Ep #380: Update: Weight Loss Medications and Coaching

Welcome to the Weight Loss for Busy Physicians podcast. I'm your host, master certified life and weight loss coach, Katrina Ubell, M.D. 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. Welcome to today's episode. I'm so glad you're here. I am just recording this as I'm getting ready to leave on a little road trip.

My high school senior son has narrowed things down for college to his final top two choices, and so we're going to be heading out on a road trip to visit these two schools out on the East coast. And, uh, normally I'm not someone who super loves a road trip. Not really my idea of fun, but when we looked at flights and stuff because we have to go to two major cities, it was just like not going to work. Because of course the two visitation days overlap, right? So there are about four hours apart from one another. So we thought, okay, well, let's just drive all the way out there in one day. Then we'll spend the morning and lunchtime with one school, then drive up the afternoon to the other school for what they have in the evening. And then that school has some things in the morning the next day as well.

[00:01:39] And then we're haul ourselves all the way back here again. So anyway, that's what I've got going on in my life. Anyone who's ever had a kid, you know, finishing up high school, making these decisions, or if you're in the mix with it right now too, it's a lot. And yeah, just new. I'm guessing that by the time my third child's going through this, it will feel a little bit more just kind of like, yep, this is what we do, this is how we roll. But the first time you're doing things with parenting, right, it's like, wow, just, um, a big deal. And I don't know that I've actually really mentioned this here so much, but my son is planning on taking a gap year.

So this is he's deciding where he's going to go, but he's still going to defer and take a gap year. And he's going to be traveling in Europe by himself for a year. So in about two months, he's going to be leaving and he's gonna be gone. So yeah, it's a lot. Um, I'm using my coaching tools on my own mother heart and just being open to all the emotions that come. I'm so grateful for coaching and everything that I've learned. You know, all the tools that I teach, I apply to myself, and I'm so grateful for them because, wow, it's a lot to go through.

[00:02:52] It's a lot of emotions and it's a huge, huge transition. At least it will be for us in our life. So that's what I've got going on over here. But that doesn't mean I'm any less committed to helping you achieve your goals with permanent weight loss and peace and freedom around food. So I want to talk to you today a little bit more about the weight loss medications that a lot of people are using, that maybe even you're using. It could be that you're using them right now. I have not actually spoken about them on the podcast since January of 2023. So that was like episode 312. This is 380. So it's been a while. It's been over a year.

And, you know, things have changed a little bit since that time. And I've had more experience with clients in my program, members of my program using the medications. And I just have a little bit more insight, some more updates for you and some more thoughts about the work that I do and using those weight loss medications. And yeah, just have some perspectives for you that I think might be helpful, particularly if you are taking the medications or have taken them in the past. Maybe you didn't tolerate them, maybe they didn't work for you, maybe you're thinking about it, but not sure. Maybe they're something you're interested in, but for whatever reason, they're just not the right thing for you right now.

[00:04:15] So I just have some perspectives on that, just some things that I wanted to let you know about in terms of what I'm seeing, what I'm noticing, and how I think it can be helpful for you to see how the two things can play together for people that that's the right thing for. And also, if the medications are not the right thing for you to not despair. That is something that I want to stress as well. We'll talk about that as well, because it can really be really painful for some people who have to stop the medications, even if they were getting good weight loss results.

So let's start with you tried the medications, one of them or a couple of them or whatever. And either it didn't work, meaning your body just did not lose weight because I've definitely had people I've worked with who've had that result or you couldn't tolerate it for some reason. And so I have also been in communication with people who've tried it, who just had to stop because the side effects were just absolutely not something that they could go on doing. But now they feel even worse because whatever weight they lost, for those who did lose it, the majority of the time, they've gained it back already, which is, you know, pretty disappointing for them. That's what they've shared with me, that they feel disappointed to the point where where some people have even told me that.

[00:05:35] They liked how quiet their brain was in terms of food chatter, so much that they kind of almost want to consider going back on the medication to have that experience, even though the side effects were like, really, really bad. Which just is so interesting because all it really shows is how desperately we want to be freed of the obsession with food, with the constant brain chatter around food. And what I also find is because right now, you know, Oprah is out there talking a ton about these medications and the media has picked up on it.

And it's actually I think they're a little slow to the party, to be honest. It's been a big thing for a while now. You know, really everybody talking about it more and more and more for those people where it didn't work or they couldn't tolerate it. I'm noticing a lot of people just feeling even worse about themselves, like feeling even more broken when everybody in the media and all these people around you are like, look at me, and I'm feeling so great, and I've lost all this weight. And you're like, well, good for you. But I can't have that. Like I've just noticed a lot more shame, a lot more really feeling like I'm broken. My person, you know, each each person individually is kind of looking at it like, oh my gosh, like, I wish I could have that, but I can't.

[00:06:52] And so they're feeling even worse about themselves or feeling even more like, you know what? This is just I'm just destined to struggle with this or I feel so horrible about it. Some people then are overeating because they feel that way. And that, of course, is contributing to the weight gain and just being in a really, really rough place about it. One of the things that I wanted to point out, that I think a lot of people really don't understand, is that taking these medications is not the only way to quiet the brain chatter in your brain about food.

So this is something that so many of us want, right? We just want the urges to go away. We want it to quiet down. We just want food to have an appropriate amount of importance in our lives. Right. Do you need to eat to survive? Yes, but you need to think about it constantly. No. Do you need to have your brain, you know, totally like, you should eat this. You should go get that, you know, like just kind of consuming your thoughts about food. Absolutely not. And I think so many people think when they hear like, oh my gosh, I started taking the medications and the brain chatter around food was just gone. They think that that's the only way for the brain chatter to be gone. And so what I want to make sure is clear to you here is that for eight years, I've been helping women physicians to quiet the brain chatter that they have around food.

[00:08:12] Like, sure, the medications might be a great way to accomplish that, but it's not the only way. And so I just want to point that out, right. Like that there are other ways to achieve and accomplish a lot of the positive experiences that people who have found the weight loss through medications to have, like that's not the only way to do it. So I just want to point that out to provide some hope, because it really I talked to some people who are like really at rock bottom, like worse than they've ever been after taking these medications, which imagine when, you know, everybody is like, it's a miracle. And you're like, it's not for me.

A lot of people have been feeling super, super bad about that. And so I just want to say you're seen, you're noticed, you're understood, and don't despair. Like there are other ways to get the results that you're wanting. I mean, when you think about it, right, like these medications, like you end up eating a lot less food. And people find that to be really pretty simple because their GI tract is just like, absolutely not. Like, do not eat more food. But some people find they're like, yeah, but eating is a natural pleasure. And I do want to actually enjoy the food that I eat.

[00:09:25] So like, is there a way for me to be able to enjoy my food, have like a reasonable amount and not have it be like, oh my gosh, I'm basically stuffed all the time, even though I'm barely eating anything. Like, is there a way to work that out? Like, yes, we work on creating that all the time. I've mentioned it before, but I'll talk about it again. You know, we have study data that shows that our program is almost as effective as Semaglutide with some lifestyle changes.

We're meaning, you know, moving your body and changing the way you eat, which I don't know how you could not change the way you eat when you're on those medications. Like you just can't overeat anymore, right? For most people, for a lot of people. So I just want to point out that it's really easy to think like, oh my gosh, these drugs are a miracle and that it's the only miracle. There are other ways of doing it. And I know this to be be the case, because I've seen it happen with literally hundreds and hundreds and hundreds and hundreds of women physicians who are members in my program. Okay. So now let's talk about when the medications are just contraindicated for you or they're just not the right fit for you. You know, some people are like, you know, I'm curious, but I don't know. It just doesn't sit right with me.

[00:10:38] I just kind of have a gut feeling I maybe shouldn't do it. It's just I'm, you know, I'm not sure what the long term consequences are, and so I don't feel comfortable doing it. Like, whatever it may be, you know, having those reservations about it, it's also easy then to think. Pretty much if I can't use the medications or if I decide not to, then I guess I'm just stuck. I guess I'm just going to be over here slogging away in diet mentality, suffering. It's gonna be awful, you know, or thoughts like that. And I want to just reassure you that, like I said, like our program is also like very close is effective. And and it's just like another way, a different way for you to get those results.

So cool thing too is that whereas with the medications, you know, it's really looking like you have to continue using them ongoing long terme with the work that we do, you wouldn't need that. Or you know, some people have actually kind of been like, well, maybe what I'll do is like for people where it has worked out for them, they get off the medication, I'm managing my mind, I'm doing all the stuff that I can do. And then if they find, like they're still kind of struggling or their weight creeps back up again, like maybe they'll take the medication for a little bit of time to bring it back down again.

[00:11:53] You know, like, I don't know, I think it's it's interesting. It's kind of the Wild West right now. I don't know, like what how people are gonna approach it. But, you know, theoretically it could be something. So that actually brings me to the next thing. Okay. Let me move on to the next thing. So if the medications are going super great for you and you might even be planning to use them long terme, you might be like, I'm fine, I love this. This is great. I'm just going to take these forever. You know, what's interesting is like, but what if you have to stop for some reason?

Like what if some side effect crops up, or you have some other issue that comes up or some other thing that happens and you know, what's really recommended is you stop taking that medication. Wouldn't it be great to be totally set up with other skills to help support? The results that you have gotten, because I could imagine that if you've been on it for a while, I don't want this to come across as where it can be sometimes. I don't know if it's quite the way that I want to say it. I don't I don't mean it in any judgmental way, but it can be kind of a crutch, right? You're leaning on it. You're relying on it to manage, you know, your hunger levels and you know, the brain chatter and urges and things like that.

[00:13:02] So if you have to stop taking the medication at some point in the future, and you don't have any other way to create that kind of a experience for yourself, where the chatter is low and where you feel like it's, you know, very easy for you to eat the right amount of food for your body. It can be, first of all, scary. It can be very difficult. Some people report the weight coming back on really pretty quickly. Some people report the hunger coming back, like with a vengeance. Wouldn't it be really, really nice to have all these skills developed for yourself and, you know, probably in use in some ways as well, so that whether you're on the medication or you're not on the medication, you know, you're going to be okay.

You know, like you don't have to have anxiety around, like, well, what if I can't find it? Or what if suddenly I can't afford it? Or what if whatever, suddenly, you know, my employer stops covering it? Or what if something else develops and, you know, I can't take it anymore? What am I going to do? Well, you already if you've already been participating in coaching, it's not like a new skill that you have to learn. It's something that you've already been leveraging. It's another support system, another tent pole, so to speak, to keep that tent upright. So I think that that I'm not the only one thinking about this.

[00:14:15] There are this has been in the papers and stuff, how there are lots of employers now who've been finding that so many of their employees have been taking advantage of these medications, that the cost has really become prohibitive for them. I read something that there's, you know, some companies that are finding they're spending way more on weight loss medications than they are even on cancer treatment or any of those types of things, and they're just not set up to be able to support that. And so some people are just having to stop, you know, some employers are just stopping covering it, at least in the US.

But another thing that's happening is some employers are saying, okay, well, you can be on it for a certain period of time or you can be on it as long as you are also participating in some sort of lifestyle well-being type of support training, which is basically exactly what weight loss for doctors only is. You know, it's like they're basically saying like, yeah, don't think you're going to be using this stuff forever. We're not going to pay for it forever. You have to be learning other tools, other skills to be able to support yourself and doing that at the same time. And I'm like, yes, I agree, because that's what we offer and I know how much it is really helping people and, you know, helps anybody who struggles with weight.

[00:15:32] So I just want to be clear, you know, some people are like whispering like, oh, and, you know, and I also on Manjaro and I'm like, you can say it out loud like it's okay. Like nobody's judging you. Just because an escalator exists doesn't mean it's better. You're like a better person if you take the stairs. But, you know, sometimes the escalator is broken. And then what? It's nice if you can take the stairs. You know what I mean? Like, I think that's kind of the way to be able to look at it. So the final thing I want to point out is something that is really often super duper overlooked. And, you know, we talk about side effects of medications, but there's also some significant side effects, positive side effects of coaching that a lot of people really don't understand.

They're like, you know, if I were to come into your program, I get help with food and weight and all that stuff. Okay, fine. But the main side effects that medications do not offer even in the slightest are how coaching helps with other areas of your life, too, right? So being thin because of being on medication doesn't make you enjoy your work anymore. It doesn't make your work any more tolerable. It doesn't improve any of your relationships. But those are things that we're constantly working on in coaching because we typically are overeating because of those stressors.

[00:16:51] You know, the things that are difficult for you in your life, like if you're emotionally eating. How about we work on those other things? So it's, you know, partly it's learning how to process those emotions, but it's also working through those issues that you have and working to solve them and improve them and make them a better experience for you. Like none of that happens for you with medication. So if you take the medication, then you have to stop. It's like your life is exactly the same. Whereas with coaching, like there's no way your life could ever be the same. It has to be better. If you're participating in taking advantage of coaching and applying that to your life.

It's just there's no way that you can ever go back to like, the before times, so to speak. You're always going to know, hey, you know what? This is so much better. Life is so much better. And like, no one can take that away. You know? You don't have to be fearful. Like, what if I can't afford that anymore? Or you know what? If I can stop tolerating whatever it is, it's like, no, this is something that you invest in on the front end. And some people even decide to invest in it. On going for a while. I know I do. I've had various coaches in my life for eight years. It's one of the best investments I can make, but is by no means to the same level of investment as, you know, taking those medications, you know, ongoing.

[00:18:09] So I don't know, I don't want to get into like a tit for tat on on cost, but it is something to think about. Like with coaching, it potentially could really support you. You know, you could learn the skills you need to be able to continue on without needing to make immediate, continued investments. Like maybe you would want to from time to time or get a little tune up or whatever, but it's not the same thing as needing to be ongoing chronically on a medication. So I just wanted to point that out. Like I have got no beef with medications at all. I'm like, look like, you know, we live in an amazing time where lots of amazing things are available to us, but it's important that we kind of back up and really see the big picture.

And I think one area where sometimes we, particularly as doctors can struggle is with some all or nothing thinking and thinking like, oh, am I going to do coaching or am I going to do medications as though they don't, you know, overlap or that they both couldn't benefit from one another? You know what I mean? And it's I think, really important. I think more and more people are going to see this moving forward that like, wow, okay.

[00:19:15] You know, it's really fun to be on these medications at first because it's always super fun to lose weight. You know, you feel great. It's awesome. You're like, I can absolutely do this forever. And then like, what happens in a year or two years or five years or now you're eating like weird shakes designed for people on these medications because you've lost so much muscle mass. Sometimes we need to start thinking about some other things, and it would be really, really awesome if you already had those mindset support systems in place to help you with whatever transitions might come in the future.

And if you're somebody where it just didn't work out for you, or it's just not the right thing for you, for whatever reason, I really again, I want to just say it again. There is so much hope. Like, don't give up hope. Please, please do not let this like spin you out into a spiral of frustration and despair and like, it's never going to happen. It's just going to be different. You know? It's just going to be different and other options and other solutions are available to you. I just want to really make sure to impress that on you. All right, my friend. Well, thank you so much for being here. I want to be clear, like people who are on these medications are contemplating them or trying to get off of them or whatever are absolutely welcome in my programs.

[00:20:26] I don't know where people thought that they weren't, maybe, but I don't think everybody thought that. But some people did. And yeah, I just wanted to clear that up. Absolutely. We are here to support you and to help you in whatever way we can. I can and my team can and whatever makes the most sense for you. Well, I want to thank you for being here, and I want to encourage you to share this episode with somebody that you think it could help, whether that's personally or sharing it on social or wherever it makes sense. It would be great if you could pass it along to somebody else, kind of like, you know, you read that book that was so great, and you give it to your friend, maybe something along those lines.

All right, well, I hope you have a great rest of your day and rest of your week. I'm going to be in the car doing a lot of driving. Luckily, my son can drive so we can trade off. That's one thing I keep telling myself that's going to be a huge benefit. So all right, well, I have a great one. Thanks again for being here with me and I'll talk to you next week. 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.