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 long term. 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 to 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 of the Conqueror Weight Podcast. I am so, so excited. I think I say I’m excited every week, but I am so particularly excited because today I have a patient, Marci, who is joining me, and we’re going to talk a little bit about her journey, what that’s looked like working with me and what this weight loss journey entails because one of the things she and I were talking about off camera before we started was that it is not easy. It is not always a very linear journey. And so I am so excited to bring her on to share her story with me and with you all today. Marci, thank you so much for joining us today.

Marci:
Thank you for having me.

Dr. Sarah Stombaugh:
I am really excited and we are going to dive in and tell our listeners all of the good stuff here. Tell me a little bit as we’re getting started, introduce yourself, your background, and of course you and I have been working together for a while now, but how you came particularly from a weight perspective to decide, hey, this is something I might be interested in exploring. I’d love to hear that from you.

Marci:
Yeah, so my name’s Marci. I am from the Chicago suburbs and I am a teacher and I found myself in a place where I just wasn’t healthy and I was starting to have side effects from excess weight, such as high blood pressure. My sugar levels were not great and I was just not feeling really well. And so I tried different things with my primary doctor and I just wasn’t able to get on a healthier journey. And so my primary doctor recommended that I meet with you, Dr. Stombaugh. And together we have just really changed my life and it’s been a really full process to watch. Like you said, it wasn’t as simple as injecting the GLP-1s. It’s been a really long up and down journey that I’m still on, and then I’m still working towards becoming the best version of myself that I can.

Dr. Sarah Stombaugh:
I love that. And I think the way that you shared that, even just to the very early decision, because when we look at someone’s weight, that is just one metric. There are so many other aspects of health and the decision to decide to lose weight and to start working really intensely on that journey, particularly on a medical weight loss journey is a really personal decision. And so I think one of the things that will be really important here is that for anyone who’s listening, recognizing that your story is your own. And so what are the weight concerns you have? What are the associated health concerns you have? And people can want to lose weight for any reason, whether it’s health, whether it’s weight, whether it’s body size, and how that impacts us in different ways. And so I’m excited for us to dive into some of those things. Tell me a little bit, because it’s probably really nerve wracking to start in a journey like this, and when you think about the beginning stages of it and before we were working together, maybe what you had in your mind and then what this journey has sort of played out, if it’s been similar in some ways or different in other ways.

Marci:
So I have tried numerous other weight loss programs and something that was always at the forefront of my mind was shame. I was always just really shameful to tell my truth and to tell what it feels like to have a really serious food addiction and to just really struggle with weight and with health. And so I remember the first, one of our first few calls together, I was telling you about some of my harder eating days and things that I ate, and you just looked at me and you were like, okay. And I was like, well, aren’t you going to make a face? I was thinking this in my head, aren’t you going to make a face or aren’t you going to judge? And I think that the non-judgmental place has been the most soothing for me and what’s really been helping me to be able to continue on this journey and to not give up every week is not easy.

I’m not one of the people who has taken the injections and then immediately the weight has come off and it’s just been really simple. It’s been a journey. I have lost weight, I’ve lost inches, I’ve gained confidence, but it hasn’t been that linear. And I think that the biggest part of that has just been having a doctor who has been nonjudgmental. And I wrote some notes down and in my notes I wrote that you, and I don’t know if this is always the case, but you present, you’ve always, you’ve seen that before. I’ve seen that before. And I’ll even ask you sometimes, has anyone else said this to you? Because I think that the feeling that you’re not alone and that you’re not the only one was so helpful to me personally.

Dr. Sarah Stombaugh:
I love that. And the reality is we live in a society with so much obesity bias that then has been really internalized by a lot of individuals who are living with chronic obesity, living chronically in larger bodies by often we see in the healthcare profession certainly where you go into the doctor sometimes for an unrelated reason. It’s like, Hey, I have a sore throat. And they’re like, did you know you should lose weight? And you’re like, does that have anything to do with my strep throat right now? Those are totally unrelated issues. And then even when, let’s say you are there for a physical in the way that when we’re talking to people, someone’s sharing a evening where they’ve had a binging episode, for example, a response of, well, it’s not healthy to eat three slices of chocolate cake. It’s like, yeah, duh. I know that. Thank you. Thank you so much for sharing that with me, doctor, but this is my goal is to create a safe space. And so I love that you felt that. I love that so many of my patients have felt that. And I think the thing when we are behind closed doors when we’re one-on-one, and my goal is for people to feel comfortable sharing those things, and I hear a lot of things, all sorts of, whether it’s our relationship with food, particular episodes we’ve had with food, recognizing our response to eating in different environmental situations, whether it’s out to meal with friends or family, whether it’s on vacation, all of those things, they’re not something we talk about in our society because there is this idea that there’s shame wrapped up in it.

And of course there is, right? There’s shame wrapped up in all of that obesity bias that we keep these things really internalized. But I think I appreciate you saying that because while everyone’s story is of course going to be unique, there are these threads of we feel like always we don’t have people with whom we can share that. And I love that it’s been a safe space for you.

Marci:
Yes, yes, totally. Totally.

Dr. Sarah Stombaugh:
Tell me when we think about our work together and what that’s looked like, one of my biggest goals is this idea of reconnecting with our body. I am certainly never going to be a place of judgment, but what often really comes up is that we recognize we’re judging ourselves, we’re judging our own decisions. We’ve often practiced doing that for years or decades even. And my goal is to help people to learn, to reconnect with their body, to think about what are the foods that are fueling you? How do different foods feel when you eat? How is your body feeling when you decompress in a certain way or when you get adequate sleep versus don’t? How is your body feeling? Different exercises and movements that we’re doing and to really just this reconnection piece I think is one of the threads that is important to me. And I’d love to hear from you when you think about some of the tools or strategies or resources that I’ve provided, what are some of the ones that have really resonated with you?

Marci:
So I think that the most beneficial thing that I have learned through my health journey and my weight loss journey is that my body has the ability to tell me exactly what it needs. I just have to listen. And I think that I always forget that, and then it reminds me, and so for example, well, just taking a step back. So yeah, so I suffered from some really bad reflux issues and things like that. When I thought about it and you and I discussed it, I realized that there’s just certain foods that my body doesn’t like and doesn’t process well. And so part of my work has been to discover those and then not to never eat them, but just to be aware of when I’m eating them and to eat them in quantities that agree with me. And so I think that it’s a really powerful tool to know that your body really does tell you things. It’ll tell you, Nope, that kind of food just does not sit well. Spicy food is just not something that I can eat because you and I have talked and I live my life right now that I can eat whatever I want, but that feels good eating.

And so I’ve really been working on listening to my body and to taking away the emotional aspects sometimes or that the emotions are separate from what my body really needs. I think that in the beginning weeks together, we spent a long time just talking about hunger scales and listening to my body before we even dove into some of the GLP-1s and things like that. So still to this day, I mean, I think it’s been over two years that we’ve worked together, do try to, especially when I’m really emotional, think about my hunger scale, think about am I craving a certain thing? Does that mean that perhaps I’m dehydrated, perhaps I’m just tired, perhaps I’m anxious, perhaps I feel like there are different things that my body is displaying are often indicators of what I need. And that’s really been, I’m almost proud of myself.

Yeah, body, you know, can tell me what you need. So I am really working on it still. Sometimes I don’t listen and then I have to be like, oh, darn try. We’ll try again tomorrow at times. But yeah, so I think that just really listening to my body, even taking a second and thinking, how do I feel is anything hurting me? Those kinds of things. And then that kind of helps drive what I am going to eat that day. If I’m ever really sluggish, I might need to eat a vegetables. It just might be like, Marci, you have not eaten enough vegetables. You just need some vegetables. Or I could need maybe some fruit, my blood sugar’s low or something like that. So yeah, it’s been an amazing tool. What you just do automatically. That years of struggle with connection to the body made me forget that part.

And I have one more thing on this topic is that the other day I was thinking to myself and I was like, I just don’t like Mexican food. And I had never not liked a food before because food was always kind of, it was always something that if the food was there, I had to eat it because I had a real, it was an obsession. And so now that I’m working to move past that, it’s like I can eat foods that I like and not eat foods that I don’t like, and I can eat foods that feel good and not eat foods that don’t feel good.

Dr. Sarah Stombaugh:
You had so many nuggets there that I’m like, what are all the great things that I can pull out? Because even just the language with which you can describe it, and I hope that anyone who’s listening hears that really big shift of, and we can probably imagine you can, as a listener, you can go into your own head and imagine these situations in the past where we really beat ourselves up. And one of the things that can be challenging is if you have a day, a week, a period of time where you haven’t really eaten in line with your goals, and then you’re just in your head and beating yourself up about it, it’s actually not very helpful to do that. It feels sort of productive because we feel like if we just work harder, if we just try harder, that we will lose weight.

If we just restrict more, we will lose weight, but tends to not be productive, even if it does help us succeed for a period of time. And maybe seeing that scale shift downward slightly, there tends to be a repercussion and sort of bounce back from that if we’ve really restricted too tight and if we’ve approached it from this place of negativity, of over restriction, of beating ourselves up. And so I love even just the tone of voice that you were like, oh, darn, I guess we’ll try again tomorrow. That’s exactly the goal in that we have these times where it’s like, well, I didn’t eat in line with my goals, let’s say, and I can either forgive myself and move on, I can beat myself up about it, or I can find this in between of, okay, how would I do that differently next time?

But beating yourself up does not help anything. And so I love the way you described that. I also really love, we think of this idea of intuitive eating and one of the biggest challenges to intuitive eating is that when our body metabolically is not working in the way that it’s supposed to, so when we have metabolic dysfunction, and this can look like excess weight, increased weight, especially around the abdomen, it can look like high blood pressure, high blood sugar, high cholesterol, a liver enzymes that can look like a number of different things. And when those conditions are in place, the biggest challenge is that are it’s hard to trust our body. It can be hard because our body has insulin resistance that’s sending us these signals to eat more sugar, eat more flour, eat things that are very carbohydrate driven. Our body may also have leptin resistance, which means our body does not feel fullness in the way that it’s supposed to.

And so when we do sit down to eat, we eat more than our body may actually need at that time. And so it’s hard to listen to our signals, and so certainly we’ve utilized medications as part of your journey, and that for a lot of people can be the tool. Then that allows the other pieces to finally start clicking into place of I am allowed and I am able to pay attention to my body and recognizing, oh, I need more energy. Maybe I need protein or I am feeling constipated. Maybe I need some fiber, fruits and vegetables. And so that paying attention to is so, so powerful. And sometimes even it is tools like the GLP is that allow those things to really take place, which is why I think all of it really plays together and has certainly for your journey as well as for many others.

I also love the food log, the hunger scale, how much I love those things, and I do them in a way that’s very simple. We don’t do any certain apps. Yes, very simple. And we’ve talked about do I need to create my own app? And I’ve got so many things that are in my brain, but that’s one. I would love to come down the PI eventually, but what are the times you’re eating? What is that you’re eating? And then paying attention. What is your hunger? What is your fullness? What is your body feeling right now? Because if you are feeling predominantly an emotion, hunger is not an emotion. Hunger is a physical signal from our body. So if you are recognizing, oh, I’m bored, or I’m anxious, or some other experience that I’m, or emotional experience I’m having at this time, it’s really, really powerful to be aware of that.

Even if you do still choose to eat at that time, the awareness that your body is experiencing those emotions is a really powerful step in the direction of your goals. So thank you for sharing that. I think there’s so many good pieces that I just wanted to reflect there. I’d love to hear, I think one of the most powerful things, we think about the numbers on the scale, and certainly those have changed for you, but what really surprises people is that many of their non-scale victories end up being the ones that really stand out as life-changing. And I would love to hear from you over the last couple of years, what are some of those non-scale wins that have stood out to you?

Marci:
Yeah, well, I was able to go off of some different medications that I was on because of side effects from being overweight, such as my blood pressure medicine, things like that. I read somewhere on social media that another woman that’s on a weight loss journey was saying that when life is just a little bit easier in the sense that I feel like before I was always having to calculate is that chair going to hold my weight? Will I be able to fit in that area? Can I go on that ride at an amusement park? And that’s not to put any shame towards that, it’s just to say that it took a lot of mental capacity in my brain, and I feel that now that I have lost weight, I don’t have to think about that as often. And it really frees up time for me to enjoy the moment and enjoy my time with different people. I was able, even just yesterday, I was reading a book to one of my nephews and he was able to sit in the chair with me. The two of us were together on a chair, and it was nice to be able to be that close to him without feeling like I remember a few years ago, he one time said, not rude, but he’s like, oh, it’s too squishy here. And I was like, I don’t want it to be squishy. And so that was cool. That was a cool feeling.

Dr. Sarah Stombaugh:
Also because he’s probably grown quite a bit. It’s been a few years, right?

Marci:
You know what? That’s very true. He has. So that was really fun. I just also think that non-scale victories, even just when I got a massage the other day, I was able to fit into the robe going just little things like that. Airplane seats are easier and a little more conducive. And I think that the thinking about and the preparation that was happening in my mind sometimes, not even necessary, but just, oh my gosh, oh my gosh, is this going to work? Is this going to work? That has been really helpful in the fact that I can really enjoy the situation now instead of worrying.

Dr. Sarah Stombaugh:
I think that’s such a powerful reflection because it does take up so much mental space, both sometimes even in the context of food noise, which I know isn’t what you’re talking about here, but the amount of time that we’re thinking about food as well as the amount of time we’re thinking about our body and having had some of those experiences in the past that of course you would be nervous, of course you would be dedicating brain space to that. And so thank you for sharing that. I think that’s really, that’s really powerful. One of my favorite things about practicing in the way that I do right now is I have a small practice and I’m able to really connect with patients on a way that they feel comfortable sharing all sorts of pictures and all sorts of wins with me. And I think one of my favorite moments, I got a swimsuit picture from a beach in was were you in Hawaii? Is that right? In Mexico?

Marci:
In Mexico, yeah, in Mexico.

Dr. Sarah Stombaugh:
Okay. And mixing up different people’s travel locations, but seeing a swimsuit picture from a beach trip, those are the things too that as your physician, it just lights up my day to see those things playing out in your day-to-day life. Yes. That’s amazing. I’m curious, tell me, especially now that we’ve been working together for a couple of years, I’m sure that you had some preconceptions starting this and that as you are in this journey now, thinking about the process, are there challenges that you didn’t expect or positives? And you may have already touched on some of these that you hadn’t imagined before we started?

Marci:
I think I didn’t imagine that how crummy my body was feeling. I kind of just thought that I was approaching my forties and so my body was just not feeling good because I was getting older. And really a lot of it I think was due to carrying around excess weight, but also just the kinds of foods that I was eating and how they were affecting my reflux and things like that. And so I feel a little bit more healthy now in terms of this journey. I don’t think I expected to be for it to, the GLP-1s are such an incredible, incredible tool. But like I mentioned earlier, it’s only been one of my tools and I’ve had to do a lot of looking inside of me doing different things together that helped me towards my goals because it’s not as simple as just an injection of a GLP-1. It’s really looking at what you’re doing, how to do it the best. Because my goal was not just to lose weight, it was to really become a healthier version of myself.

And I think that it can be a really isolate. Okay, so GLP-1s are increasingly popular these days, but even two years ago when I first started working with you, I don’t think that they were as popular. And so it was a very, and even now I just feel like it’s a very personal and almost private journey that I was on that I didn’t really feel comfortable talking about in the beginning, not even so much because of judgment, because I don’t really, I mean this what’s helping me, so I’m going to embrace it, but more because of the sense that what if it doesn’t work? And what if I tell everyone that I’m doing this and then for me, it doesn’t work, which again, who cares? But it’s just the fear of judgment in all different forms was on the top of my mind. And I still find myself comparing myself to other people like, oh, she’s been on a GLP-1 for less time. I feel that she’s lost more weight. The judgment can really eat me up. And we’ve talked about this and I’ve texted you at 10:00 PM am I the only one that it’s taking this long? I think that just remembering that my journey is my journey and I am committed to doing this in a way that is healthy and that is going to fuel my body in the best way possible.

Dr. Sarah Stombaugh:
I think that especially in the context of what we often see, there’s so many on social media before and after, and if those pictures were one year or two years, five years apart, we don’t always know for starters what the difference between those pictures were. I also, sometimes, while there are so many wonderful people sharing real stories, I also sometimes also wonder if some of those stories are fabricated, which may or may not be true, and everybody’s journey is just their own, your own individual health history. All of the things related to how we think the choices of food that we make have so much more to do than just like, oh, this is the most nutritious perfect item that I could eat right now. Our food choices are influenced by so many things, whether we’re feeling sick that day, whether we’re PMSing, whether we’re running out the door because we’re late to work versus if we’re eating on a weekend out with our friends, we have choices influenced by the people around us, by experiences that we’ve had even in our childhood.

It’s really powerful to start to see some of those things come up where we recognize maybe a food was off limits, maybe there was recommendations of always clearing your plate, you have to eat dinner before you eat dessert, some of these different belief systems, all of those bring us to a point in our adult lives that we’re all starting from a different place, both in terms of perhaps the number and the scale, as well as perhaps just us as individuals where as unique genetically as we are in this way as well. And so it’s that measuring against oneself that is so, so important. And I always really will encourage a slow weight loss journey, slow being often one to two pounds per week at the beginning of a journey, but it slows down. I mean, as you’ve experienced in multiple ways in that your body may have less weight to lose or your body certainly does have less weight to lose.

And so it starts to slow down recognizing that there may be new things we’re working on and working through in different ways. When we look at the effect of different medications, for example, how we choose or layer those on with one another, that will be a very personalized thing. And how we decide, a lot of people think of the GLP-1s on their own, but with a lot of my patients will use those in combination with other medications even that may be impacting different pathways, for example. And so it’s so easy to compare, and I think this is true in a lot of other areas of life as well. And our journey is just our own. And so it’s like if we’re getting better, 1% better every day, and I don’t mean better in a morally better way, but better in if every day I’m just moving in the direction of my goals, even it’s the teeniest tiniest step, even if I’m pausing from time to time, it’s when we go backwards that we have challenges and things may go backwards as well in terms of perhaps the number and the scale, but backwards mentally.

And so my goal is that we’re always moving forward in the direction of our goals. And when we do hit plateaus because plateaus come up, okay, let’s look at why is this the case? Is there something that’s happening in your life? Is there something we need to address nutritionally? Is there something we need to address medically? Certainly as people go through different other health conditions, people go through surgeries, people go through injuries, all of these things, life happens, and learning how to navigate your weight loss journey amidst the rest of your life is so, so powerful because my goal for you, my goal for all of my patients is that you’re accumulating all of these tools. You’re accumulating this relationship with yourself, with your body, that five years from now, 10 years from now, 20 years from now, 50 years from now, whatever that looks like, that you still have those tools in your back pocket to be able to best support yourself and to come at it from that non-judgmental way. So thank you for sharing that. I really love that.

Marci:
And I just want to add to that. That’s so true because I feel like just the part about, so for example, I feel like sometimes the message that we tell ourself is, oh, you can’t have that food. Whereas that is not always what is going to help me with my journey. Sometimes it’s more of how much does my body want right now or how hungry am I? What is my hunger scale going? I want to eat some cookies, I’m going to eat some cookies, and then I’m going to get it out of my system and then I’m going to move on. Whereas if I’m never eating cookies and I’m never eating cookies, they become too powerful to me. And we had this experience, you and I with french fries, I was very fixated on french fries and I didn’t want myself to have any french fries, and they were becoming almost like an obsession.

And then one day you told me, eat the french fries, Marci, eat french fries every day. I forgot your exact wording, but try to just leave a couple on your plate each day. And I did that. I ate french fries for a week straight, maybe two weeks, and I learned how to, through that, I learned, okay, one, I don’t really feel that great when I eat french fries every day, and two, it is okay for me to eat french fries sometimes. So they became less of on a pedestal for me. They lost their hold on me and they became just another food in my food pyramid. And so I think that totally, instead of the mentality of eating for the next 50 years versus just eating to lose the weight was such a big driving force in my journey.

Dr. Sarah Stombaugh:
Yeah, thank you for sharing that story because I give variations of that assignment frequently, and whenever I do, people look at me, I have 10 heads. I think if I shared that on social media, if I recommended that to someone or recommended that as a broad recommendation, people be like, what is she talking about? I’m supposed to eat french fries every day. I have done this with so many different patients with ice cream and cookies and breads and french fries and candies and very, whatever the food item is. It’s really fascinating to recognize when we have a scarcity mindset of that food may not always be available.

And it’s really common that we have that for a lot of different reasons. Even just the diet culture of, oh, I’m starting a diet tomorrow. I’m not going to be allowed to eat cookies or french fries or whatever the food item is. And so therefore when I have the opportunity to eat them, I really need to enjoy every last one of them. I need to eat every single one, and we end up eating more than we really even would have wanted or that our body even really feels good with. And so it’s fun to have that experience. The assignment with you is there always needs to be just at least one leftover in the plate. And so it was like, I want you to know, and there’ll be more tomorrow. There’s going to be more tomorrow, and it let’s just leave a little bit and different variations of that depending on the individual, but there’s going to be more tomorrow.

There’s going to be more tomorrow, there’s going to be more tomorrow. And sometimes we realize, oh, actually that food item wasn’t actually as good as I thought it was, and it turns out I can eat french fries whenever I want to. And that freedom and now that practice belief of like, yes, truly I can eat them whenever I want to. For one, almost everybody, I think maybe there’s an exception, but almost everybody to whom I’ve given an assignment that has lost weight while they’ve been eating whatever forbidden food item for a period of time, which is always really shocking to them. How did I eat this food and lose weight? But it loses that power. And so it is about this, how am I designing the tools that I can use for the next 50 years? And especially starting out, I think that’s probably one of the biggest things that sets apart the type of work that I do compared to a lot of traditional diet programs.

If we were to take a robot that had obesity and say, let’s plug in a formula for how this robot would lose weight, I think a lot of people can very successfully have a robot lose weight. There’s certain nutritional principles that are going to apply that if we don’t have a human brain with human psychology and behaviors that we could just apply those principles. But the reality is we are humans with a lot of deep belief systems and working through and understanding those and then making decisions of what is that relationship that you want to have with food long-term if you’re going to cut out a food for the rest of your life, sure, you might, if you’re allergic to a food, if it’s going to cause a severe reaction for you, but a food that you really like, are you going to cut that out for the rest of your life? Probably not. And if you’re not going to, then you need to learn how to have a relationship with that food that is in line with your goals.

Marci:
Yes, yes. Exactly. Exactly.

Dr. Sarah Stombaugh:
Yeah. Thank you for sharing that. I think that’s such a fun example that we could share with someone. I’m curious if someone is listening to this podcast episode and they’re just starting out, they’re feeling really nervous, unsure whether they’re working with me or just their weight loss journey in general, what advice would you give to that person who’s just starting out?

Marci:
Yeah, so I a hundred percent believe, and this is not because you’re looking right at me, but you need to find a doctor that you trust. I went through lots of different programs and approaches and even other nutritionists and doctors. We have very intimate conversations with each other, and you probably know more about me than anyone else in my life, honestly at this point, at least in terms of my health. So you have to find a doctor that you are comfortable with and that you feel really has an understanding and a background in obesity medicine because Dr. Sambo, what you shared with me, one of my first sessions is that obesity is, I don’t know the correct term, but it’s a health condition. It’s not just like, oh, I can’t stop eating. No, it’s a health condition that needs to be treated according to research and an expertise you wouldn’t go to, I wouldn’t see you to clean my teeth because that’s not what you are trained in.

And so I think it’s really important, and I saved up for a while so that I could afford to see somebody that I trusted and that I believed in and that we had kind of similar goals about weight loss. And so I think that that is kind of the number one tip is to find someone that you trust and to not overly talk about it in the sense that sharing it with people that you feel comfortable with sharing it with and not feeling like I felt first I felt like I was lying if I didn’t tell people right away like, hi, I’m Marci. I’m on a GLP-1. No, you don’t owe that to anybody. It’s just like I wouldn’t tell them about other medicines that I am taking. So I think that finding a good doctor and keeping what you want close to you is not lying or it’s not like an omission, it’s just it’s your personal health information.

Dr. Sarah Stombaugh:
Thank you for sharing that. I actually did a podcast just a couple of weeks ago on that same topic because it comes up so frequently and you do not owe anybody an explanation. It is your own private health history. And so you get to decide if and with whom you share that information. And I think, if you don’t mind my asking, one of the things that as I’ve moved into my private practice over the last few years, I no longer accept insurance. I did work in a big healthcare system, I accepted insurance. It looked like a traditional primary care practice, and now I am a direct pay practice, meaning that patients pay me directly for their visits, it’s out of pocket. And we get a lot of questions about why is that worth it? And I think you’ve really done a nice job sharing that for me as a physician, I want to be able to connect with my patients in a way that I didn’t feel like I was able to in the previous environment.

And it’s so powerful for me to get to know my patients in these really intimate ways. It’s like I know their friend’s names or their kids’ names or their pet’s names or their boss’s name. I learned these different things, seeing the challenges that they’re going through and walking beside them. It is such an honor to be able to walk alongside someone in a journey like this. And it’s because I’m able to spend more time with my patients, I’m able to see them more frequently. And unfortunately in our current environment, that cannot be done in the setting of an insurance-based practice. And so I appreciate you saying too, just in terms of saving up and the decision to do this and that, it’s felt like it’s been really worth it.

Marci:
Yeah, I mean, I think that for me personally, if I was going to, once I decided that this was the path that I was going to take, I needed somebody that was going to almost be on call for me and for anyone listening, I recommend that it’s a really big blessing that I’m able to do this, and I know that this might not be anyway. And so I just want to say that I feel that there was a lot of times where, for example, I wasn’t feeling well or I had a question or I had a concern. And again, you’re not calling your friend necessarily and telling them, so you need someone to talk to you. You need someone to say, my stomach is hurting me, or I am a little bit nauseous today without, and so I was able to text you and that was such a huge part of this, and I got a response right away.

Or I was able to just say, I’m feeling a little nauseous today, or I’m feeling a little bit side effect today. And to have that direct response from you, you being a doctor, I mean, that’s pretty cool that I was able to get responses from a doctor so quickly because it’s true. I have an HMO. I am not able to get responses. I can’t even call any of my doctors anymore. I have to message the call center, call the call center. They call me back, and then I’m usually with the students so I can’t answer, and it is just become this huge thing. So I really wanted that. And so I found I got less manicures and I found the money in other ways in order to take care of my health. And it’s been one of the best decisions that I’ve made. And I tell my friends, I have friends that are on GLP-1s that are perhaps doing it in a pathway, and they’re not always as successful, and they don’t always stick with it. And I feel like not to harp too much on this money aspect, but some of my friends that did try it a different way did it one way, but it hasn’t worked in the long haul. And so it was almost like a waste of money. So it’s almost like putting the money down in the beginning gets you where you need to be later on, if that makes sense.

Dr. Sarah Stombaugh:
Yeah, absolutely. Thank you. I really appreciate you sharing that with me. And it’s been so fun to support you and many of my patients in this way where I feel like I can be the doctor to them that they deserve, and I love that about my practice. Let me ask you, because I think one of your hesitations, as we were thinking of sharing, you’re like, well, I’m still on my journey. I’m still working and I still have additional weight loss goals or health goals, for example. So I’d love to hear from you as you think about what does it look like for you moving forward, what are the pieces that you’re most excited about as you’re continuing your journey, whether it’s your health, your lifestyle, or personal goals for me to all of this?

Marci:
Yeah, I think in terms of my health journey, I want my body, I want to continue to lose weight because I still feel that the body that I’m living in, the size is still causing me some health conditions. I still think that there’s things that I want to do that would make it easier to move better and to explore the world better and to travel better and to snuggle with my friend’s kid better. And so I think that that’s really what’s driving me, and I just feel so much better. And so I’m thinking like, wow, I could just continue to feel better and continue to really enjoy all that’s around me in this life and go places and do things. And so what’s next on the horizon is just to continue. We’ve talked, I want to continue to work on my cardio fitness and see if I can make that a little bit better, to make it easier for me to run up and down the stairs in the middle schools that I work at because a lot of stairs and just different, just different things like that. So I think it’s just continuing to find ways to make my body feel better.

Dr. Sarah Stombaugh:
I love that, and I’m really excited to support you as you continue that. Marci, thank you for joining me today. This has been such a pleasure. I’m so honored to support you. Thank you for trusting me in your journey, and thank you for coming here on the podcast today. Thank you so much. I appreciate you. And for everybody who is listening, if you are looking for a physician, I would love to support you in your journey. I’m seeing patients online or by telemedicine in Illinois, Tennessee, and Virginia. My in-person clinic is located in Charlottesville, Virginia, and we are enrolling new patients, so you can learn more at www.sarahstombaughmd.com. We’ll have all that information in the show notes. Thank you so much. We’ll see you all next week.