Katrina Ubell: You are listening to the Weight Loss for Busy Physicians podcast with Katrina Ubell, MD, episode #60. Welcome to Weight Loss For Busy Physicians, the podcast for 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.

Well, hey, there, everybody. Welcome to the podcast. Thank you so much for joining me today. I am so excited to do another Q&A podcast for you. I realized not that long ago that it's been quite some time I went and looked at all the questions I had and I thought, “Whoa, okay. Let's do this.” Hi, I've got some questions to answer and that's what we're going to do today.

I firstly just want to talk to you very quickly about iTunes reviews. I love to share an iTunes review that just kind of pops out to me when I take a look. I've been on this mission to get 500 reviews and you guys have totally come through and giving me over 500 ratings which I'm so thankful and grateful for. Thank you so much, but I'm still looking for more reviews.

The one that I'm picking today is by Cultural Icon and the title is MD in Chicago. That's very close to me. It's right around the corner. And this person rates, “Wow, life-changing, which makes sense because she is a life coach. I actually don't have much weight to lose but her podcast have so much wisdom about how to approach life, dealing with setbacks and just becoming a happier, more self-reflective human. I've recommended this podcast to so many people, most who are in the medical profession. If you're a busy mom or a female, I suspect, she will speak to you. And if you are a busy mom/female/medical professional, she will really speak to you. Wisdom and compassion, I always feel better after I listened to her podcast.”

Cultural Icon, thank you so much. I'm so glad that this work and everything that I'm bringing to every week is making such an impact on your life and that you are willing to share it with your friends. I appreciate that so much. That is so great.

Okay, let's start off with these questions. Number one is from Diane, and she writes, “I have a question about food journaling. To stay a naturally thin person, do you need to continue to food journal forever? I am concerned about needing to record my food indefinitely to manage my weight because (I believe) it makes me focus more on food and obsessed over it. I was wondering if you might be able to talk about this at some point on the podcast or include it in a Q&A.” In fact, I can, Diane.

“If I'm always needing to record what I eat, I feel like I will always be thinking about what I eat. Would love some day not to have to give it a second thought and just enjoy life and relationships without having to stop to record it.” Okay, Diane, this is such a great question and I know so many people are going to benefit from you asking it.

This is where you're getting confused. If you are thinking that food journaling causes you to think and obsess about food so much, then we've got some other issue going on. In my world, when I think about food journaling, it literally takes a second and then we're done. What I'm wondering is what your thoughts are about food journaling and what your thoughts are while you are actually journaling your food. I'm wondering if you're spending a lot of time judging what you are eating thinking that maybe you did something wrong or you should have done something differently, that you have a lot of brain chatter about that food.

The other way it feels like you're constantly having to access your food journal is when you're eating all the time. If you're snacking and eating all the time, then yeah, you're going to be thinking about this constantly and stopping and recording it. But when you really, really constrain your food and constrain your meals and you stop snacking, and you don't eat very often, you almost never think about your food. It's the exact opposite of what you're concerned about.

What you're doing is taking a quick moment to jot down what you ate, paying attention while you're eating so you know what it is, and then taking a quick moment to do that and it really is as simple as that. You are enjoying your life and your relationships because you are not spending so much time focusing on food and obsessing over it.

I don't think that it's actually the food journal that's causing you to obsess over food. I think it's your thoughts about food. That is where you need to focus some of your attention. To answer your question though, do you need to continue to food journal forever? Some people are going to decide they want to do that. They're going to decide that it keeps them accountable. It keeps them in check in line with what their goals are, and there's absolutely nothing wrong with that especially when it's as easy as food journaling can be, where you really are barely thinking about it.

I will say that after my clients get to maintenance, I usually suggest that they continue food journaling for at least another year, if not, maybe even another 18 months. It kind of depends on how much of that maintenance time they've spent spinning in confusion and dealing with a few pounds gaining and losing and all that stuff if there's been a lot of drama during the maintenance phase, then they need to do journaling longer.

But if they've gotten to maintenance and it's really just super dialed in, then they can experiment without doing it and see what happens. The great thing though is that as soon as you start noticing that your weight is going up or you're not sure what's exactly going on with your food or you're just not getting the results you want finding that you're snacking again or something like that, you know exactly what you need to do. You go right back to food journaling. You start paying attention to everything and you get yourself dialed in.

That is exactly the same thing that you do when you've been planning your food ahead of time like do I have to plan my meals for the rest of my life? Well, maybe. Maybe that's what you need to do to keep yourself in check and maybe it really serves you. For most of us, we're going to get to a point where we're like, “You know, I'm so dialed in on this. I'm going to experiment with just eating the same things over and over and not planning the night before and see how I do. If I personally ever find myself having any drama around food or any issues, the first thing I start doing is going back and planning my food the night before again.

It doesn't take long, literally, two or three days before I'm totally right back on track again. That's a tool that I can implement and utilize to help me continue to get the results that I want. Now, over the course of time, many, many years out, then, of course, that's our goal to just not even think about it ever. It's just the new way that you eat is not even new anymore. It's just the way that you eat. But for many of us, when we're in this process, continue to journal is what we're going to want to do, and plan food as well until we get to that point. Thanks, Diane, for that question. That was so great.

This next one is a little bit similar, along the same vein so that I want to talk about that. This is from Delaine and she writes, “I started implementing many of these ideas after listening to the Decisions Ahead of Time podcast. I have a planner that is working well and already implementing many of these concepts. I have been living by the mantra, honor thy plan. I've been able to really dial in my days and to-do lists. The issue I'm running into is my husband complains about my lack of spontaneity. How do we ‘plan' for spontaneity? I appreciate all you do, Katrina.”

Okay. Well, thanks Delaine. I appreciate you sending me this question. This is such a good question. We think that when we plan everything, then there's no time to be spontaneous, that we just are always so rigid in everything that we do and that's actually the exact opposite of what actually happens. When you plan out your day, what you do is you also plan time for rest or plan time for literally nothing.

You can have a chunk of time on your calendar where you're going to do whatever you feel like doing then, and it's really important that you do that because otherwise, what us overachievers like to do, what we like to do is just be as accomplished as we can possibly be, be super, super productive and in doing so, we are blocking out and planning for every minute that we're awake and sure, that's great. You get a lot done but then, you're not spontaneous. You're not getting the rest and relaxation that you need, and a lot of us really struggle with allowing ourselves to rest.

For some of you, this isn't an indulgence. It's something you really, really have to work on. What I want to offer to you is that if spontaneity is important for your husband, then you can plan that in. Have a whole Saturday afternoon where you have nothing planned and you guys can just do whatever you feel like doing. That is how you can “plan” for spontaneity. You give yourself some chunks of time where you have nothing planned at all and then you just do whatever you feel like doing.

Now, when it comes to spontaneity with food, that's what some of the husbands or other people on our lives will complain about like, “Well, sure. Now, we didn't know what we're going to eat at this restaurant. Now, you have to follow your other plan.” When you really have been losing weight and have your protocol really dialed in, the weight loss plan that you're following, then what you can experiment with is going, “Okay, well, I know that I can have like a plan B and if it really is that somebody wants to go out to another restaurant or I'm not going to eat at home or whatever this latest thing came up suddenly, then, what I'm going to do is eat this food group, this food group, this food group.

I'm going to have a bunch of fat. I'm going to have some vegetables. I'll have some protein and then also knowing that, say, you get to a place that's only pizza and pasta or something and there really are no salads. There's like nothing that is for your flour and sugar for you to have, then what you can basically do is just not eat.

You go out with your husband. You totally enjoy his company. You enjoy being there, and then you eat your own planned food when you get home. This is something that's really, really important to spend some time developing for yourself, this idea of going out with people and not eating even when they're all eating. I know it sounds weird. Trust me, many of you are rolling your eyes at me right now. I can feel it. You're like, “Katrina, that's weird. I'm not doing that part.”

But listen, you have to practice doing it so you can see that it is not weird. The whole point of going out is to have this contact with people, this connection, this communication and that's all available to you whether you're putting food in your mouth, chewing it up and swallowing or not. It's really that food part is completely irrelevant and the only way you're going to prove this to yourself is by actually trying it out.

You can do this if you're not hungry when everybody is eating. You're just not ready for some food. You don't have to eat anything. The food is an unplanned. You don't like that. It doesn't even matter what the reason is. It's a really good thing for you to practice to just go, like, “Yeah, absolutely, I want to go out with you and go there.” If they don't have anything, it's totally no big deal. I eat when I get home.

That ties us into the next question. You guys are so good. How did you know? All right, this is from Pamela and she writes, “I am relatively new to your podcast.” Welcome, Pamela. “And I've really been enjoying them the last few weeks. I started intermittent fasting and low-carb high fat on 12/31 and have been really working hard to learn how to fast and manage my thoughts around stress eating and hunger signals, et cetera.”

“I was listening to recent podcasts about how to live like a naturally thin person and one of the things you said was that naturally thin people only eat when they're hungry. I'm trying to rationalize this concept with what I am also learning and practicing about fasting, which is that hunger is transient and can be ignored. Hunger is ignorable and not something to worry about but also a signal that naturally thin people use for when to eat. How do you put those two things together? Thank you so much for all you do. You're seriously changing my life right now and I'm so grateful.”

Pamela, thank you so much for sending me this question because this is so good. How do you reconcile these two. What I want to offer to you is that when you are not very fat adapted, when you're a still a sugar burner and your body is expecting flour and sugar and really easily digestible forms of carbohydrate to keep you sated. What you're going to find is that your hunger is totally out of whack, like your hunger signals are not reflective of what you actually need.

It doesn't feel ignorable when you are having like a hungry spell, like you're so hungry, this has to be solved immediately. It definitely feels like an emergency. What you're learning by doing some fasting and getting out that flour and sugar from your diet and getting your body more fat adapted is that hunger really isn't that big of a deal when this happens. That's exactly what we're talking about. Like so you're hungry in between meals, like it's okay. It's not a big deal.

You're right. There are going to be some naturally thin people who are like, “Well, I'm hungry and it's three. I'm going to eat a little something.” What you're more likely to find with a naturally thin person is that they actually forget to eat a meal. They are “ignoring their hunger” or they just aren't that hungry, and so they'll end up only eating one meal that day because they just sort of forgot to eat.

Whether that's something where they intentionally to themselves, “Okay, well, I'm really hungry and I'm going to ignore it and I don't need to worry about it. They just are like, I got busy and I didn't eat. There's like literally no drama in there at all like it's just this is how I'm rolling today and so hunger is ignorable and not something to worry about.

Now, when naturally thin people are actually hungry though when they get to a -4 in the hunger scale, they're like, “Oh, okay. Yeah, I think I'd like to eat.” Now, that happens to us when we're fat adapted. Sometimes maybe I'm hungry to -4 or -5, so I start making dinner but the hunger kind of goes away. By the time we sit down to eat at 5:45 or 6:00 or something, I'm not actually hungry anymore. I still will eat them because it was my plan to eat and also because I was hungry earlier. Like I know my body is ready for some food. I don't have to necessarily be at a -4 hunger level immediately when I'm eating, if that makes sense.

We basically could reconcile them in the sense that they're both talking about the same thing that naturally thin people, if they're actually feeling hungry, too hungry then they will eat. But if they're just having like a little hunger pain, what I would call like a -2 on the hunger scale where you don't even feel like it's worth the effort to get up and make food. Like they wouldn't describe themselves as hungry. They would just be like, “Yeah, I don't really want to eat anything right now.” That's kind of the difference there and I hope that makes sense for you. Thanks for that question, Pamela.

Okay, next one is from Annie. Annie says, “The question I have is about the things that have to get done every day ideally at the same time but just to have happen like plan food, food journal, make dinner, meditate, laundry, practice piano with child, walk the dog, et cetera. I find that my daily task list gets bogged down with this mundane daily repetitive chores. Do you have a separate list for things that have to get done every day and aren't going away (will never be checked off)?”

Annie thanks for that question because that's actually really a good point. What is important to recognize is you're probably not going to forget to make dinner and you're probably not going to forget to walk the dog because the dog is going to remind you. But you might forget to practice piano with your child. God, the number of times that I've forgotten to have my kids like practice their speech therapy stuff or whatever they're supposed to be doing, like they're the ones who come to me and they're like, on amoxicillin for an ear infection. They're like, “Mommy, wasn't I supposed to have my medicine?” I'm like, “Oh, yes, you were.” And I'm a pediatrician. What?

I agree, like having some sort of checklist is a very, very good idea. Huge fan of the checklist. Annie, this is what you can do. For the things that always have to get done, you can have something separate. Now, I know you might be like, “Seriously? Another thing? Like I've got my calendar. I've got my bullet journal. I've got my 15-minute increment thing like I need to add something else?” But what I want to suggest is that you actually just create some sort of document.

You can hand write it or you can do it on your computer that has little boxes for the check marks and you put all the things, all these daily tasks. If they are really time-specific, you can for sure put that time on there. But yeah, a lot of them aren't. In the evening, you want to plan your food, food journal, make dinner. If you want to meditate in the morning, you do that. If every night, you want to just throw in one load of laundry, you can put that on there. You can divide it up like your morning task or like before work, after work. You can even have a separate section for weekend things.

I know for me, I would end up doing a lot of the laundry stuff on the weekends and kind of doing some kind of catching up types of things that always needed to get done. You can divide them up with these little check boxes and then you can just get it laminated, or you can even buy these little laminating pouches where you just open it up. It's like the two pieces of plastic, clear plastic are already mostly bound together. You slid in your paper and then unstick the little stickies and smooth out all the air and boom, you've got a laminated piece of paper there. Those are really cheap. You can get them on Amazon or from OfficeMax or a place like that.

Then, what you can use is an erasable marker on them over and over again. I know it seems kind of silly like I have to remember to make dinner but like if it's really something, gosh, I remember. This happened to me a couple of years ago. I always joked that when kids go back to school, it's sort of like a mother's New Year, because we have all these new resolutions like, “Okay, we're going to get up on time this year,” like we have this whole way of thinking. Like, “This year is going to be different,” and we have these kind of resolutions and I remember thinking like I have got to start making dinner earlier because I would wait until I was feeling hungry then end up snacking a ton while I was making dinner. Still eat dinner even though I wasn't hungry anymore. Kids going off to bed way too late like just it ruined my whole night.

I remember one year at the start of school, my resolution was I need to start thinking about dinner at 4:30, like whether I actually start or not, it's up to me but I need to be thinking about it. I need to have a plan. When I was at work, obviously, I wasn't doing that but that meant that I already had a plan for the nanny, like the nanny knew what she was going to be making for the kids or if it was a whole meal for everybody, then she knew what she was doing. Or I knew that, okay, we're just having leftovers that day. These things have to be heated up.

It took awhile. It took me a few months, but after a certain point, I didn't have to think about it anymore. Now, four o'clock rolls around, 4:00 or 4:30 and I immediately just start going, “Okay, what's our plan for dinner,” if I haven't already delineated everything out. Usually, I kind of know what I'm going to do anyway, but I might have to just go, “Okay, if we need to be gone at 6:45, then I should start at 5:00,” or whatever it is.

You'll find that over the course of time, the more you do this checklist, it might take weeks or even months, but before you know it, your brain is totally just going to be like, “Oh, yeah, these are all the things we do.” But I agree like especially at the end of the night, you'll forget the food journal, or you'll forget to plan your food or you'll be like, “Shoot, that's right. I wanted to meditate. Now, I didn't do it again.”

When you have that checklist, then you just can mark them all off. It keeps what you need to be doing top of mind and then you can just check them off with your erasable marker. I think I've just used those ones that you use like on a whiteboard, like a marker board type of thing and then erase back off again. You start again the next day. I think you're going to find, it feels so great to just check things off and know that you're finishing things.

Again, that's that achiever strength that most of us have. At the same time, you're going to make sure you're getting it all done. Now, remember, you're going to have this all on there and then you're going to see meditate, and you're going to be like, “Oh, my God, the last thing I feel like doing right now is meditating.” You're going to do it anyway because this is on your list of things to do.

You might have a rule for yourself that you're not allowed to watch TV or relax or read a book or get on Facebook or any of that until your evening tasks are all checked off, whatever it is. Then, pop in a podcast and just get it done, as fast as you can so that you can have that rest time that you need and want for yourself.

This is a great way to keep yourself on track with all those things you need to be putting them and rewriting them every single day in your daily to-do list. I agree, that kind of gets repetitive and probably isn't even that helpful. What I would do is just have this little laminated sheet which is sitting on my counter or wherever you are congregating for the most part and then you just know at night, “Okay, kids are in bed. What do I need to do? And the answer is always, “Go, look at my list.”

The other thing you can even do is use that erasable marker to add a couple extra task if there are things that you want to get done that day that you don't typically have to do. That could be something easy where you're just like, “Oh, yeah. I need to just wash the towels too,” instead of just the normal laundry or whatever it is. That's an option as well.

And really what it comes down to for all of these organization and productivity kinds of things is figuring out how to tweak the system to make it work for you. These are, of course, my suggestions, but you can figure out a way that really makes it so that you do these things because that's ultimately the result that we want, is that all the things that need to get done get done, and you have time to rest, relax, rejuvenate yourself and really feed yourself, do that self-care that you really need. Thanks, Annie, for that question. That is great.

Okay, and then our last question today is from Alicia. And she has questions about food. She says, “I have two questions. Number one, what do you think about green smoothies?” And then she tells me about the things that she puts in them including a couple of cups of fruit.

Alicia, I am not a fan of smoothies just in general, even ones that are 100% veggies. And the reason why is that when you blend up smoothies, what you're doing is making foods that need to be chewed up in a slower digestive process completely blitzed into this liquid that your body can absorb very quickly. Especially when you have fruit in there, the fruit will give you a much bigger insulin surge than if you just ate the fruit.

If you think about it, you have two to three cups of kale or another green, and then you've got some coconut water, unsweetened almond milk and then two cups of fruit. That's a lot of food, especially for a breakfast. What I would much rather see you do is work on getting some fat in, like a lot of fat in breakfast time to extend your overnight fast and then get used so that you're not very hungry in the morning and then get to a point where you can possibly just have maybe coffee and cream or something like that.

Some people end up just not having anything but just water or something like that in the morning. And the reason why is because you're getting that big insulin surge, and in order to get you more insulin sensitive so that your weight set point can drop, you really do want to avoid those.

Now, here's what I say about smoothies because then, there's a bunch of you listening, “But I love my smoothie and I love that whatever and I can't ever have that?” I'm not saying that at all. My suggestion is that you get to your goal weight, get yourself straightened out in maintenance so that you're maintaining your weight. And if you really want your smoothie, then try it. Then go back to it a couple of times a week and see how you feel, see what your hunger level is like. See if it kind of messes you up or if it feels great and then see what your weight does.

I would just say that while you're losing weight, I would avoid it. if you're not happy with where your weight is right now and you're looking to lose, I would cut those out for now. Second question is, “Do you have any cookbooks you'd recommend for cooking with healthy fats? I love your descriptions of the olive oil heavy meals you make, et cetera. I would love to find a cookbook or two with recipes following this principle.”

All of my clients, current or who have ever worked with me, will know my answer and my answer is, “Don't buy any cookbooks,” which is so funny because so many people who are trying to help people lose weight are like, “Yes, buy this, buy this and you need this other thing.” And what I want to offer to you is that all of that is distractions. And when you think that you need a cookbook to help you figure out how to eat, you're just indulging in indecision and confusion. You absolutely do not. All you have to do is look at the food that's on plan for you that you already like to eat and figure out how to add more fat so that it would taste good.

Literally, that can be a simple as well. I usually cook my eggs in some PAM spray and instead, I'm going to put a bunch of olive oil or some butter in the pan. And the eggs will kind of absorb all of that or mix it all in and then I'll get more oil in fat in that way. Adding full fat dairy to anything is always an option eating eggs, high fat cuts of meat, I mean, really, really constrain and simplify your meals. You absolutely don't need a cookbook. It's just going to make this process even harder for you.

I know that's probably not what you guys want to hear, but I'm telling you that you already know these answers. And once you just realize like, “I don't need another book or a cookbook to tell me what the answers are, all I need to do is just use my brilliant brain to problem-solve this for me and come up with a solution.” You're going to start seeing solutions right and left.

And then you'll trying some things and you'll like them or you won't like them, so you're going to have some hits and you're going to have some misses. And you're just going to be able to move on from that, but getting your meal super constrained down like you don't need a lot of options. You literally need 5 to 10 meals and just keep repeating them over and over and over and over again. Okay, Alicia, so I'm saving you some money. And when you want to eat your kale, just chew it up, like use your teeth. And kale is awesome. Fruit is fine too. You just want to use your teeth to chew it up instead of blending it all up so you can drink it down so quickly.

All right, you guys, thank you so much for sending me your questions. This is always one of my favorite podcasts to record because I love knowing what you guys are thinking about, what you're struggling with. Please, if you have questions about what I've taught you or anything related to that, you can always send those questions to me at hello@katrinaubellmd.com, or you can also go to the podcast show notes pages which you can find … This one, you can find at katrinaubellmd.com/60 and leave a comment. The next time I do a Q&A, I will do my best to answer your question. And if you wouldn't mind leaving me an iTunes review, I would appreciate it so much.

As a final note, many people have the most success doing that off of their computer. Please, whether you're a PC or MAC user, you can just have your iTunes account opened up there and you're able to leave that review. It's so much easier to search for Weight Loss for Busy Physicians and enter that review.

All right, take care. Have a wonderful week. I'll talk to you next time, bye-bye. Thanks for joining me today. If you like what you heard here, be sure to hit subscribe in your podcast app, so you never miss an episode. You can also get my Busy Doctor’s Quick-Start Guide to Effective Weight Loss for free by visiting me over at katrinaubellmd.com.