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

Katrina Ubell: 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 listen to this episode, so glad that you're here. 

Alright, before we get started, the Soul Symposium; I told you about this last week, and I just  want to tell youa 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 a 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 calloused hearts, does that sound like anybody you  know? I'm like yep. It's 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.