of it, then you're not going to enjoy, right? It's going to feel like a struggle every single day to get in your macros. And so by helping my patients to look at things a different way and approach their lives in a different way, those daily things become their life. Dr. Sarah Stombaugh: Absolutely. I love that protein example, for example, because we hear about meeting our protein goals and making sure that we're getting those and we can provide list of food that are high-end protein, we can provide recommendations of, you should get this many of grams per meal, or how many times per day, for example. But when a person starts to reflect on the day that I had a blueberry muffin for breakfast, how an hour later I was feeling really hungry, starting to look for the next thing versus the day that I had a really protein rich breakfast. Maybe it was eggs and eggs on avocado toast, or maybe it was dinner leftovers, cottage cheese, yeah, leftovers from the night before. For example, I recently discovered cottage cheese in scrambled eggs. I don't know if you've ever done that before, but Dr. Aalia Al-Barwani: I haven't. But my patients have taught me, again, I learned so much I've learned that. Or also blending the cottage cheese and then putting it in your smoothie or blending it in your smoothie. Dr. Sarah Stombaugh: Yeah, absolutely. Everybody is super excited about cottage cheese these days, but starting to then do that and see, okay, wow, I feel so satiated for 3, 4, 5 hours and realizing how as you said, well energized my body feels and starting to not just, oh, you should get protein, but wow, I feel so good when I do this, for example. Exactly. So I love that. Dr. Aalia Al-Barwani: Exactly. And along those lines too, Sarah, I'm sure you also do this, is that oftentimes when people come to us for weight loss, when patients come for weight loss, they are just focused on the scale, don't, that's the goal. And I think that by breaking up the goal into these little bits of different aspects of their lives in terms of, okay, what does your energy look like day to day? Are you feeling low energy? Is that something we should be tracking as well? How are your clothes fitting? How are you going through your day? How is your sleep? And kind of finding these other goals that we want to focus on that we know as obesity physicians that if we address all of these different lifestyle things, then the weight will also improve or the weight will, patients will lose weight and get closer to their goal. So by also kind of pointing out some other parts of their lives that they could benefit from, improvements not on, we can also change their mindset about how they look at their weight as opposed to just this one number that needs to come down. I've had patients now say themselves without me even initiating, well, this week or the past two weeks, I didn't lose any weight, but that's okay because my clothes fit better. I feel so much stronger, I'm seeing my body change because I'm weightlifting three times a week, et cetera. And so starting to hear that language is so encouraging because at the end of the day, that's what we're helping our patients to do is improve their health. It's not just getting that number down. So I love that as well. Dr. Sarah Stombaugh: And I think that piece so often on the very first visit, a lot of times patients will ask me about setting a goal weight. And I think an answer that I give often that's frustrating is we'll sort of know it when we get there. And a lot of times where you're starting and all of the things that you're feeling are so much more than just that number that you may have an idea in your mind of when I got married, I was a certain weight, or before I had kids, I was a certain weight or these different things that you desire to get back to. And you may realize that that number either does make a lot of sense and we're working towards that. Or maybe your body at a different number is feeling more strong, is feeling more energized. And we know as we're getting and moving to that place, just what is the whole piece, not just what is the number and the scale, but what is all of it. And so I love that. Thank you for sharing it. Tell me about self-sabotage, because this comes up a lot as well where we're not even meaning to, but all of a sudden we're starting to sabotage ourselves in the journey. Tell me how you help patients to recognize that and how to address it. Dr. Aalia Al-Barwani: That's an amazing question. I agree. I think that it plays such a big role, not just in the weight loss journey, but also in the weight wellness, so maintenance aspect as well. And so the way that I address it with patients or clients is with first of all, so oftentimes again, as I get my clients to get into this practice of reflecting and tuning into their bodies, tuning into what's happening in their day-to-day that they appreciate or things that are difficult for them, they're often able to bring up these patterns. They're able to notice like, oh, whenever I take an example, whenever I tend to get to this weight, I tend to do this whenever I am around X or whenever I travel. So then they start to notice themselves these patterns where they are slipping up and maybe slipping into old patterns. So the first thing is really I teach is self-awareness and paying attention to these patterns. The next step is really understanding what is happening behind these patterns, whether it's a negative self-talk or a limiting belief. So for example, if at the core a patient or person doesn't feel like they're actually able to achieve X goal, then whenever there's the opportunity to get close to 'em unintentionally, they're going to sabotage. So if people feel like, well, there's no point because I'm not, there's no point in even trying because I'm just not going to be able to get there, then every time that they are getting close and they're seeing results, they'll have a binge or they'll go binging, or they'll buy snacks that they don't normally buy anymore, et cetera. And so it's really understanding what is actually happening internally. And so I do that with my clients in my coaching sessions by asking these questions, what are the patterns that are coming up? What are you telling yourself in those instances? Or maybe what emotions are coming up for you? And often by addressing those things, which we tend to to ignore because takes a little bit of effort, we have to kind of sit with uncomfortable emotions sometimes or address what the actual issue is. And a lot of patients, especially women that I work with, we tend to reach for emotional eating. So that's another thing that I bring up for patients. So it's the limiting beliefs and then the emotional eating. Those are the three big ones that I talk about with my patients to help them to identify those self-sabotaging patterns. Dr. Sarah Stombaugh: Absolutely. Well, we think about the way our thoughts drive our feelings, for example, and you can imagine, I've recently addressed with a handful of my patients, actually a 200 pound barrier, where they have this belief that their body cannot drop below 200 pounds. And as you said, they're getting closer to this number. And when you're starting to think and you have this deep belief system of I can't drop below 200 pounds or whatever the number is, it's just interesting that's come up with a couple of people that you start to feel really defeated like, oh my gosh, no matter what I do, my body's not going to drop below 200 pounds. And you're feeling a sense of defeat, even if everything's been going really well, you've been really in line with your goals, you've been seeing the weight decrease, you've been seeing your health metrics improve. You have this deep belief system that starts overriding all of these other things. And when you're feeling really defeated, you can drive yourself towards emotional eating or just behaviors that are less in line with your goals because you're like, well, if I can't get below 200 pounds. But the interesting thing is that so often we don't even realize it's this bringing the awareness to, and I'll start to hear sometimes people say, oh, it's really hard for my body to get below X, Y, Z weight, or I really am struggling to do this. And while they likely have a lot of evidence for why that sort of thing has been true in the past, starting to question and then move. Okay, and how could that be different this time and starting to really work through that? Dr. Aalia Al-Barwani: Exactly. Absolutely. Something that I teach as well, and this may be helpful for you and your listeners, is that our beliefs are set in our subconscious and our subconscious is there to keep us safe and to protect us. And so on some level, when people have a limiting belief, it's because they've been taught from past experiences that this belief will keep them safe. And so often what I'll ask them to do is maybe a little bit of journaling, maybe a little bit of visualization, and trying to imagine the other side of things, trying to imagine, okay, what would it look like if you did get below 200 pounds? And so oftentimes why this can be really powerful and shift for a lot of people is that we are oftentimes, we think we know what we want, but we don't really, right? We have these vague, I want to lose weight. That's not really a goal. And so what I have them do is close their eyes and say, okay, when you get where you're going, what will it look like? What will it feel like? Who will you be around? And so by getting them to get into that space, they're able to see what are the things that they're enjoying doing in that version of themselves that they're trying to get to, because sometimes they can't put it into words, but their subconscious can bring that forward for them. So visualization is really powerful in terms of helping people to come overcome some of these limiting beliefs and to feel safe through visualizing it first. So their subconscious is able to see it in their mind's eye so that as they get closer to it, in reality, as their weight continues to come down working with you, then they're going to feel comfortable in their body and in their mind. And so that's something that I've found really helpful for my patients. Dr. Sarah Stombaugh: Thank you for sharing that because I think being able to visualize and see what are the things I'm afraid of at a certain way, am I afraid that a relationship will change? Am I afraid that there's certain foods that would be off limits or that I'd have to behave in a certain way? There's a lot of things that will often come up as we start to reflect on that. Exactly. Amazing. Tell me, what about when things are challenging, you feel like I've hit a plateau, maybe I've gained weight during this journey, or it feels like, oh my gosh, I just went this journey to move more quickly. How do you support your patients and clients in continuing to feel motivated and move past some of those times that it's slow or at a plateau, for example? Dr. Aalia Al-Barwani: I love that. And so that's a great point. And of course it's a journey and it can be, as you said, slow at times and faster at other times, especially in the beginning, it can feel really fast. And then suddenly when things slow down a little bit, even though you're still on track, it can feel like things are stalled. And so what I help, again, I mentioned this earlier, but I help my patients to realize other goals that they are interested in achieving besides just their weight. So whether it's to feel strong, whether it's to have more muscle mass, to be eating healthy consistently in whatever healthy looks like for them, whether that's meeting their macros or eating X amount of vegetables daily, et cetera. So finding other goals that they can track on a more day-to-day level maybe, or week to week level when the scale isn't moving. So I like to do that and break down the goal, and that can help people to find more realistic things in their day-to-day that they can track. The other thing that I will also teach and tell my patients is, or actually a client taught me this and I love how she put it, and I asked her similarly, what do you think will help you to keep you going? And she hadn't reached her goal yet, but I like to kind of also future cast and kind of bring forward things once they've achieved the goal, what does maintenance look like, et cetera. And again, part of that feeling safe in their body thing. And so I asked, what do you feel? What has you feeling comfortable or so confident that you will be able to maintain this after? And she said, and how can you embody that version of you? And she said, I'm already practicing it. And I loved when she said that. She's like, I'm already practicing that version of me. And when she said that, I said, what do you mean by that? And she said, well, if I'm practicing being that version, then there's no failure. You just show up again the next day and you practice again, and you keep practicing until you get better. And I love the way she phrased that because I have very, in elegantly tried to teach my patients that. But the way she said it was so beautiful because exactly that if you're practicing, there's no failure, right? You're just showing up every day and doing the best that you can, knowing that each practice, you're getting closer and closer to your goal. Dr. Sarah Stombaugh: Absolutely. Well, and you start to see that identity shift, right? And we think about behaviors and goal setting, and we start to see, I am the type of person who is healthy. I believe that I'm a healthy person. It can even be as simplistic as that. And starting to see that, okay, what would a healthy person do? What would the person, the version of me who is meeting her goals and feeling really strong and confident, that identity shift and really visualizing and embodying that, it's really, I'm excited for your client because it's, that's her weight goals. They're inevitable. When you have that shift, it will take time and it becomes almost inevitable, which is amazing. Dr. Aalia Al-Barwani: I completely agree. I've got chills when she said that, and I'm really excited to see, and she's, she's had such a big shift, and I love when patients come in kind of just open to the experience and see how different, just in my head, I don't always point out, Hey, you didn't used to say that before, but I'll keep track and be like, oh, she used to say the exact opposite of this, and now her world has expanded, her potential has expanded. And those I am statements, those identity shifts that I see are so beautiful because at its core, we know that in order to elicit true and meaningful and lasting change, when we can have an identity shift or a purpose shift, then we know that as you said, success is inevitable and it's more permanent because we know that that'll have a trickle down effect on their behavior and their skills and their potentials, et cetera. Dr. Sarah Stombaugh: That's wonderful. And I love patients come in, clients come in, Angela, there's this weight goal often in mind, right? They come in maybe with a certain number and tracking everything else over time and seeing all of the other shifts that happen is absolutely my favorite part of being able to support patients in this way. Dr. Aalia Al-Barwani: I agree. I agree. Dr. Sarah Stombaugh: Lemme ask you, in the last couple of minutes here, is there anything you haven't yet shared with my audience that you think is really important for them to know? Dr. Aalia Al-Barwani: I think that for a lot of women and people in general, what I would say is really important is to have that connection with yourself. So being, as I said earlier in this reflective space where you're really paying attention to what your body is trying to tell you. And oftentimes what I see, again, I work with mainly women, is that we don't do that. And when we don't, we tend to have this emotional response, which leads to emotional eating. And that is one of the biggest saboteurs in terms of both getting to your weight goal and afterwards with weight maintenance. And so I think that it's really important to pay attention to your emotional regulation, nervous system regulation. I see that now trending, but it really is an important aspect of this whole journey. And all it comes down to is really recognizing and being comfortable with the different emotions we're experiencing and having a healthy outlet for that. And so to that end, if I may plug, I do have an emotional healing emotional eating course where I address just this. Exactly. So how do you stop going from, I've had a really tough day, I've had a really stressful time, and I'm just going to eat to numb my emotions to how do I experience things fully and move past it and now make better choices? And so I would love to offer that to your listeners if they would choose to take a look at that. Dr. Sarah Stombaugh: Yes, absolutely. And tell us where can I learn about that course or other ways to find you? Dr. Aalia Al-Barwani: Absolutely. So my practice is Albidaya Wellness, which Albidaya is an Arabic word for the beginning. And so I'm on that. It's AlbidayaWellness.com is my website. And then the same name on all social media platforms. And if you go to my website, you'll find the link to the emotional eating course there too. Dr. Sarah Stombaugh: Okay, wonderful. And we will make sure to put all of those links in the show notes so that all of my listeners can find those. Thank you so much, Dr. Albani. This has been really fun to talk about. I think we could probably talk all day long about mindset and how that impacts our health goals. Dr. Aalia Al-Barwani: I agree. Thank you so much for having me. It was such a pleasure. Dr. Sarah Stombaugh: All right. Take care, and we will see you all next week.