Katrina Ubell:      You are listening to the Weight Loss for Busy Physicians podcast with Katrina Ubell, MD, episode number 174.

Welcome to Weight Loss for Busy Physicians, the podcast where busy doctors, like you, get the practical solutions and support you need to permanently lose the weight, so you can feel better and have the life you want. If you're looking to overcome your stress eating and exhaustion and move into freedom around food, you're in the right place.

Hey there, my friend. How are you? Welcome back to the podcast, so glad you're here today. If you're new, welcome, so glad to have you here. This is actually going to be a really good episode for somebody who is new to this podcast, new to this work, and also for somebody who's been a long time listener. So for no matter who you are, there's going to be some good stuff for you here.

I want to start off by telling you the latest installment of It's Come To This. I shared with you before that I've groomed my dog, cut my husband's hair, things like that. I actually had my husband remove my nails with his Dremel tool. I'm still trying to decide if it was a good idea or not, to be honest. I don't even know how to describe this. Without recognizing that I was doing so, I ended up with fake nails, okay? That's how I should preface this. I did not have acrylics or anything like that. I had something called hard gel. And so what happened was, I was just going to get a regular pedicure. I was working with this one nail tech who's really great, and she was helping me with the fact that on one of my toenails I constantly had this crack. I would finally grow it out and everything would be great and there'd be a crack going up into the nail.

And so then I bumped my toe on the slightest thing and it would crack this nail again and we just could not figure out how to get this fixed. So she said, “I have this hard gel that I can put over it and that will really protect it while it's growing out, it'll make it so much more solid and it's just so good.” We did that and it completely solved the problem. What this means is she puts this, it's called hard gel, but she puts it on, it's soft, and then she uses the light to cure it and then it's hard, and then she polishes over it. I was totally loving it and also, by the way, does not chip. My pedicures would last forever, like forever ever, ever, and so that was super awesome.

And then before I knew it I was like, “Oh yeah, let's try it on my hands too.” I don't think I really understood what I was signing up for, which is fake nails. I knew that I couldn't do regular manicures because it didn't make sense to do a regular polish, one, because in three days it's already chipping off, and doing a regular gel polish manicure was fine, except that I could only do those about two or three times in a row before my nails got so thin that it was just bad. I had one summer, a number of years ago, where for three months, every two weeks I went and got a gel manicure and my nails were absolutely wrecked, super-duper bad.

So I was telling her, “I wish I could do that but I can't.” And she's like, “Oh no, we can do this thing. Let's try it and see.” And before I knew it, I had these fake nails basically. So they were still short, they looked like normal nails, but it's not like I could just get it off myself. There is a way to get gel, soakable gel nail polish off. This is hard gel. It's literally super bonded to your nail. You can't get it off. And what she uses are these really special tools out of Europe, these special European manicuring tools, that are basically electronic tools that are kind of like a Dremel tool, only much smaller and much more adjustable and things like that.

So I've watched her maintain these for a couple of years now, and so they were growing out and I was trying to be patient, and I was just filing them down and I had a very neutral color on so I thought, “It's not going to be a big deal, I can just let these grow out.” And then I just could not take it anymore. So we get to that place where we just cannot stand it one second longer, and that's where I was at. So I asked my husband, “Do you think you could use your Dremel tool and file off my nails?” And he's like, “Well, I mean I guess I could try.” Of course he's a surgeon, so I have all this faith in him that he's going to be able to figure it all out, except neither of us knows what we're doing.

So long story short, what happened was is he filed them off. There was a little bit leftover of the hard gel that's just sort of been flaking off. But what we both learned, is that the line between where the gel ends and where your natural nail begins is number one, hard to determine, and number two, very thin. So what has happened is that on some of my nails, actually most of them, they're drilled down and some of them … He did not go through, don't worry, but some of them are very thin in places which does not feel good and they're super, super weak as well.

So anyway, it's just been a really interesting situation. He, of course, feels terrible about it and I told him, “Listen, I don't think anybody could have talked me out of this. I wanted them off. I would still want them off even if you hadn't done this, so I'm glad.” Now my toenails, I have not touched and I think I'm going to just let those grow out and that's just going to be … What I had thought was, “I'll get this off and then I can do my own manicure at home.” Except now my nails are in such a bad state, I'm just letting them recover and it'll probably take like three to four months for them to grow. So lesson learned people, It's Come To This.

Okay. I want to tell you something else. I recently was interviewed to be on a virtual summit. If you've never been on one of these online summits, let me tell you a little bit more about it. What it is, is somebody, a certain host puts it on and they interview a bunch of different people on a topic that's, there's some sort of theme to the summit typically, and all of the interviews pertain to that theme. And then what they do is they make live a certain subset of those interviews every day for a certain amount of time, a week to two weeks, something like that, and then at the very end, that's all free. And then at the very end, if you want to have access to all of them, ongoing, you can purchase all of the recordings at the end.

So this is Peter Kim, he's the Passive Income MD, and he is someone that I met in the last year and we've become friends, so he asked me if I would come on and talk about coaching and other streams of income for physicians. I was like, “Absolutely, of course. I'm all in.” So we interviewed that … Sorry, we recorded that interview a couple weeks ago and I want to let you know that the summit is now live. So when you're listening to this, it will have started yesterday, on the 11th, and it's going all the way through the 22nd. So I actually don't know right now, as I'm recording this, where in the lineup I'll be, but it's totally free if you want to hear about how I got into coaching and how I turned that into a business, you are going to hear that story on there.

What he's going to have there is a whole bunch of different physicians who are doing all kinds of different things in terms of how to create another revenue stream for themselves. So what I've heard from so many physicians recently is how upset they are that they're having pay cuts and that their job wasn't as secure as they thought it would be. They always thought being in medicine was a very secure job, and so now they're finding out the truth is that it never was secure, it's just that they had thoughts that made them feel secure about it. So I think whether you decide to create another stream of income for yourself or not, I think it is going to be really interesting to just hear about all the different options and all the different things that you can do.

Now, in my interview I actually talk about some things that don't require you to have any training, that you can literally just take the knowledge and expertise that you have right now, and create something of value that helps you to bring in money. So I really think if you're interested in that, you should listen to it for sure. And so what will happen, is you'll find out which of the interviews are available every day. He said that it's going to be about four to six every day. I wouldn't plan on probably listening to all of them. It'd probably take too long, unless you're home with nothing to do, then you can list them all. But I would probably just pick out one to two that seem the most relevant to you and make sure you listen to those.

If you find that it's been super helpful and it's something that you really want, then like I said, you have the option to purchase it at the end. So if you're interested in getting all that information so that you can get access to that and start listening, no matter when you listen to this, go to katrinaubellmd.com/summit, S-U-M-M-I-T. Again, katrinaubellmd.com/summit, and we'll get you all the information you need so that you can get all that info and start listening. Super fun, right?

Okay. Today I want to talk to you about some weight loss tools that are still going to apply to your life, even when you're in a crisis, even when you're in a pandemic. I know that so many of my listeners have essentially thrown out the baby with the bath water. They're like, “Oh my gosh, I'm just not doing the things anymore. It seems like these things don't apply. I was able to do these things that served me in the past and those were super helpful and useful, and now I'm not doing them. How do I do them again?” It seems like all the rules have changed and everyone feels just in upheaval and they want to know what they can do.

So this is going to apply to you whether you're at your goal already and you're maybe having some issues with your food and gaining weight, or maybe just noticing a lot more food chatter in your brain than you usually have, or for sure, if you still have weight to lose, maybe you're gaining still on top of it. Maybe you were doing a good job losing and now you're tracking back up again. Or maybe you don't even know if you've gained because you refuse to step on the scale.

Yeah? Those are all people who are going to benefit from this, so no matter what, if you're a person who eats food, I think you're going to get a lot out of this podcast. So I want to talk to you, like I said, about specific tools that you can be applying to your life no matter what. Whether you are full on frontlines or whether you are home with no patients to see at all or somewhere in between, you can definitely be doing these things no matter what, and be really careful when your brain starts giving you lots of reasons why you can't do it.

Okay, the first thing I want to talk about is eating to the hunger scale. What this means is eating when you're actually physically hungry and stopping eating when you are satisfied, that means when you are no longer hungry anymore and you've had enough food. I did a podcast, I should have looked up which episode it was, it's in the first 10 episodes of this podcast, all about the hunger scale and all that information, but I'm going to give you a quick review here. The way I teach the hunger scale is on a number line going from -10 to +10. Zero is where you're just neutral, you're not feeling hungry, you're not feeling full, you're just feeling nothing, just sort of a content emptiness in your stomach. The negative side is the hungry side and the positive side is the getting full side, more satisfied side.

So -10 is ridiculous hunger, you are literally convulsing on the floor dying of hunger, ridiculous hunger. And -4 is what we call just like, “I would like to eat now. It's not an emergency, but if I could get some food to myself soon that would be very useful and I would really like that.” -2 is like, “I'm getting a little hungry.” -1 is just the hint, the first hint of hunger. -5 or -6, so you're past the -4, which is the, “I would like to eat but I'm doing okay,” that is what happens, you get that level of hunger, -5, -6, and further down the scale, you get that kind of hunger when you're not fat adapted, when you are someone whose body is used to eating a lot of easily digestible sources of nutrition, such as flour and sugar, it will just clobber you over the head with hunger and the hunger will feel very, very extreme and strong.

So one good way of figuring out if it's true physical hunger not or, if you're fat adapted or not, is how intense is it? Where would you rate it on this scale? If it feels like it's a -8, I would start looking at okay, is this emotional hunger? Is this that I just completely have never gotten fat adapted before? Some people will say, “Well, if you've been fat adapted, but then you've been eating off-plan for a couple of weeks, are you completely, have you lost all your fat adaptation?” What I have found is that the longer you stay fat adapted, the more you can eat off-plan like that and get back on and have it be like nothing. But if you just became fat adapted six weeks ago and then you've been eating off-plan for three weeks, it's probably not going to be as easy of a transition for you.

So that's hunger. So we want to eat when we're at a -4. So every time you're thinking, “Maybe I should eat something, maybe it's time to eat,” you can check in real quick, get out of your brain and into your body, and assess, “Do I feel physical hunger right now? And if I do, where is it on the hunger scale?” You want to be aiming to eat only when you're up to a -4. So you want to start eating when you're actually hungry.

Then on the flip side of that is when you stop eating, that's the plus side. So +10 is the most ridiculous, overly full, you're begging to vomit and empty your stomach contents because it's so uncomfortable level. +1 is the hunger has gone away and you are starting to have the first little bit of contentment. And then you get up to +4, +4 is feeling like, “Okay, I'm satisfied, I've had what I need.” What I always say is with +2, you are satisfied, you've had enough food and you still feel like you could run around the block, very, very light and energetic. Whereas +4, you don't want to run around the block but you could definitely take a walk. It's not like you need 30 minutes to digest before you could go take a walk. +5, +6, that's the, I always think of when you're pressing on your stomach and leaning back, or if you're ever pregnant and you're did that. It's just that kind of leaning back type of thing, making a little more room in there. That's when it's too much. You want to avoid getting to +5.

Now, if you eat very quickly, if you're a very fast eater and you just inhale your food, you're going to have to stop probably at a +2 or maybe a +3. Because you eat so fast, it takes time for your brain to catch up with your stomach or your stomach to, yeah, no, your brain to catch up with your stomach, that you're going to need some time to have your brain actually recognize how much food is in there and that you don't need more. Now, of course slowing down is very, very useful, but if that's something that you're still working on, then work on stopping at a +2, giving your stomach some time and seeing if you get to +4. And if you don't, then you can have a little bit more food.

So that's what you want to be aiming for. You want to be aiming for starting eating a -4 and stopping eating at a +4. This means that you're eating a meal, right? You're not just having snacks, you're not having a handful of this and that and the other thing. That doesn't mean that you're like, “Okay, I'm already at a +4, but I still want a little dessert, or a little sweet thing, or a little bit of fruit, or nuts, or cheese or something to top it off.” That's how you end up eating too much. So you stop there. Now, if you want to have some fruit after dinner, that's fine. Then stop eating your dinner at a +3, so the fruit takes you to +4. This is how you figure out exactly how much your body needs. Your body will tell you if you're willing to listen.

Now, let's talk quickly about emotional hunger versus physical hunger because I touched on it briefly before. Don't forget that true physical hunger comes on just kind of like a wave. It just comes and it's there and it's just like, “Hey, letting you know, some food soon would be nice.” It's definitely not barking at you. It's not screaming at you. It doesn't feel like an emergency. Emotional hunger comes on strong and fast. If you are like, “Oh my gosh, I don't even know what's happening. I'm so hungry, I have to eat right now,” you should really pause and take a moment to understand whether that's emotional hunger or not.

If you typically aren't experiencing hunger that is that strong and that intense, it's even more likely to be emotional because why would you suddenly have such intense physical hunger? It's going to be emotional. And what I found with emotional hunger is when I just stay curious and I go, “Huh, I wonder if this is going to go away?” I mean, this is especially after you've just eaten a whole meal and you're like, “Really? I'm that hungry again? Interesting.” It's not like, “Oh, I haven't eaten in 14 hours,” quite hungry. It's a little different. But when you're just like, “Oh my gosh, I'm feeling so hungry,” then I'll just wait a minute and see. And it as quick as it comes on, it will quickly go away as well.

Whereas true physical hunger, if you need food, it will linger a little longer before it goes away. Probably like 15 minutes or so. Where emotional hunger, when you're willing to be with it and feel it, it tends to just, it just quick, goes away. It's really fascinating to pay attention to. So that this is something you can be doing no matter what you're doing, no matter where you're working, no matter what's happening. A lot of people are worried about money right now and everything, I promise you, when you eat according to the hunger scale, you will eat less food and that will cost you less money. So if you're looking to be frugal with your money and wanting to pinch pennies and things that, this is an excellent place to start for sure.

I will also let you know that if you're drinking alcohol, it will make all of the hunger scale work much, much harder. So I would just say that definitely take some time to work on this when you are not having alcohol because once you have the alcohol, of course your brain isn't functioning totally at its highest level and you're not able to assess the stuff. You're also able to convince yourself that you are at a different place. If you're really at a +4, when you're drinking, your brain's just like, “I mean, come on, let's just call it a +2 and call it good.” And then allow yourself to eat more. So just be on the lookout for that.

Okay, next tool, drinking water. Everyone hates this one. I don't understand it because I'm a huge water drinker. I love water. I've always been a huge water drinker my whole entire life. But I understand that most people are not. And what I can tell you is when you are not drinking enough water, which most physicians are not, your hunger will be much more intense and you will really be convinced that you were having physical hunger. But what you really need is to drink some water.

So I haven't talked about this too much on the podcast, but I really want to emphasize here that you need to be doing this, especially if you've got a whole bunch of PPE on and you're basically not drinking through your whole shift, you're basically making it so that you're just living off of what you have. You need to be pre-drinking to hydrate yourself, and then after the fact, you need to be drinking too. If that means you have to get up in the night a couple of times, then so be it, but you need to be hydrating your body. This is very important. As you know, your body's made up of mostly water. You need to be replenishing it. And if you don't, your body will answer with hunger. It may not be thirst. In fact, often it's not thirst. If you're drinking some alcohol or a lot of alcoholic, you need to be drinking even more water.

What I suggest, is if you're a coffee drinker in the morning, is before you even get your first cup of coffee, you have to earn it by drinking 20 ounces of water. Just get it all down. I don't care how you drink it. If you want to drink it bubbly or flat, if you want to float a slice of citrus in it, that's totally fine. I would say that if you're doing the flavored bubbly beverages, that that can be a problem. So this can become an issue in and of themselves. It's fine a little bit, but if you're drinking can after can after can, it might be too much.

So limit yourself to about one of those a day, and instead either go for just the plain bubbly water like San Pellegrino or if you have a SodaStream or something like that, or just Club Soda, or whatever it is, or go with the flat water. Try cold, try with ice, try it room temp, try a straw cup, try a cup that you just pour and drink in your mouth. I mean, try all the different things, but you've got to get that water in. I love looking at it like, “Okay, I can totally have that cup of coffee, but I need to drink this water first.” It makes you feel so much better, I promise you. Okay? You have to drink water.

Next weight loss tool, getting enough sleep. Right now, we can't say that we're too busy to sleep or we have too much going on. If you're not sleeping enough, the reason why is because you're staying up too late watching shows. We really don't have all the excuses that we usually have. So right now is a perfect opportunity for you to get the sleep that you need and make sure you're doing it. Just experiment. If you follow your hunger scale and drink water, and you get a good amount of sleep every night, or every possible night, just see how you feel. Just allow yourself to investigate how might your life be better or different even, maybe it's not better, when you get enough sleep. But you have got to focus on getting that sleep. It's so, so, so important.

Okay, next weight loss tool that applies, moving your body in a loving way. You know me, I'm always saying, “Hey, if you're exercising to try to lose weight or things like that, please stop doing that.” But what you are probably underestimating is how much moving your body helps you from a mental health standpoint. There's so much research on this, seriously tons and tons and tons, and all the psychiatric literature has it all in there. This is really, really important.

So what I'm talking about is moving your body in a way that feels good to you. When I say moving in in a loving way, that means not beating yourself up and doing some super hard video that you found online because you want to try to work off the ice cream that you just ate. Not that. I'm talking about getting outside, going for a walk, getting some fresh air. If you have a Peloton or something, maybe you can do a lighter version of a workout. If you are … I mean you can do yoga workouts online. There's so many different things you can do, but do a restorative version. Do something that is actually helping you to de-stress, that feels good to you, stretches you out. You will be so surprised at how much it helps your mental state.

I think of this as free coaching. I think like, “Yeah, sure. I can do all the work to manage my brain or I could go exercise a little bit,” and then it just happens for me. Then I have that much less self-coaching than I have to do. So if you do all of that, and just by default, you're already having a better state of mind, then it's much less likely that you're going to be eating food that you don't need to try to feel better. So by default, you're going to eat less because you're feeling better from doing something else. So find a way that you can move your body in a loving way. I have to say, depending on where you live, the weather can be up in the air.

I had wanted to walk yesterday and then it was cold and raining and I gave myself the pass. I'd done some other stuff, so I thought that was okay. This morning I got up and it was supposed to be 47 and raining the whole entire day. So I did what I needed to do, and I put on my rain gear and I went outside and I walked for almost an hour. And honestly, it was amazing. It felt great. I was so glad to be out there. I love being in the rain. Everything was green. It was so beautiful and I'm so glad I went out. So challenge yourself to not let yourself come up with excuses. Dress for the occasion, get out there and do it.

Okay, next weight loss tool is basically just setting yourself up for success with decisions ahead of time. So make sure you are planning your food, not because planning your food necessarily helps you so much to stick with your plan, although it totally does, but because when you plan your food, then you can grocery shop appropriately. If you have bought some things and it was a number of weeks ago, or a week and a half ago, and you don't even know what you have or how to make a meal out of what you have, so much easier to just order in and have something delivered or go pick up some takeout.

And what I'm telling you, is if you just plan out what you're going to make, then you make your master grocery list, you go shop for your two weeks and you make sure you have all that food. It is literally the easiest thing to be able to look at like, “Okay, these fruits, these veggies, they go bad more quickly, so we're going to eat those first.” And then we're going to hang onto these things like cauliflower or cabbage or whatever you happen to, apples, things that, that hang on longer and then you can eat those later into the two weeks. So just set yourself up for success by knowing what you're going to make. Choose things that are easy.

This is not the time to go down the rabbit hole of entertainment with food, but it might be a good time to actually figure out how to plan meals and find things that are easy for you to make and your family likes to eat. And then even after all this is over, you still can be making those same meals because you've given yourself that chance to basically test out a way of doing this, rather than before where you were too busy, and you had too much going on and you're trying to outsource it to other people and other things.

Okay, and then the final weight loss tool that still applies, there are others that I thought of but I thought six was good, I didn't want to overwhelm you, is managing your mind because really this is what it's all about. When you are able to not eat for emotional reasons and when your hunger is appropriate to how much food your body needs, and the amount of desire you have for food is appropriate for how much your body needs, weight loss is so easy. So there's all these things we can do to get fat adapted and to make it so your desire is lower, but we have to do the mind management part, which is the emotional eating part.

If you are not recognizing that your thoughts are creating your experience of your life right now, your thoughts are creating your results, what it's like for you to be you in your life right now, then you're missing the boat here. You have to take ownership of the fact that your thoughts are creating your results. If your results right now are that you've gained weight because you've been taking the action of overeating or snacking, or all these other things, you have to understand that where you look is not in finding some diet plan you can follow. You have to look at what are you thinking and feeling that is driving you to eat? It's really important for you to understand that.

What's happening right now, is that so many people are feeling so much fear, and so much stress, and so much uncertainty, and so much frustration that you don't want to feel that way and you don't recognize that it's not your circumstances that's creating that feeling, it's the way you're thinking that's creating that, and you don't want to feel that way, and rather than changing your thinking, you eat some food or drink some alcohol to feel better. It's really, really important that you double down on managing your mind, recognizing what are your thoughts, what are actual thoughts and not facts, understanding that the way that you are approaching your life is creating results. If you don't like your results, you got to look at the way you're thinking. You have to look at that and work on changing that so that you can create the results that you want. So important.

Okay, so those are six tools that you can start applying right now. If you were doing them before, come back to them. If you had never applied them, then it's a good time to start. What I would say is pick one and start applying it immediately, and give that a couple of days or a week to settle in, and then pick up next one. So to review, we've got the hunger scale and recognizing emotional hunger versus physical hunger. We've got drinking more water, sleeping enough, moving your body in a loving way, setting yourself up for success by planning your food and shopping accordingly and managing your mind. I'm telling you, it's the best work that you can do. So important.

And if you want to get in on those interviews for that virtual summit about other sources of income for physicians, then go to katrinaubellmd.com/summit and we will take care of you. All right, have a wonderful, wonderful week and I'll talk to you next time. Take care. Bye.

Did you know that you can find a lot more help from me on my website? Go to katrinaubellmd.com and click on Free Resources.