Ep #296: How to Help Your Patients Who Struggle with Their Weight

Katrina Ubell: You are listening to the Weight Loss For Busy Physicians Podcast with Katrina Ubell, MD, episode number 296.

Welcome to the Weight Loss For Busy Physicians Podcast. I'm your host, master certified, life and weight loss coach, Katrina Ubell, MD. This is the podcast where busy doctors like you come to learn how to lose weight for the last time by harnessing the power of your mind. If you're looking to overcome your stress eating and exhaustion and move into freedom around food, you're in the right place.

Well, hello there my friend. How are you today? I'm so glad you're here. Thanks for joining me. I'm so glad you're here. If you are new, you might be new, then I'm just offering an extra special welcome, I think this is going to be a great, great episode, particularly for people who work in the healthcare industry and are offering care to patients. I think actually people who are not in that role in this world will get a lot out of this as well.

But this one, today, is geared more towards the people who take care of patients from a medical standpoint. So, I'm super excited, especially if maybe you had a friend who recommended that you listened to this episode, so glad that you're here.

Alright, before we get started, I have a few things to let you know about. So, today, I want to tell you about the podcast survey one last time. We are wrapping up taking your survey. Well, actually you can keep filling out the survey even after this deadline.

But this Friday, September 16th, will be the last day to answer the questions on this very short, very easy to fill out podcast survey, so that you can have your name in the running to win one of four $25 Starbucks gift cards. Just my thank you for taking a few moments to just fill that out.

We are really just looking at all kinds of different options and things that are available in terms of where to take this podcast and things that we could add to it or do differently. And before I make decisions, I would like to know what you want. I would like to know what you think.

So, if you are available to do that, if you are interested in having your opinion count, then I would definitely invite you to come and join me by filling out that podcast survey – you will not join me, you'll do it on your own.

But you'll go to katrinaubellmd.com/podcastsurvey, and answer the brief questions there. And then we'll let the four random winners know, I think next week once we have everybody entered. Okay, thank you in advance for doing that.

Next thing, the Soul Symposium; I told you about this last week, and I just want to tell you a little bit more. I actually have a little bit more information about the books. I'm excited to tell you a little bit more about them because it's actually going live, it's happening right now.

So, if you didn't listen to last week's episode, the soul symposium is basically a free little symposium that's going on this week that's spotlighting five authors who have books coming out this month and next month.

In fact, I think, my book is the only one that's coming out this month. All the other books are coming out in October. So, that's very exciting.

And the point is for you to learn a little bit more about these authors, learn a little bit more about their books, and just get some good, great help for free. And then if you're interested in preordering all of the books, then you'll also get a great free bonus from every single author.

So, you get something from everyone, which is so, so cool. And I'll tell you a bit more about what to do with that pre-order book that you get too. Okay. So, just from my standpoint.

Now, my update, where I was highlighted was actually already yesterday. So, I just want you to know that if you're just hearing this now, you can still go and register for it and be able to listen to my interview there, for sure. So, no problems at all. When you're hearing this, you're going to be able to go and get it.

And I want to tell you a little bit more about the other authors, because I told you a little bit last time, but I want to tell you just a little bit more, because I'm really excited about these books.

So, Tim Elmore wrote A New Kind of Diversity: Making the Different Generations on Your Team a Competitive Advantage.

“While diversity is usually seen as an ethnic, gender, or income issue, there's a new kind of diversity that only 8% of U.S. companies even recognize; diverse generations on teams. Interactions between people from different generations can resemble across cultural relationship.”

I'm telling you how often is this an issue in medicine in particular. You've got the medical teams and you've got people from totally tons of different generations. And I remember sometimes there being doctors from the old generation complaining about how we've got it so good.

And so, after my intern year was the first year where there were work hour restrictions. So, intern year, they could work us as hard as they wanted. Then there were work hour restrictions, and to be quite honest, that actually made a lot of things even harder for a little while.

So, not to say that it shouldn't be done, but it was a challenging thing. But the whole work hour restrictions, there are definitely people in the older generation who are just like, “What, you guys have it so easy.” And we're like, “It doesn't feel easy.” So, not really sure what to say about that.

And I think even more so, the generations really look at the world very differently and to work together as cohesive team, it's just so important to know how to do that better.

So, this book provides the tools to get the most out of the strengths of each age group on your team, so good; foster effective communication instead of isolation among people, build bridges rather than walls so that loneliness becomes connectedness, and connect people to learn how both veterans and rookies can mentor each other. I think that's so, so, so good.

So, particularly, if you work in any kind of mentorship role or even if you are a mentee, I think there's just so much that everybody can learn from this book.

Okay. Next one, Tammy Lewis Wilborn. She wrote Playing a New Game: A Black Woman's Guide to Being Well and Thriving in the Workplace.

“Dr. Wilborn offers much needed advice on how women of color can be high-performing and successful professionally without sacrificing their physical, mental, and emotional wellness. Through her evidence-based best practices that promote self-care and self-empowerment as necessary tools for professional success, black and brown women can flip the script by prioritizing their wellness, even as they advance professionally.”

I can't wait to read this book. I think it's going to be just really a game changer for so many people. And even if you do not fall in the black and brown category, I think you can really learn a lot by reading this book and just understanding what other people are going through.

I think that's one of our biggest things that we're being called to do, is to not just assume that everyone's having the same experience that we are.

Okay, so good. Jeremie Kubicek, The Peace Index: A Five-Part Framework to Conquer Chaos and Find Fulfillment.

“Without personal peace, we're at war with ourselves and with the world. Look around you, it doesn't take long to witness unrest, disruption and chaos. We often settle for cynical minds and calloused hearts as a means of coping with the chaos.”

Cynical minds and callused hearts, does that sound like anybody you know? I'm like yep. It's like basically that's like burnout right there. His groundbreaking Peace Index equips you to identify your perceived level of peace in five critical areas; purpose, people, place, personal health, and provision. So, that's a great one, very excited about that.

And then Lee Richter is going to be speaking with Kary Oberbrunner about Blockchain Life: Making Sense of the Metaverse NFTs, Cryptocurrency, Virtual Reality, Augmented Reality, and Web3. I told you last week, I'm like, “No, I have heard these words before, but like what?”

“This book is the simple map to help you navigate the noise and discern between hype and hope. With unbiased expertise, the authors unpack the pros and cons of the metaverse, NFTs, virtual reality, augmented reality, cryptocurrencies, and much more.

Discover how to save time by identifying practical use cases for cutting-edge technology, create unending wealth by turning your ideas into protected digital assets, stay relevant by developing a customized metaverse strategy, and decide what technology to accept or reject by integrating your values.”

I love that. I think that understanding that we don't have to do all the things, but when we know what our values are, we can find a values match — that's like such a good kind of like compass. It's like, “Okay, this is a values alignment, I'm going to explore this more. This is not a values alignment, I'm going to let that be.” I think that's so, so, so good.

Okay. So, check it out. So, the way to get yourself registered for Soul Symposium is to go to, soulsymposium.xyz. Super good. It's free. Why not, check it out.

And then finally, so my book is going to be released, its next Tuesday. Can you believe it, in a week? I can't believe it. I like can't believe it. So, what has happened is that last week, I actually got two big boxes from the publisher full of hard cover versions of the book. And I was like, “What is happening?”

She's pretty you guys. I tell you, she's a beauty. She's a real pretty book. And I'm just so excited about it. It's like this is real, like what is happening? It's so, so cool.

So, anyway, I just wanted to remind you, let you know that if you pre-order or even just purchase the book in those first couple days after it's been released, so basically by September 23rd, you can get a free ticket to my virtual bonus workshop, that's on September 24th called, Guarantee Your Weight Loss Success.

So, all you have to do is just pre-order the book anywhere you buy books, and then you can take that order number, go to katrinaubellmd.com/lasttime, enter that order number, and then you'll get the information on how to come join us for that workshop.

So, the point of that workshop is like how often do we buy a book and we do nothing with it? Like I want to help you to get your mind ready to learn what's in that book and apply it to your life and get some results. So, that's the point of all that.

Now, say you're like, “Yeah, but I want to get the Soul Symposium, like I want to get all of those books and get all those amazing bonuses from all the authors.” And don't worry because that order number will work as well. Isn't that so cool?

So, if you decide to buy the Soul Symposium package and you're pre-ordering my book in there, then you will be able to enter that at katrinaubellmd.com/lasttime, and you will be able to get your ticket to the workshop.

And I just will say if you're like, “But I already pre-ordered the book and then I have to buy everybody else's book and whatever.” Listen, I'm going to give you just a really, really good example of how you can use that extra book just today, even on this podcast. So, good.

Alright. Let's dig in. So, just recently, I was interviewed on a podcast and the podcast host was letting me know, like, “We got a lot of questions about what it's like when you're someone who's trying to lose weight, about like how to deal with your doctor who might not be approaching things the way you want them to, or like how to work with your doctor in terms of losing weight.”

And then I thought to myself, you know what, like I've never done an episode about how to help your patients who are struggling with their weight or with overeating. And I think it's high time. Let's talk about that, because it is actually something that I think a lot of doctors struggle with and a lot of other healthcare workers struggle with as well. Like we just don't know what to do.

And I'll be a hundred percent frank, like with the dawn of social media and stuff, there just sometimes feels like there's just a lot of like sort of doctor hate out there about like, “And then the doctor said this and they're awful.” Like very victim mentality.

And so, it can start to feel like, “I'm just trying to help you. Like will you even listen to me? Like I'm telling you, this would help a lot.” Like it can create a real barrier between the patient and the doctor and getting the result that both sides want, which is for the patient to feel their best, to be as healthy as possible. And I just don't think it has to be like that. And I do have something to say about this.

And so, I just want to say that particularly if you are taking care of patients or you know anybody, you have friends or colleagues, maybe they don't struggle with their weight personally, and that's why they've never listened to this episode.

But I would definitely recommend that you refer your friends and colleagues to this episode, because it's important for doctors to know kind of some best practices or recommended ways to approach talking to their patients about this.

Because the fact of the matter is, is there are plenty of people where if they were successful in stopping overeating, in losing weight, it probably could really, really help their bodies in some way. And somehow for a lot of people, that message is being interpreted in an unintended way. It's being interpreted as like shaming, as being critical, as blaming the patient or blaming their body for everything. And so, we got to work through that.

Now, the thing we have to understand is (because first and foremost, this is a podcast about our thoughts and our feelings) that you could do everything “right” or in alignment with what you think is the best way to do things. And you will just never be responsible or able to manage how it's received.

And so, I do just want to say that people are coming to us with their own issues that they're working through and you could be the most compassionate, most amazing healthcare provider. And the way that whatever you say is received, to them, they'll make it mean that you were attacking them or shaming them or whatever.

And that's the thing where like we aren't in charge of that, they're on their own journey. And hopefully, they'll be able to work through that at some point. But I think the most important thing is that you feel in alignment, that you feel really solid in what you did and why, and the way you showed up, letting them then be responsible for the next steps of that.

So, I just want to say that. Like it can be real easy to be like, “Well, now, it's my job to like manage their thinking.” Well, I think there's definitely things we can do to make it easier for them to not be offended. But still some people who want to be offended are going to be offended. So, I just want to want to just put that out there and like for those people, like we'll do what we can do and they're on their own journey.

Now, I’m going to talk about all the people who really do want your help. But they don't want to feel blamed. And that's really something that is even established in the literature. That like people who are overweight or obese — say someone comes in with like knee pain, the doctor might be more likely to not offer pain medication or physical therapy or things like that, because they'll say, well, like losing weight is the solution, this is because of your weight.

Well, even if that's true, they're not going to lose it by tomorrow. And the pain they feel is real. So, like what can we do to work with them? Like how can we collaborate together?

So, I have four steps here, kind of four things that I want you to really consider, particularly if you take care of patients or even honestly, like a lot of us kind of can get a little evangelical when we start telling other people about things like you might want to listen to.

Okay. So, the first thing, when you're wanting to help your patients to struggle with their weight, the first thing is you have to understand that this is a sensitive subject for most people. You have to recognize that someone sitting in your office who weighs more than we would typically expect for someone of their height, it's not like they don't know that that is a thing. It's not like they don't know that they're overweight.

So, we just have to come in with that knowledge of like they're probably pretty sure, they know that this is a thing. Now, what they think about it, we don't know, but it's not like they're unaware. And I think for a long time, there were a lot of doctors who just weren't saying anything. Like, “Let's just kind of pretend like this isn't a thing.”

I actually, several years ago worked with a client who came to me, I think she was over 400 pounds when we started working together. And I said like, “What have doctors said to you over the course of time?”

And she was like, “Yeah, they just haven't said anything.” Like the only doctor who said anything to her was her OB-GYN when she was pregnant. Since her obesity definitely put her at higher risk for pregnancy complications.

She's like, “Yeah, they just, like never said anything.” It's not like she didn't go to the doctor. She did. She had other things that required her to go to the doctor.

So, it's just interesting. If you don't say anything, that is kind of saying something. And we don't have to like tiptoe around stuff, but we have to just come from an informed standpoint, like this is a sensitive subject for people. For often, it's been something that they've been dealing with already for a long time.

There's definitely people who have gone through some sort of trauma in their life, maybe sexual abuse, abuse or neglect when they were children and making their body bigger was part of their coping mechanism, was part of how they kept themselves safe, was part of how they dealt with the after effect of that trauma.

So, you just want to be informed. It has the potential, at least, to be a sensitive subject, we want to be very respectful and tread lightly, and just really meet the patient where they're at. This is when utilizing your emotional intelligence skills is going to be money. That's where it's going to be really, really important.

We want to do our absolute best to understand where they are coming from. We don't want to make assumptions that we already know or that we know what the problem is or what they've tried or what they're even struggling with. Like we don't know. And we want to be asking questions, being curious and being very open and accepting.

Number two, this is really important. You really want to (if you haven't already) start becoming aware of your unconscious biases around weight. Even if you struggle with your weight yourself, there are a lot of people who struggle with their own overeating and weight, who also have their own unconscious biases, or maybe even conscious biases around people whose bodies are not considered the “normal size.”

And so, this is actually super well-documented in the literature. And I'm not going to say this client's name because I haven't actually gotten her consent to do that. But there was a client who was emailing me about some of this stuff, and she was even sharing some of the information that she knows.

And so, what I'm about to say actually comes from what she sent to me. So, this is all based in fact. We know that obese people are seen as lazy, inferior, incompetent, less intelligent, unmotivated, as having poor hygiene and lacking in self-control. So, that is not the case. That's not the truth about them. This is how they're seen.

And for us to assume that we don't have any of those biases in us is probably … unless we've really done a lot of work on this, it's probably in there somewhere, there's probably at least some residue somewhere in your mind around this.

So, the internal work for ourselves to become aware of where we might be treating people who struggle with their weight a bit differently is extremely important. It's part of our awareness, part of our knowledge.

It's not a blaming thing, it's not saying that you are a horrible person. It's just saying that if you have grown up in society, these messages, basically, they have warmed their way into your brain and have formed some belief systems that you may not even be aware of.

And so, what we want to be doing is creating awareness around it so that we can check ourselves. We can notice any kind of strange thoughts that come up. Even a thought of like, “Well, I could offer that to them, but they probably won't do it.” Like is that your unconscious bias that they're an unmotivated person? Like hmm, interesting. Again, no blame, no judgment. Just understanding, just curiosity. It's very important.

Number three, my recommendation is that you ask for consent to discuss weight. Well, also, I just want to back up and say that I have actually at times felt railroaded, like the doctor just starts talking about my weight and I'm like, “There's not a problem. Like why are we even talking about this right now? That's not why I'm here.”

I have also avoided going to the doctor as a patient because I didn't want to have to hear from them what they thought about my weight. Like I was already mean enough to myself. I did not need somebody else pointing it out too.

Like it was kind of like this very sensitive thing. Like if I didn't see the doctor, then it could just be this private thing that I was trying to deal with on my own. But if I went to the doctor and particularly if they said something about it, then it was like shame fest.

So, I feel like I've gotten both sides of this coin. You may have too, or maybe not. But I do think that just this simple question of, “Hey, would it be okay if we talked about your weight for a moment,” or just, “I wanted to see if you'd be open to having discussion about your weight and how that could contribute to what you're here for today.”

Or something like that, gives them the opportunity, first of all, to say, “No” or to say, “You know what, I'm actually already working on that myself, I'm really happy where I am right now. This isn't actually an issue for me.” Or like whatever it is.

So, it gives them the opportunity to say no, which helps them to create an emotional boundary. It helps them to feel like they've got some control. It's not just this thing, this experience that's happening at them or to them.

But also, gives them the opportunity to go, “Yeah okay, let's talk about that.” That's like a signal to their brain of like, “Okay, I'm agreeing to this. Now, I don't have to blame the doctor for bringing it up. Like I've said that, ‘Yes, we can talk about it.’” Which is I think very, very helpful.

I think it's very important to let the patient know that you're talking about it because you care about them, because you want what's best for them. You want them to understand that part of your job as a doctor is to help them to know all the different ways that they could feel better or that they can manage their health problem better.

And there's lots of different things that we can do. And one of them could be losing weight, which you understand can be a complicated thing and can be a difficult challenge for a lot of people. But it's part of your job to let them know of this connection or whatever.

So, it's not like blaming them. It's just saying, “Hey, I want you to know that this could help you in certain ways. And kind of like what you do with that information is up to you. But I don't want to just pretend like it's not a thing or it doesn't exist or have you be confused in thinking that it doesn't contribute when you know that it does, or it could.”

Because that's the thing, back to our knee pain example, to say like, “Oh, well, losing weight will help your knee pain.” Well, like maybe, maybe even probably, but we don't know that. There are plenty of people who are thin who have knee pain.

That's our biases. That's where we have to be really careful. We have to go yes and; yes, maybe losing weight would be helpful, and what are the other ways that we can help treat this patient? How else can we help them to get the outcome that they're looking for?

And then number four, please make sure that you have some useful weight loss resources available to offer to them. I hear this a lot from people or people tell me what people they know have told them. They go to the doctor, they say, “Doctor, I'd really like to lose weight, what should I do? What can I do?” And the doctor says, “You just need to use more will power.” Like what, really, really?

Even though that we have known for a very long time and the data all supports this, that that is not possible. Like that's not going to be helpful. We have to educate ourselves just like we have to educate ourselves on so many other things as doctors, we have to at least give them some resources that we feel pretty confident can move them forward.

I think another thing that I hear is like kind of whatever the fad diet of the moment is, or kind of restrictive diet of the moment is, or maybe even like, “Well, I had two patients last week who told me they had lost a bunch of weight doing this very restrictive or elimination diet, or like whatever kind of a thing.” Then thinking that that's going to be the answer for everybody, going like, “Hey, I had a patient who lost 60 pounds on keto, you should try keto.”

But hold on, like there's so much more to it than just that. And when a patient gets that kind of recommendation from their doctor, they're so much more likely to give up. Maybe they've already tried that, maybe they just know like, “That's not the right thing for me, and they have nothing else to offer me. Like that's not helpful.”

So, again, listen I understand, there is so much information to keep up on when you're a healthcare provider. It's like overwhelming, so many things, but you don't have to be up-to-date on the latest, every little thing on weight loss. What you need to be doing is giving people some sound, reasonable, logical advice or a resource.

Now, I know plenty of people, and I know this because I read the comments to my podcast, the podcast reviews. So many people are like, “My doctor told me to listen to this podcast.” So, I know that some doctors are going, “Hey, listen to this podcast.” Of course, pretty soon I'm going to have a book that you can refer to them, How to Lose Weight for the Last Time: Brain-Based Solutions for Permanent Weight Loss.

So, what you can maybe do is if you have that second pre-ordered copy that comes, you could go, “Hey patient, you know what? I just picked up this book. I'm actually really interested in it. I would love to loan this to you. Why don't you give it a read and then come back and let me know what you think, or write me a note, email me or send me a message, letting me know what you think about this book.”

Like you can utilize that as a way to open up the conversation with people. There could be another way. Maybe there's something else to consider. Does this resonate with you? It's a collaborative thing. So much of what I teach is like nobody can be an expert in your body, like what's right for you. Or like nobody knows when you're hungry, but you, no one knows how food feels in your body, but you.

So, when a doctor is just like, “I know you should just eat keto.” It's like, no, that's not what they should necessarily do. Also, maybe it is. But for most people, it probably won't be.

And if it's not that, maybe you can refer them to somebody within your local area or system. Maybe it's a dietician that you work with closely. Whoever it is, like whatever the resources are in your community, making sure you have something for them, so they feel like they're not just being told, “Fix this and oh, PS, I don't really know how to help you do that.” You know what I mean? You want to be able to give them something that's actually going to be useful and helpful.

So, those are really the things. Make sure you understand this is sensitive. Like when a doctor says, “Well, you just need to eat less and move more.” I'm like, “Oh, you clearly have never struggled with your weight if that's the way you view this, because there’s more to it than that.” Just really not helpful when people say things like that.

Number two, become aware of those unconscious biases.

Number three, ask for consent to discuss their weight and help them to understand you really care about them, and that's why you're talking about it.

And number four, make sure you have some good weight loss resources for them. At least, just point them in a direction that's going to be helpful. That's what I ask of you.

So, of course, take what resonates, leave the rest. Maybe you already have a way that you address this and it's working great for you. But you just hear the feedback from people who are patients and that there are a lot of people still struggling with this.

So, again, if you have any colleagues or friends who take care of patients who also are like, “I don't even know what to say,” or are starting to think like, “Oh my gosh, like, how do you get through to people?” Maybe offer them this episode. It could be helpful.

Because actually, a big part of the impact that I want to make is I really want to help healthcare professionals to know how to help people who struggle with their weight. It's very, very important to me because we're failing on this front. We can do better for sure.

Alright, my friend, thank you so much for your attention today. In one week, this book is out. I can't believe it, so exciting. And I didn't even mention all my friends in our circle, our book ambassador's group, oh my gosh, such a great group of people.

So, I just want to say hi to all of them. Shout out to all of you. Thank you so much. You're so awesome. And yeah, you can still come and join us actually too. That's available to you as well.

Alright. Have a great rest of your week and I will catch you next week. Have a great one. Bye-Bye.

Ready to start making progress on your weight loss goals? For lots of free help, go to katrinaubellmd.com and click on free resources.