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Conquer Your Weight

Episode #110: Weight Loss During Stressful Times



Show Notes

January 29, 2025

In this week's episode, we are talking about how to support your weight loss goals during times of stress. We'll talk about tips for how to manage emotional eating as well as how to simplify your routine, to make it as easy as possible to meet your goals.

Have a podcast topic you'd love to hear about? Email us at info@sarahstombaughmd.com

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Are you taking a GLP medication? We are thrilled to share we are offering an online course, The GLP Guide, to answer the most common questions people have while taking GLP medications.

To sign up, please visit: www.sarahstombaughmd.com/glp

Transcript

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. 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 this week's episode. We are talking about weight loss during stressful times and before we talk about the episode, I want to share that this is a topic that came to us from a listener. She reached out to us by email and said, Hey, I'm having a really difficult time and I was hoping you could do a podcast episode on this topic about weight loss during really stressful times because I'm really struggling right now. And as I looked back, I realized this is a topic we've been talking about a lot in my practice. So patients who are working with me, we've been talking about this in some of our weekly group coaching calls, but it has actually been quite a while since I've done a topic like this on the podcast. And so I am so excited to bring it to you today. But what I wanted to offer to you, my listener, is that if there is something you are struggling with, if you are like, oh my gosh, I wish that Dr. Stombaugh would have an episode about XYZ topic, I would invite you to please email us and we would love to support you with that. You can email us at info@sarahstombaughmd.com. We'll put that in the show notes, but it's info at S-A-R-A-H-S-T-O-M-B-A-U-G-H-M-D as in medical doctor.com. And I would be so happy to create an episode that helps support you during your health and weight journey because this is a long-term thing and it is the combination of both how do we support you physiologically, whether it's with our nutrition, with medications, with things, and how do we support you psychologically because we know that for any medical intervention, when you can combine those two things, understanding your mind, understanding your body, and using those two things together, that is where the absolute magic happens. And so today we're going to talk actually a little bit about some of the physiological piece because when we are dealing with stress, there is actually a physiological response that happens in our body that can make weight loss more challenging or can even create weight gain in situations. I'm sure you've had, many of our listeners have probably had that experience in the past. And then there's of course the psychological effects of, oh my gosh, it's really challenging to be doing this new program or a really comprehensive program and working to change my life while life just feels really hectic right now anyway. And so let's talk a little bit about what that stress piece looks like. First I want to talk about the physiological effect because I think that this often gets blown over. We know that there's a huge psychological effect of stress, but there's a physiological effect of stress as well. And recently I feel like we've been hearing a lot on social media about cortisol, which is thought of as our stress hormone and the role that plays in weight and other parts of our cardio and metabolic health. But the reality is cortisol does increase during times of stress. And while that helps to sort of stimulate our body, it can create issues such as we have an increased appetite. We often will have cravings for foods that are very highly dense energy sources, things that are either high in fat or high in sugar, maybe high in both. There's a promotion of fat storage during times of high cortisol. We often see that that can create poor sleep because we're kind of revved up. And then there's this component where the cortisol can drive things like insulin resistance, for example. And so the role of cortisol can be really significant, and we know that both short-term acute stressors as well as long-term or chronic stressors can create that for us. And while you may hear about all sorts of supplements or things like that that can help support the cortisol, the reality is for most people working through relaxation techniques, working through our mindset, working through that will actually help to regulate those levels physiologically. So it's amazing this sort of mind body connection that we see and stressful times are such a important example of how that comes up. And our mind and body sort of work back and forth together, this emotional eating part comes up as well. And one of the ways that I like to define emotional eating is eating for any reason beyond physical hunger. And I think that's important to note because we often identify that during times of stress or anxiety or other maybe really specific emotions, we will turn to food. But emotional eating can happen in the context of things like boredom. Boredom is an emotion, and eating when you are bored is in response to that boredom emotion. We often eat for happy reasons as well, like celebratory events for example. And so emotional eating, we often give a negative connotation, and that's certainly very common in what we'll talk about today. But I think one of the things that's really important to realize is that emotional eating can take on a lot of different forms and sometimes we don't always pay attention to some of the more subtle forms like boredom eating or pleasure eating, for example as a source of emotional eating. But in the situation of a stressful time, that is certainly one of the, I would say sort of quintessential examples that we think about when we think of emotional eating. There are a lot of people who will turn towards food during that time. Now there are a subset of people who actually don't eat when they're feeling really stressed out. And we will take a moment here to address that as well. But let's first talk about the stress eating response because this is partially hormonally driven, so related to things like cortisol for example. But then there's also this psychological effect where food actually, especially specific foods that are hyper palatable, these high fat, high sugar foods for example, those can actually make us feel better in the short term. So when we look at the brain and brain chemistry, food is regulated by a lot of different hormones and there is sort of the you must eat and just regulation of appetite and true physiological hunger. And then there is hedonic eating, for example, where there's a lot of cravings. Our body is seeking food, sort of that cravings and urges. And this is often part of our dopaminergic pathway. So dopamine is a hormone in the brain that creates pleasure when we experience when our brain receives dopamine or when it releases and then it hits the receptors, that dopamine is perceived as pleasure in the brain and we get a dopamine release from so many different things in our life, whether it is things like food or alcohol or shopping or spending time with our friends and family or an enjoyable activity and hobby that you're doing. We can also get these very inappropriate surges of dopamine that often come buffering behaviors. So I want to talk a little bit about this because this is so common during times of stress. If we think about all of the human emotions, some of them are going to be positive and some of them are going to be negative. And both of those two things are important. It is important that we have the experience of both positive and negative emotions. And there is often this misconception in our society that we should be feeling happy or some sort of positive emotion all of the time. And a lot of times this comes up if you talk to a mother, for example, and you'll say, what do you want for your children in their lives? And you'll often hear responses, I just want them to be happy. And while on the surface something like that sounds really nice and lovely, we're actually often conditioned that we should only be experiencing positive emotions and that when we have a negative emotion, that is a bad thing. And what I will offer to you is that experiencing negative emotions are a very normal part of the human experience. And if we did not have those things, it would be very bizarre. So for one, having negative emotions allows us to experience the positive emotions in a much more significant way. When we understand the sadness of losing a loved one, we see how wonderful it is to be able to love and cherish our loved ones in our lives, for example. And the balance of that negativity allows us to really appreciate the full positivity in our lives. We also think about, for example, when certain events happen to us, let's imagine you get a flat tire on your way to work. It is a normal human experience to feel some sort of emotion, frustration, irritation, rage, whatever it is that comes up for you in that situation, it is normal to feel that way. Now, you don't have to feel that way forever. Sometimes we get sort of caught in this cycle where we're feeling extreme negativity for prolonged periods of time, but it is normal to have some sort of gut reaction by which you are feeling negative because you got a flat tire or to feel sadness and grief or despair when you lose a loved one that is the normal and expected response. And if you didn't feel that, that would be weird. And again, that doesn't mean that in experiencing that, you have to be sort of stuck in that place forever. Sometimes it feels that way when we're in the depths of our despair and having a really difficult time dealing with something. But it's not going to be like that forever. However, we are so often taught that it is not normal to experience negative emotions that people often dismiss our negative emotions. They often quickly want to sort of force us to a place of positivity or sort of poo poo or negate almost our negative emotions that we're feeling things like, oh, you're going to be okay, or, oh, thank goodness. I remember getting in a car accident and my car was totaled and I was really upset because it was wasn't a new car, but it was a new car to me and it was a pretty significant accident. And my husband and I walked away fine, which was amazing, and my car was totaled. And when I told people about the accident, the first thing that 98% of people said back to me, it was like, oh, who cares about the car? Thank God you're okay. And it was so enraging because I did care about the car and I was sad and angry and all of the things that you're allowed to be when your car has been totaled. And of course I was thankful for my life and for my safety and for my husband's life and safety, of course I was, but I didn't want that piece of my sadness to be discounted and it was so automatically discounted. And that happens a lot in our society where we say, oh, it's going to be okay, or at least this thing. And the reality is learning how to both understand that having negative emotions or even that we are having negative emotions, maybe identifying the negative emotion that we are having and then recognizing that being in that isn't something we're going to be stuck from forever. And oftentimes we are taught that when we're feeling in a negative emotion, because we are taught that it's not normal, people often try to help support that or sort of move it away for us of, oh my gosh, your boyfriend broke up with you and so one of your friends brings over a bottle of wine, for example. Or you didn't make the sports team in high school and your mom takes you out for ice cream. And not that we can't do things that make us happy when we're feeling sad, but we often skip over completely the negative part and think that we need to use food, use, drink, use other things in order to feel better. And that's where these buffering behaviors come in. And so what happens with a buffering behavior is that when you are having some sort of negative emotion and instead of processing that negative emotion or allowing that negative emotion, we try to escape from it and it ends up creating this actually sort of net negative results in our life. So let me explain a little bit. So imagine that you've had a really stressful day at work and you come home and you're like, oh my gosh, I just want to feel better. That can result in things such as mindless eating, overeating, consuming alcohol, maybe going out to eat and ordering too much food, ordering an appetizer and dessert and alcohol in addition to your meal, really more than you wanted to. It may mean that you scroll on your phone and endlessly on social media, you sort of zone out or zone out watching Netflix or searching the internet for hours on end, kind of going down random rabbit holes. Maybe you're online shopping or physically shopping, sort of retail therapy, trying to make yourself feel better. Maybe you're doing other things like seeking attention from other people, looking at pornography, trying to forget about it and bury yourself in your work or cleaning your house, things that may actually feel positive on the surface, but we're just trying to escape from the negative emotions that we're feeling. Sometimes these overworking behaviors, for example, can even be ways that this comes up, but it ends up creating this net negative result in our life where maybe we're more stressed, or especially in the weight loss journey, for example, you can imagine that you've been trying to lose weight, you've been trying to follow some sort of healthy diet and exercise and lifestyle routine, and now you've had a stressful event that's come up. And if your go-to during times of stress has been to turn to food, that turning to food, it's likely going to be foods that are those very satiable, highly satiable, hyper palatable foods, those high fat, high flour, high sugar things that are giving us that dopamine surge. It ends up creating this net negative results in our life where we felt good temporarily, we had those foods, those foods surged, even dopamine in our brain, and it felt good physiologically, we can usually identify that. Yeah, it felt really pretty good to do that thing, but it was really short lived just for a couple of minutes. Did that feel good until it all sort of sets in, you're like, oh, I can't believe I ate that thing or drank that much, and that was really stupid, right? I've been trying to lose weight and that was not in line with my goals at all. And now you're kind of in this even more negative cycle where you're beating yourself up because you ate or drank or whatever in response to the negative emotion that you were having. The difference between that and seeking true pleasures in our life is that true pleasures actually create a positive result in our life. So when we are having a negative emotion, either allowing that emotion, recognizing, wow, I'm feeling really sad right now, I'm really disappointed right now, sort of identifying that emotion. It's interesting because usually that emotion sticks with us for a very short period of time before the intensity of it usually passes and it may come up in waves. And if you're dealing with a really significant stressor, if you've had traumas in the past, these are absolutely things that you may want to work through with the support of a therapist, for example. It's not necessarily something that you have to do on your own. It can absolutely and should be in a lot of situations done in the context and with the support of a trained professional. But when we allow that emotion, when we start looking at things in our lives that create true pleasure for us, it allows us to have the experience of whatever the negative or challenging event is and see the places in our lives where we're getting true pleasure. And so things that are helping to dispel that stress, things like slowing down and taking a deep breath or going for a walk, talking to a loved one about your stressful situation, maybe spending time in prayer or in meditation, doing some sort of exercise class, particularly something like yoga where there's deep breathing and you're really sort of in touch with your body and allowing your body to relax. These things can actually create this sort of true pleasure in your life that can help to offset the negative emotions that you're having from a stressful event that you're challenging or that has been challenging for you recently. And so I think recognizing that it's so normal and we are so conditioned to not feel our negative emotions, that it will often drive these escapism behaviors. And so I think one of the most powerful things you can do during a time of stress is recognizing am I trying to escape from it? And then am I sort of sabotaging my way? Weight loss goals? And so if you've been working on your health and weight journey and your condition stress response during times of stress in the past, you've always turned to food, for example, recognizing that either A, that may already be happening. And so recognizing, okay, this is happening. Is there something else that I could be doing in place of this? Or B, if you're not doing that at all, are you actually sort of finding yourself in a negative place because you're taking away the thing that has always traditionally made you feel good in the past? So that piece of recognizing and having awareness of when you're feeling stress, how are you coping with it, is such an important thing to do. And like I said, it may be something that you get support with a coach, with a therapist, with someone who is trained to support you in this way can be so valuable. Now, the other thing is a lot of times in a weight loss journey, we've been working on new foods and new routines and things in our lives that sometimes feel simply overwhelming during times of stress. And so what I will offer to you is make it as simple as possible. If you are trying lots of new recipes and you are getting really excited about that, that is all good and wonderful. But if you don't have the time to spend an hour in your kitchen now where you did a month ago, trying to force yourself to do that right now is simply going to feel so too much. And so you may turn too fast food or things that are just easy and less in line with your goals. And so thinking about what are the things that are both easy and in line with my goals? And that may mean getting pre-made meals, for example, from a meal delivery service or going to the deli section of your grocery store and buying pre-made food. And I will tell you that if you go to the deli section of most especially a high end grocery store, there's really high quality pre-cooked food there that you would probably just absolutely enjoy. Or are you going out to a restaurant? And if you know, Hey, I love Chick-fil-A, for example, and I know that I am likely to stop there because it's convenient on my drive home, take a look at the menu and decide in advance this is a food that I really enjoy and is in line with my health goals. And so even though I'm going to be swinging through the drive-through, I know I don't have time to cook, you've decided in advance maybe one or two meal choices from that restaurant that are going to be in line with your goals. And so you can say, Hey, it's been a crazy day. Maybe you're taking care of an aging parent. You're driving sort of back and forth, you're driving past your favorite fast food restaurant. Is there something on the menu that's in line with your goals so that you can still make it easy, make it convenient, but not feel badly because you've eaten out of line with your goals? Also, paying attention too to sometimes really simple things like your hunger and satiety. A lot of times during times of stress, if we're really busy, we may be trying to eat really quickly and that can lead us to not eating mindfully. And I will remind you that mindful eating does not need to be some sort of meditative experience where you're savoring each and every bite of food. It can be, but it can also be just let me focus on my eating for five or 10 minutes and focus on that rather than on trying to multitask. And in doing so, you may recognize, am I hungry? Am I full? Am I ending the meal when I'm appropriately satiated versus sort of accidentally overeating because I wasn't really paying attention? So that mindfulness piece can be really important as well. I will also say that just bringing in this simplicity, are there other people in your life that could help you? Are there quick snacks or things that you could just instacart to your house or pop by the grocery store and pick up that you're going to have snacks in the car, which is easy if you're listening to this episode live, it'll be released in February, and so it's cold outside. You could leave snacks in your car without worry that they'd go bad, but can you leave certain snack foods or foods in the car or in your office or in your pantry that are just easily accessible such that you're kind of running out the door and you have something in line with your goals easily available? Are there things that you can do to set yourself up for success? And so that is absolutely a thing as well. Are there things where you can work to lean on your community and ask for help? I was talking with someone recently about our society right now, we don't really ask for help very much in traditional US culture. And so can you ask for help? People love helping. And so that may mean asking help with meals, asking help with running people to and from activities. Are there things that if you could offload one or two tasks from your life that would be really supportive of the stressful situation that you're going through, I am almost sure that there is someone in your life who would be so happy to help you if you would just ask. And so that can be a really hard thing to do. But if it's even coming into your mind, I think so-and-so in my life might be willing to drop my kids off at school or pick up an extra shift for me at work or whatever the thing is, that's something worth considering as well because a lot of times people are really happy during times of stress. And then like we talked about too, sort of in the buffering conversation of instead of escaping from our negative emotions, are there things that we're doing that create sources of true pleasure in our lives that allow our bodies the opportunity to sort of take that deep breath, either figuratively or literally, and allow us to start relaxing so that we can reduce that stress response that's happening in our bodies, even despite the external circumstances in our lives that we can sort of take a deep breath and work through that? Now, it's very common in the weight loss journey that you may see plateaus during times of a weight loss. And what I will offer to you is that during stressful times, if let's say in a stressful time in the past, you might have traditionally gained weight, gained five pounds in a month or something because you were just dealing with this extreme stress. If right now during a really stressful time, your weight hits a plateau and stays the exact same, that may actually be a huge win. And so sometimes if we've been chugging along in our journey, we've been seeing consistent losses and feeling really good about that, and now things are at a plateau that while it can feel really negative because you were having that experience of, oh my gosh, it was going so well, I was losing weight and feeling so wonderful, I will offer to you that oftentimes of the past, you would've gained weight, that a plateau may actually be a huge, huge win. And so do not discount that either, because supporting yourself physically, choosing foods that fuel your body, carving time out for that deep breath or for a walk for example, can help support you honestly during any time, but especially during those times of stress. And so if you can continue some of those habits that you've built, it will help you during the stressful time to continue to feel as good as possible. And if you are going through a really stressful time, just know that my heart reaches out to you. It is such a huge challenge, but is absolutely possible to keep up with some of your health and weight goals during that time. If you are in Illinois or Virginia or Tennessee where I am licensed to practice medicine, I would love to support you, your health and weight goals. To learn more about my practice, you can visit www.sarahstombaughmd.com. We'll put all of that information in the show notes as well. Thank you so much for joining me today. We'll see you all next week. Bye-bye.

Sarah Stombaugh, MD

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