Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh, and you are listening to the Conquer Your Weight Podcast, episode number 27. 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, thanks for joining me today if you can believe it. I have had my baby since you last heard from me, and she will be about three weeks old when this episode airs. Our life is a little hectic right now, but I am so happy to be here and talking with you all today. And even though it's only been about two weeks, or it's been two weeks since my last episode aired, it has been well over a month since I recorded my last episode for you all. So it feels like it's been a while. So I just wanna say, hey, how are y'all doing? I notice I have quite a few new listeners who've joined me over the last couple of months. If you're new here, I wanna say welcome. I'm so glad to have you along with me on your weight loss journey, and if you're returning, thanks for sticking around. I'm glad to have you all here. So even though I'm keeping up with my podcast every other week while I'm on maternity leave, I have taken a pause from seeing patients in my telemedicine practice. But even though I'm not taking patients right now or not seeing patients right now, I am enrolling new patients to start in January of 2023. So if you're interested in working together and you live in Illinois or Virginia where I'm licensed to practice medicine, please do still feel free to reach out to me on my website at www.sarahstombaughmd.com so we can start communicating and set up a meet and greet appointment together. And today we are talking about exercise, but before we do, which I know you'll are dying to hear, I have to tell you a story from breakfast this morning. This is our third child. So even though life is way more hectic, we are also more experienced and we're more chill as parents. And one of the things my husband and I have started doing is weekly breakfast dates and we just bring our newborn along with us and it's been really great. So this morning we were out to breakfast and I overheard the most interesting conversation at the table next to ours. So the woman at the table ordered a second breakfast, and I was so fascinated by the situation, I wanted to share it with you all. So she had ordered a Belgian waffle and the waffle came out and it was sort of like thin and flat. My husband actually ordered too. He got chicken and waffles. So I got to experience it myself. And I am no waffle connoisseur, don't get me wrong, but I have to hand it to this woman. When you hear Belgian waffle, you think of a thick and fluffy waffle. And to be honest, this looked like a regular plain, normal waffle. And so the waitress had come to check on them after the first few bites of their meal, and the woman said to their waitress, I would like to order something else for breakfast. This waffle isn't what I had in mind, and it's not worth the calories. And she proceeded to order scrambled eggs and a biscuit on the side. And I feel like it's relevant to note that this restaurant is famous for their biscuits. And so while the waffle wasn't worth the calories, I suspect she knew that the biscuit would be quote, worth the calories. And that was that she was polite about the whole thing. She didn't make a huge fuss. She wasn't complaining or insisting that her meal be compensated. She simply realized this waffle wasn't what I had in mind, and I'm not going to waste my calories on it. And I'm not saying that this was the right move or we should all be doing this, ordering second meals and throwing away food. I honestly, I don't know this woman, she was just sitting at the table next to me. I don't know about her life and her food plan and her goals, but I wanna point out that she came up with a solution to her problem because so often we find ourselves in situations like this and we fall into victim mentality. We're like, oh, poor me. I ordered a waffle and this waffle sucks, and now I've wasted all these calories on a food that I'm not even going to enjoy. So I just have to hand it to this woman. She found herself in this situation and she took ownership and she found a solution. And I think we could all learn something from that because before we fall into victim mentality, stop and ask, how could I take ownership of this situation? Is there a creative solution to the problem? And maybe that solution is just ordering something else. Anyway, I had to share that with you because I thought it was such a cool moment, the type of thing that I would work with with my patients and my clients. And I just saw it out in the wild, so to speak. But all right, here we are. We are going to talk about this long awaited topic of exercise and it took 27 episodes and we are finally here. I've had a few people ask me why we haven't talked about exercise yet. And the main reason is I don't think it should be the first priority in someone's weight loss journey. I used to have a mentor or I have a mentor who used to say, you lose pounds in the kitchen and ounces in the gym. And I'm not sure if that was his original quote, but I have found this to be true over and over again as I work with patients on their weight loss journeys. And please don't hear me wrong, exercise has a role. In fact, when we look at our overall health and our heart health and our bone health and healthy aging, it has an extremely health important role. But when it comes to weight loss, it is usually not my number one priority with patients. When I meet a patient for the first time, we go through an extensive history. It includes diet, exercise, sleep, medical conditions, and the medications we take for those conditions and psychological history. And it's important to take a look at that whole picture. And ultimately, once weight loss plan will need to acknowledge all of those same factors. However, when I first create a plan with someone, often we are only addressing one or two factors at a time. It drives some of my patients totally crazy at first, but I beg them to trust me on this because so often when someone is' embarking on their weight loss journey, they just want to change everything. They want to totally overhaul every aspect of their life, and that is totally possible. But I usually find that when we decide that we need to quote change everything, we often get overwhelmed and we end up changing nothing or we're really committed for just a few days or maybe a few weeks, but we drop those new habits really quickly when we can instead focus on one goal at a time. We can work to achieve that goal and then layer on our next goals. After that, when we're able to set a goal and achieve it, we begin to develop trust in ourselves. And when I work with my patients, my goal is to help them lose weight permanently. Who cares if you lose weight just to regain it all in a few months or a few years? The goal is to lose weight forever. And the best way to lose weight long-term is by learning to trust yourself to fully believe that I am someone who does what I say I'm going to do. When we make a new food plan and we stick to that food plan, we get to reinforce that thought. I am someone who says I am who does what I say I'm going to do. When we plan to log our food and our hunger signals and we follow through with that, we again get to reinforce, I am someone who does what I say I'm going to do. When we plan an exercise regimen and we stick with it, we get to reinforce, I am someone who does what I say I'm going to do. However, if you make a plan and you don't follow through, it eats away at your relationship with yourself. You begin to learn that your word doesn't mean anything. You say you're going to do something, but maybe you will, maybe you won't. Setting a goal becomes less meaningful when you aren't committed to the follow through. So instead of trying to change your whole life in one day, I find that most people achieve the best long-term success when they change one aspect of their life at a time. They can go all in on one goal, they can get fully emerged in it. And once that goal is just old hat part of their habits, we can layer on the next goal. And in theory, you could choose any area to focus on first, and if you decide you want to tackle exercise as your first goal, by all means you can do whatever makes the most sense for you and your body and your journey. So for people who are already in a routine of exercise, it's usually not an exer. It's usually not an issue, just keep doing what you're doing. But for those who are not in a routine of exercise, I think it makes sense to choose another area to focus on first. What I have found is that increasing exercise will often increase your appetite. So if you haven't chosen a food plan, if you haven't learned how to manage your mind, if you haven't learned how to manage your cravings and urges, exercise might actually lead to increased eating or increased weight gain because you're having so much hunger. And that comes with cravings and urges because exercising does not guarantee that you'll be at a healthy weight. There are plenty of people who are at an overweight or an obese weight who are capable of completing a half or even a full marathon. And have you looked at people who compete in power lifting events? Why we often think of bodybuilders and people who are just totally cut. Honestly, most weightlifters are actually overweight or even obese. And I don't mean that they have an elevated BMI. We all know that BMI is just a calculation of your weight compared to your height. It is a screening tool. I mean that they are overweight or obese by other definitions like increased body fat, for example. So if you're new here and you're embarking on your weight loss journey, my recommendation is not to start with exercise first. My recommendation is to start with logging, food, logging, hunger signals, and developing a food plan. And once you've been able to implement all of those food goals, you can decide how you want to proceed with exercise, exercise from there. And once you've decided you're ready to embark on your exercise journey, you get to decide what that will look like for you. Again, I want you to keep in mind your overarching goal of I am someone who does what I say I'm going to do. When you set a goal for exercise, I want you to read that goal back to yourself. Let's say you've decided I'm going to exercise 30 minutes a day for five days a week. Say that goal out loud. And when you say it out loud, how does it feel? How confident are you that you'll achieve that goal? If you had to rank your confidence on a scale of one to 10 where one was not confident at all and 10 was a hundred percent confident that you'll meet your goal, what number would you assign to your goal? And be honest here. If you give yourself a confidence score of anything less than eight, I want you to change your goal until you feel at least eight out of 10 confident that you'll be able to achieve your goal. It is so, so, so much better to set a goal of exercising three days a week and achieve that goal than to set a goal of exercising five days per week and only exercise three days per week. Even though the outcome is the same, you've exercised three days a week. When you've set a goal of exercising three days a week, you can confidently say you've achieved your goal. And again, I know I totally sound like a broken record here, but you get to reinforce the belief I am someone who does what I say I'm going to do. And once you've set your goal, I want you to ask, also, ask yourself, what would get in the way of achieving your goal? Brainstorm a list of everything that might keep you from exercising. Some of the excuses might be quote, good excuses like I came down with the flu. And if you come down with the flu, that probably feels like a legitimate reason to skip your exercise plans. And skipping your planned exercise is the most loving thing you could do for yourself in that situation. But what about all of the other excuses, the real reasons that you might not stick with your new plans, like, I'm too tired or I don't have time, or I had planned to work out with my friend, but she wasn't able to make it. Or I'll do it later. I'll do it tomorrow. It sounds tedious to brainstorm all of these excuses, but don't skip this step. Come up with a list and address each one. What are you going to tell yourself when your brain starts rattling off all these BS excuses? When you think I'm too tired, can you instead think I'm feeling a bit tired, but I know exercise will wake me up when you think I don't feel like it? Can you remind yourself? Exercising always makes you feel better afterwards. So on the morning of your planned exercise, if your alarm clock goes off and you think, eh, I'm too tired. I'm just gonna do it later, you could remind yourself that was not an legitimate excuse. And so you get out of bed and you do it anyway. And be honest with yourself. Have you ever regretted exercise? Probably not. You've probably finished your exercise and felt really good about yourself, both emotionally and physically. All of this is an example of using your developed brain, your prefrontal cortex to make decisions. This is your logical, your thinking brain that allows you to plan and has your best interest in mind. All of those BS excuses, those come from your primitive brain, the brain that wants to protect you to conserve energy. Do you really want to lead your life from your primitive lizard brain? This is the amazing thing about being human. We have these developed brains and we can use them. Sometimes we just have to remind ourselves to do so. And anytime you use your developed brain, that prefrontal cortex to make decisions, you are going to make decisions that are best in line with your goals for yourself. And so here we are most of the way into this episode, and I haven't told you what the best exercise is. Do you know why? Because I don't believe that there is one best exercise. It is better to be 100% committed to any exercise program, literally any type of exercise that you want to do and enjoy doing than to be partially committed to the quote best exercise program out there. The best exercise is the exercise that you'll actually do. Just like the best diet is the food plan that you actually will follow filled with foods that you love. So before I give you some recommendations, I want you to really stop and think about exercise. What do you enjoy doing? What are the activities that you're excited about, about which you feel motivated to get off the couch and actually get moving? Your exercise plan might evolve over time. It probably will, but start by building a plan that sounds enjoyable, and you're like, okay, okay, but what should I actually do? What is the best exercise regimen? So here's what we know. Some of the best data we have comes from the National Weight Control Registry. This registry was started in the early nineties and has tracked over 10,000 people who have successfully lost at least 30 pounds and maintained that weight loss for at least one year. And when we look at participants in that study, we know that 94% of them increase their exercise in order to help achieve their weight loss goals. And 90% of the people exercise about one hour per day on average. And generally speaking, most of these people were doing cardio type exercises, things like running and jogging, walking, biking, and swimming. But again, this is just about huge groups of people, not you who is an individual. And there's no reason that that has to be your goal today. You don't have to exercise one hour a day every day, start low, go slow, start with a goal, you feel nearly 100% confident you can achieve and achieve that goal and then build it from there. And there's a lot of other factors to consider as well. So we talk about cardio exercise because those are known for burning calories, but the reality is there's so much importance to things like strength training and weightlifting. These are really important for building muscle mass, and that helps to support good bone health as well as supporting a more robust metabolism. If you're someone who's brand new to strength training, it is generally my recommendation that you work with someone like a personal trainer who can help you to learn what you're doing when you start out. You're unlikely to injure yourself if you're using two pound or five pound dumbbells even. But learning that proper form and technique is really impor important for your long-term journey. You want to learn how to perform all of those exercises correctly so you can prevent yourself from causing injuries along the way. There's a lot of other stuff to consider as well, like the timing of exercise. Multiple studies and really just logic have shown us that going for a walk after meals can be really helpful for reducing insulin resistance, which makes sense. When you eat a meal, you absorb the energy into your bloodstream fairly quickly. When those energy particles like glucose are floating around your bloodstream, they are available to be used or they could be stored. So if you use them by going for a walk, for example, they don't have to be stored away from later. So if you know you have an insulin resistant condition, something like diabetes or pre-diabetes, but realistically, anyone who has increased fat mass on their body, taking walks after meals can be hugely beneficial. And so taking a 10 minute walk three times a day, 10 minutes after breakfast, 10 minutes after lunch, 10 minutes after dinner, can make a really big impact and found it to be surprisingly doable. If you build it into your schedule, you can literally just set a timer for five minutes and walk out your door going one direction, and then when the timer goes off, turn around and come back. And if you're protesting, well, Dr. Stombaugh, my schedule would never allow for something like that. Totally fine. You don't have to do that. You don't have to do anything. It's just an option, just a suggestion. So if that doesn't appeal to you or fit into your lifestyle, just keep brainstorming options that do resonate with you, things that sound fun, that fit your goals and your lifestyle. Because ultimately, this is all about you. We aren't doing some sort of crazy six week program for you to lose weight quickly. We are cultivating a plan that you can evolve over time and ultimately maintain for your whole lifetime. If you are working on your exercise habits. Let me know how I can best support you on your journey. You can visit me at my website, www.sarahstombaughmd.com. That's S-A-R-A-H-S-T-O-M-B-A-U-G-H-M-D dot com. To learn more about me and enroll in my medical practice if you live in Illinois or Virginia, if you don't live in Illinois or Virginia and you'd like help getting connected with an obesity medicine physician or a life coach who might be a good fit for you, let me know. I would love to help out. Thank you so much for joining me today. I'll see you all back in two weeks. Bye-bye.