Ep #42: Your Questions Answered: Breastfeeding, Meal Planning And Family Health

It has already been 10 episodes since the first question and answer episode, so it’s time to address some important questions that have come my way. Today’s episode is packed full of valuable information including how to maximize your weight loss in a healthy and sustainable manner while breastfeeding. I also share some insights into how I meal plan, as well as tips on how to keep it simple and consistent so you can stay on track and get the best results possible.

In this episode we’ll also dig into the touchy subject of discussing health and lifestyle with family and friends. While it can be hard to know what your role is when we see people we love engaging in unhealthy habits and behavior, I’ll offer an approach to help you navigate these treacherous waters. Finally, you may be surprised by my advice on exercise and why it is not necessary for weight loss. Although different methods work for different people, my recommendations are quite different from what you may have been learning and hearing most of your life.

Listen To The Episode Here:

In Today’s Episode, You’ll Learn:

  • How to manage hunger spikes and other issues that may inhibit weight loss while breastfeeding.
  • The importance of keeping a food journal and how long you should keep it up – even while in weight maintenance mode.
  • The best way to meal plan – keeping it simple and easy.
  • How the need to help others is often a reflection of our own happiness and how to avoid this tendency.
  • Ways to handle loved ones with unhealthy habits.
  • Why exercise may not be as necessary to your weight loss as you think.

Featured In This Episode:


Get The Full Episode Transcript

Read the Transcript Below:

 Katrina Ubell:      You are listening to The Weight Loss for Busy Physicians Podcast with Katrina Ubell, MD, episode number 42.

Announcer:         This is Weight Loss for Busy Physicians, the podcast where busy doctors like you get the practical solutions and support you need to permanently lose the weight and feel better so that you can have the life you want. This is the resource you’ve been looking for to guide you on the journey to overcome your stress eating and exhaustion and move into freedom around food. Here’s your host, Dr. Katrina Ubell.

Katrina Ubell:      Oh, hey, there. Welcome to the podcast. How are you today? I am fantastic. We had the most fun weekend this weekend. I generally am not someone who likes to over-schedule at all. See, introvert me. I need my time at home alone, but we happened to get tickets Friday night to see Rent, Saturday night to see Monty Python and the Holy Grail, and then John Cleese live after that, and then last night on Sunday night, we saw Steve Martin & Martin Short live, and they were amazing. Our seats were the fifth row back, so they were like right, they could’ve basically spit on us, and it was so fun.

I did not know that Steve Martin is a very accomplished banjo player, and he plays with this one bluegrass group that is also amazing, and they were there as well, and they all played. It was really amazing. I would not say that I’m typically a bluegrass music fan, but wow, it was really, really fantastic to see them all live. It was super fun.

I’m feeling really energized from that, which is great because typically something like that might make me feel really depleted, to be honest, but the kids have off school today. My little kids are off at a sitter’s house, and my big guy is upstairs practicing piano and doing his voice, practicing, and all the other things he has to do, and so I thought, “Well, let me just take this opportunity to record this podcast for you.”

You know I’ve been asking you for iTunes reviews, and you guys are coming through and leaving me some, so thank you so much, but I definitely would love to see more, so I’m going to keep asking. If you’d like me to stop asking, maybe you could just do me this huge favor, “Do me a solid,” as the kids say, and leave me a rating and review on iTunes. I would so, so, so, so, so appreciate it. If you have an iPhone, it is so easy now. You just go into the podcast app if you’ve upgraded to the new software, you just go into where you find this podcast in your podcast app, scroll all the way to the bottom, and there’s an area right there where you can click on ratings and reviews and leave your rating and review. I would appreciate it so much.

I just want to shout out to a couple of people who have left me reviews and read their reviews. This first one is from this really interesting, I cannot pronounce this, it’s Chyrxhk4556, and here she writes, “I have binge-listened to this podcast over the last few weeks since discovering it. I’ve always been a slightly cynical person, but I am sold. Can’t wait to see how changing my thoughts will help me on both my weight loss journey and in life. No more “I’m busy” excuses. Thanks, Katrina.” Yeah, that’s awesome. No more “I’m busy” excuses. That’s for sure.

sjacob22 writes, “This podcast has truly changed the way I look at my life. I’m a better wife, mother, and pediatrician because of this podcast. Thank you for allowing so many of us, even if we aren’t in your coaching groups, to benefit from your wisdom. I am truly grateful,” and I am so grateful that you’re listening, sjacob22. So great, and hey, how about this? How about the next time I run a coaching group, you just join, because that would be fun. We can work together.

Then there was this other comment on last week’s podcast about EMR charting that I thought was so great. It was from someone named Jackie, and I just wanted to shout out to Jackie here because I just love this comment. She writes, “I’ve always said, ‘You know what doesn’t make charting better? Time.'” I literally laughed out loud when I read that. I was like, I love you. Yes. Time does not make charting better, but she writes, “Several podcasts ago, I reaffirmed the negative thinking around having so much virtual desktop. I have to do it. I can be grumpy, or I can save time thinking about it and get to it. Taking the emotion out of it is so helpful. I do have to reconfirm this every once in a while. Usually, it ends up being 15 to 30 minutes of my day, and then I start the next day fresh.” So good, Jackie.

I have gotten a lot of really good feedback from that podcast. I know many of you are like, “Okay, I’m going to do it,” like super determined. I think that’s so great, and so I just wanted to put that out there, you guys. If there is a thought that you can just keep telling yourself. I love “You know what doesn’t make charting any better? Time.” Just do it. Get it done. Love it. So good.

Today, we’re doing another Q&A podcast. I was looking back, and it was already 10 podcasts ago that I did the first Q&A and asked you guys to send me questions. I wanted to get down to it and answer some of these podcast questions

The first one. “Hi there from a fellow lady doctor. I love your podcast, and so much of it rings true for me. My current situation is that I have a four month old, exclusively breastfeeding and being the heaviest I have been other than nine months pregnant. I joined Weight Watchers at six weeks postpartum but have been hovering around the same weight. My goal at the time was to not gain as honestly I know I can quickly escalate. Although I have accomplished that, I wonder if it is possible or even okay to lose weight. I struggle with questions of proper nutrition and enough calories and enough supply. Although breastfeeding is a short phase in the grand scheme of life, it will be my reality for a while. I breastfed my first born to 19 months. Is this a topic you might take on in your podcast or blog? I am probably one of the many physician moms who are breastfeeding and wonder how to best manage this monkey wrench, although I do love breastfeeding. Sincerely, Ornella.”

Ornella, first of all, congratulations on your baby. That’s fantastic. Super, super exciting, and I’m so glad you asked this question because breastfeeding is amazing. Clearly, I’m a pediatrician. I agree and always support that for those who can make it work for them.

I breastfed my kids, and it was not easy. All three of them had their own set of issues. Well, mostly, they were usually my issues, somewhat related to their issues. One of them had his own set of issues, but we made it work, and we pushed through, and I get it. You gain all that weight, and then you have the baby, and then you think certainly placenta and baby should have weighed more than 13 pounds. That’s all I ever lost. I was like, “That’s it? I gained 40 pounds or 45 pounds, and all I lost was 13 having the baby? What?” so using breastfeeding as an opportunity to lose some weight, I think is fantastic. You totally can do it.

I’ve worked with multiple women who are breastfeeding, and there’s actually very, very little that you need to modify when you’re breastfeeding. I’ll just put that out there to make that clear. The only thing that I ask my breastfeeding moms to not do is to do extended fasting, meaning 24 hours or longer than that because you really do need to give your body some fuel to create that good breast milk for your baby.

This is the thing about nutrition. We have a lot of thoughts that we need to be feeding our bodies this certain way to be able to have good milk for the baby, and to a certain degree, that’s true. I mean, you do need to provide yourself with some nutrition, but you really don’t need to overthink that you need to be extra food or you need to be consuming extra vitamins or things like that.

The thing is, is our bodies are super smart and really want to propagate the human race. What that means is that unless you are already nutritionally super depleted, which you probably are not, then your body will leech out all the nutrients from you that are required to create good breast milk for your baby. If you, say you’re super, super vitamin D deficient, then of course, there might be an issue, but you should be supplementing your baby with extra vitamin D anyway, so maybe that wasn’t the best example, but you know what I’m saying. It will literally, we kind of joke, your body will suck the life out of you to create that milk for that baby, so you don’t need to worry about that so much.

You should still be taking your prenatal vitamins. You should be getting plenty of vitamins and minerals from that, and so you really don’t have to overthink that too much. That’s really, that basically makes it so you’re just like one like anybody else who’s listening to this podcast trying to lose weight.

The first thing, though, that I want you to focus on is managing your thinking. One thing you wrote is how to best manage this monkey wrench, kind of this idea, this belief that breastfeeding makes it more difficult or more challenge. What if it wasn’t a monkey wrench? What if losing weight when you’re breastfeeding was like the most optimal time to get to your permanent ideal weight, and then when you’re done breastfeeding, all you have to do is work on modifying your eating so you don’t gain after you’re done breastfeeding, and then boom, you’re done. Boom, “I’m right where I need to be, and I don’t need to lose more weight.” I just want you to really question that thinking, looking at it like it’s something somehow difficult or somehow making it more complicated because it really doesn’t have to be at all.

The other thing I want to mention, you didn’t really write about it, Ornella, in your question, but you hear about this all the time is when women talk about how hungry they are when they’re breastfeeding and how they just have these cravings for food, and they’re just chowing down constantly. For sure, your hunger could go up, potentially, because usually you’re burning an extra 500 calories or so a day when you’re breastfeeding exclusively.

If you’re supplementing with formula or if you’re giving the baby any solid food, then it’s less than that. Your body will make you hungry to make sure that you’re eating enough, but here’s the thing. When you’re eating a bunch of flour and sugar, that’s going to be so much worse. Your cravings are going to be worse. You’re going to be hangry so much more often. You’re going to be eating the puffs, the baby’s puffs, yourself, which are disgusting, by the way. Who would ever eat those, but you’re like, “I need some food,” and that’s what we want to be avoiding.

Becoming fat-adapted is seriously one of the best ways for you to reduce that super strong hunger pang, those pangs that can come and make you so, so hungry and make you snack a lot and basically overeat while you’re breastfeeding, and it can make it just so much more tolerable. When you commit to not eating flour or sugar, you’re going to need a lot of fat. That is what I want to make sure you’re doing. We worry so much, like, “Am I getting enough calories?” When you’re consuming of fat, you’re getting plenty of calories. You don’t need to count them. You don’t need to count Weight Watchers points. You literally just make sure you’re eating a lot of fat.

Now, at first when you’re doing that, in between meals, you might be still feeling super hungry. At that point, while you’re being fat-adapted, that first one or two weeks, then go ahead and eat a snack that doesn’t contain flour and sugar that’s high in fat to just help you get through that time. What you’re going to find is after the first couple of weeks that your hunger goes way down and that you just don’t need those snacks and you really can manage your eating so much better so that you’re eating just three meals a day, and you’re just not even having to think about snacks, which is so great. It’s so much less food that you have to think about and prepare for yourself.

Seriously fantastic. Super, super good to do that. So good for your body, and I think you’re going to find that when you get down to not eating flour and sugar and eating three meals a day and that’s it, no snacking, that your body’s going to start releasing some of that baby weight that you gained.

The other thing I want to mention is that if you get to a point where you just don’t even really want breakfast, it’s okay to eat all your food over lunch and dinner. I’ve definitely had breastfeeding moms extend their overnight fast through breakfast and just eat really solid, very high in nutrition lunches and dinners, and they do great, and they love it. They love not having to stress out about eating a breakfast in the morning. It’s already hard enough to get out of the house when you’re nursing. You need all your pump supplies, and you know how it is, all the stuff, not having to worry about eating or bringing your breakfast with you is just one less thing you have to worry about. I strongly recommend that if your body naturally moves towards that to let yourself do that. That’s totally great.

You’re going to cut back on snacks, eat lots of fat to fill you up, lots of vegetables, moderate fruit, moderate grains, moderate protein, and just hydrate yourself like crazy. You gotta drink, drink, drink. We often think that we need to be eating more to have more of our breast milk supply. What you really, really need is fluids. That’s so much more important.

Then get really much better in touch with your hunger scale once you’re fat-adapted, and really just eat only for physical hunger. You might find that you still have some emotional eating that you need to work through, or you’re stressed at work or stressed for the family or upset about something, and you want to reach for something to make yourself feel better. You’re going to want to work through that as well and be careful with that as well, but Ornella, this is totally the time to do all of this. You’ve got all these months to get this weight off. Perfect timing. You can do this. Can’t wait, and when you get it all off, send me a message and let me know. I can’t wait to see, and send me a picture of you and your baby.

Next question from Shelly. “Katrina, I have a question regarding keeping a food journal. Do you recommend keeping a food journal even after losing weight, or do you just write out your plan for the next day and stick to it? Do you ever plan your meals for the entire week and write them all down? Do you have any dinner planning websites that you recommend? What is the name of the artisanal bean company you use? Thanks. I love the podcast.”

I love how everybody’s like, “I need to know about the beans.” I will tell you about the beans, but first, let’s answer the first question. She asked, “Do you recommend keeping food journal even after losing weight or do you just write out your plan for the next day and stick to it?” Yes, I do recommend that you keep a food journal, even at maintenance for a while, probably at least one to two years because maintenance is what most of us struggle with, especially those of us who have yo-yoed who go up and down. We know how to get down typically, or we’ve had success with that, but we don’t keep it off.

You’re going to basically get down to maintenance, and then you’re just going to keep doing what you’re doing. Maybe you can modify a little if you keep losing and you don’t want to lose anymore, but you’re going to follow that plan and keep doing your food journaling because it’s so good. This is such good information. If you get down to maintenance, and then you start regaining a little bit, you’re able to look at your food journal and go, “Oh. What am I doing? Oh, look at that. I’m actually kind of snacking on some extra coffee and cream in the middle of the day. I ended up having a few more joy eats than I normally would,” because you have that information there. It is great to write down what your plan is for the next day and stick to it for sure, but if you don’t always end up following it, then you don’t have that information.

I think it is one of the best things you can do to continue keeping your food journal and also making sure that you are accurate with it, that you’re not just writing things down and blurring the edges a little so you’re like, “What did I really do there?” Sometimes, I’ll find myself just writing down coffee and cream. Well, that could be one cup, that could be like six cups. Who knows. It does make a difference, so keeping track of that is so good.

Then after many years of doing it, you can kind of decide if you still need to do it or not. You could try going off and seeing how you do but still weighing every day, and if you start trending up, then you know you need to get right back on it again.

I, usually at this point in maintenance, don’t write out my plan for my food for the next day because I have a very, very discrete plan. So many of the decisions of what to eat are already made ahead of time. I’m basically just plugging a few things in that day, and so I generally tend to find that I don’t need to plan it the day before because I don’t have a problem sticking to my plan day to day. I’m getting the results that I want, but there have been times when I’ve gained a little bit or I’ve struggled a little bit, or that’s like when I had to cut peanut butter out of my protocol because I was finding that I was really wanting to overeat it. That was when I needed to start pre-planning again, so then I will go right back to pre-planning my food, have it all laid out, and then I’ll do that for a while to get myself totally back on track again.

It’s a great tool to use when you are first losing, and through the whole process of losing, I highly recommend that you preplan your food the night before the whole time. It is so, so, so good to do that. I know you’re going to be resistant. My clients are always so resistant to doing this. They’re like, “Ah, but I don’t want to.” So interesting how our brain tells us these stories, like it’s just so hard to do it, but it isn’t at all, and that’s what I want them to learn. When you can strain your food down, preplan what you’re going to eat takes a minute. Literally a minute to a minute and a half. It’s so fast. One of the best things you can do for yourself.

I do not plan my meals for the whole week, but there’s absolutely nothing wrong with doing that, and I definitely have clients who do that, and they love it, so if that works for you, and you just want to sit down and preplan everything right away go for it.

In my family, we’re … I just don’t know what I’m doing. Today’s Monday. I don’t know exactly what we’ll be doing on Friday. We will eat leftovers, so sometimes, I need to see what we have left over. Sometimes, I’ll just look and kind of cobble something together based on little snippets of this and that that we have left over and feed the kids that. My husband and I just have a big salad or something like that, so I don’t do that because that doesn’t really tend to work well for me. What I find is that I need to modify it too much, but if that works for you, more power to you. Excellent. For sure, do it. I think that’s great.

You asked about any dinner planning websites that I recommend. I really don’t recommend any dinner planning websites, and this is the thing. When you’re looking to those websites, you are ignoring the inherent wisdom that you have of how to eat very, very simply and a very constrained diet. You already know food you like to eat, you already know very, very simple meals that you can throw together. Just make a list of those and only eat those. You don’t need new recipes.

Now, I will say, and a little caveat to that, occasionally, I have some clients who really struggle with vegetables. They really are just not people who eat many vegetables, and I find that people who really eat very few vegetables lose weight a lot slower. They just do because vegetables fill us up. We can get to a nice plus four on the hunger scale so much faster when we have some nice volume and fiber from our veggies. I’ve always been a veggie lover. I don’t love them all, but I love a lot of them. I found some salad dressings that I love. I love roasting vegetables with a ton of olive oil and some good salt. Very, very simple preparation, and it tastes delicious, but occasionally, I have these clients who just are really convinced that they don’t like vegetables, and I do think that looking for some new preparations for vegetables is a really good idea, trying things again a different way.

The classic example is a lot of people think they hate Brussels sprouts because they hated how their parents made them when they were growing up, and then when they make them, maybe roast it or something like that, they just think they’re the best thing ever. They love them. I am not one of those people. I didn’t like them when I was a child. I don’t like them now. I’ve tried them a hundred million different ways, and I just don’t care for them, and that is okay, but you might find that you didn’t like broccoli. Well, now when you steam it and toss it with some toasted sesame oil, or what I love to do now is just toss it in a bunch of olive oil and roast it for 425 for five, six minutes with some really good salt on it, it’s delicious. Oh my God, it’s so good. So, so, so, so good. We just love it.

You might just have to try different preparations of it. You might need to try it cooked a little more, cooked a little less, try it raw. There’s so many different ways of trying veggies. If that’s the case, then I do give you a little permission to start looking at recipes and asking friends for their tips and things like that, but once you find what you like, then that’s it. You have to cut it off. You have to get right back into like, this is my list, this is what I eat, and that’s it.

As far as the bean company, it’s called Rancho Gordo, and you can find them at ranchogordo.com. They are fantastic. Bean of the month club. Woot, woot.

Next question. This is such a good one. This is from anonymous. “I thought long and hard about my relationships. I thought I don’t have any relationship issues because I put a lot of effort into creating harmony in my family. Of course, that is not 100% true, and there is some discord with my husband occasionally. One relationship I have an issue with is that with my brother. He smokes, is very overweight, and struggles with anxiety, although now off meds, and for sure has a lack of discipline in managing himself. Although he has a great work ethic when it comes to his job, on his high-demanding season, he work 80 to 100 hours per week. We have a strong bond of love, but he avoids me. He has, in the past, reached out in a severe moment of despair and considers me the first person to reach out to, but in general, day to day, he avoids me as, of course, it is uncomfortable to hash up with me all that’s wrong.

“Of course, he knows if he calls me up, I will give him a lecture about his lifestyle, dangers of his ways. I always tell him I’m worried about him. I wish he could accept professional help. I recognize, especially in the past talking with him, I bring in my frustration and judgment and even ineffective methods of approaching this. I don’t want to get to the point where we are given devastating health news and it is too late to change. I feel the clock ticking as he approaches 40 and keeps smoking and eats everything and anything. Sometimes, he goes on a diet, but three months later, goes back to the same patterns of eating and gains it all back and then some. We talk about not controlling other adults, but I wish I could make him see he’s speeding towards danger. Most of the time, I think he is in denial and overwhelmed.

“I read awhile back the biggest predictor of adult eating patterns and losing weight in a study was mothers. I think more and more about my mother’s parenting style. I recognize how I’ve been approaching myself with the patterns of behavior she taught me to use. My mother is the sweetest, most docile person. She was an engineer, worked a lot, and I think overcompensated when was home by letting us discipline ourselves and giving into our feelings. She gave us too much freedom, I guess, believing we could figure it out and make our own path. In my adult life, I definitely gave in to my feelings more than I should and committed to dieting 80% of the time. 20% of the time, I could do some serious damage. When you said that in your podcast, I laughed out loud. So true.”

All right, anonymous, thank you so much for writing in. This is so, so, so, so good. I really wish that I could coach you live. Maybe we’ll have to do that some time in a podcast. It would be fun, but so here is the deal. You are wanting to control your brother so much. You write, “We talk about not controlling other adults, but I wish I can make him see he’s speeding towards danger.” It’s so classic because you’re not the only one who does this. We’re like, “I understand I can’t control other people, but let me just control this one person this one time because it really will help them.” It’s so funny how we’re like, “No, but we need an exception for this one time because my control would really help this person.”

This is the thing, why do you want him to stop smoking? Why do you want him to have less anxiety and to eat right and lose weight so that you can feel better? You have created this whole story for yourself about what’s wrong with him and that he has to change so that he can be happy so then you can be happy. It’s so fascinating because you write about how he struggles and all these things and that you’re his go-to person, but that he avoids you, and but then you say how you basically judge him and you’re frustrated with him and you tell him always about why he’s doing everything wrong, the danger of his ways, a lecture about his lifestyle. You could imagine, if you were the person who had needed to reach out, and the person you felt most comfortable reaching out to would then judge you and be frustrated with you and try to control you and tell you why everything you’re doing is wrong and how they’re worried about you, that would feel terrible.

What you’re wanting is for him to be different so that you can feel better versus accepting him for who he is. He’s your brother. He smokes. That’s neutral. The only reason you think that’s a problem is because you tell yourself that if he smokes, it’s going to create health problems for him in the future, and he is overweight, and that’s okay. Just accept him for who he is. He’s somebody who overeats to make himself feel better, and it sounds like you do too, so rather than judging him and thinking he should somehow be different, I wonder about creating emotions for yourself and thinking about it in a different way so that you can approach him from a place of maybe compassion and love because that would feel so much better for you because this is the thing.

He’s going to do what he’s going to do. This is the thing. He’s an adult, and we adults, guess what? We get to do what we want to do. Yup. We really, really do. He wants to smoke, and he wants to work 80 to 100 hours a week during his high season, and he is going to keep having this great work ethic, and he is also going to keep overeating to deal with the stressors of doing that, and he’s still going to have anxiety, and he’s going to need some help with that at times.

Just imagine approaching him, think about that model, you always have feelings driving your actions, so if your feelings are compassion and love, your actions are going to be totally different than when your actions are driven by frustration and judgment and fear. You have so much fear about what this lifestyle he has is going to create for him. You write about how you’re worried you’re going to get the phone call, the bad news notification that something’s happened to him, and I want to invite you to just drop that and enjoy him and love him while he is here with you because this is the thing. You’re telling yourself this whole story about how his lifestyle is going to lead, most certainly, to an early death, when there, I mean, the reality is, we don’t know that to be the case.

The risks are higher, for sure, but there is lots of people who smoke and overeat and are overweight and live well into their older years for whatever reason that we don’t understand or don’t know about. Rather than focusing on the scarcity mentality of I only have limited time with him, which you say, like, “I feel like the clock is ticking as he approaches 40,” it’s very drama laden. A lot of worry and all these dramatic emotions, and all of that story creates this need to try to control him and make him different so that you can feel differently about him. At this point, you say that you don’t really have a lot of contact with him, that you don’t interact with him often, and maybe that he avoids you because he really doesn’t like the way that you approach him.

Of course, we can’t guarantee that if you approach him differently that he will respond differently. Maybe he still won’t communicate with you more. Maybe he still will avoid you, but at least you get to feel love and compassion while you’re reaching out to him and interacting with him rather than being all up in his business, which is what you are here thinking that you know better than him about how he should live his life.

This is where it always comes down, is think about it when someone else thinks they know better than us how to live our lives. Feels terrible. We’re like, “Dude, back off. You don’t know me. You don’t even know anything that I’m going through. Enough. Don’t think you’re inside my head,” and so, but then we do it to other people all the time from a good place. I know, this is the thing, you love your brother, and you really want to help him, but it’s not helping him, and it’s not helping you because it’s creating so much negative emotion for you, and the result for you is that you feel like you’re trying to control him, and it’s not working.

The other thing I want to just mention here is talking about your mom who sounds like she was an amazing mom. What I want to offer to you and anybody who has mother issues out there is that you had the perfect mother for you. The reason you did was because she was the mother you had. Thinking that you should’ve had another mother or a mother who parented you differently does not serve you in the slightest. There are people who have moms like yours who really allowed their children who have a lot of freedom and to really figure it out for yourself and make your own path, like you said, and that doesn’t work out for them. There are people who have mothers who are much more controlling and strict and really have these narrow guidelines in terms of how you’re able to act, and they really struggle in their adulthood as well.

The idea that somehow being parented differently would have made you into a different person is not a belief that serves you in the slightest because it is totally based on the past needing to be different in order for you to have a different experience of your life and have the experience you want of your life, and that’s futile because the past is over. It only lives in your brain, and there’s literally no upside to thinking about it that way.

I think your mom sounds great because she gave you that opportunity to figure it out. Instead of looking at it like, “Oh my gosh, see, she didn’t give me enough guidance to help me to have a little bit more discipline in my life and know how to follow, for instance, a dieting plan 100% of the time,” you can look at it like, “She gave me the opportunity to figure things out. Now I’m an adult now, though, and so now as an adult, I’m responsible for myself, I’m responsible for my own discipline, I’m responsible for my own commitment to myself and what I want, and how she parented me really can be irrelevant. Now, I might want to utilize some of the things she taught me because they might be helpful, or they might not be, and in that case, then I can just drop those things and just create something entirely new for myself here.”

I really want you to own up to it and do it for yourself, and the same thing has to happen for your brother. If you would had a different mom who was much more strict, he probably would still have anxiety, he might still be a smoker, and he might still be overweight because lots of people smoke and are overweight, and lots of people have anxiety, and they all had different kinds of moms.

That idea of who our mom was and all of that, it might explain why we struggled up to this point, but at this point, it’s time to take personal responsibility for all of it. Own all of it. Be that emotional adult. Take full responsibility for all of your emotions. Don’t expect other people to create any emotions for you at all. You create them for yourself. You create the actions that you need to take to create the results that you want, and that is the definition of being an adult. SO, so, good.

I want to invite you, anonymous, to love your brother have some compassion for him, know that he’s struggling as a human just like all of us are. He’s living the best life he knows how to live, and let him be in his business, let you be in your own business, and decide what kind of relationship you want to have with him from your side, how you want to show up to your interactions with him, and then just see what happens with him. You might find that you are able to create the relationship that you always wanted because all you changed was yourself. I’ve seen this time and again. So good, and nobody else had to change. Only you had to change, and that’s the best news because you’re the only person you can change. So good. Thank you so much for sending in that question. This is such, such, such good stuff. Love it. I’m going to do one more question.

“My question for a future podcast is regarding exercise. I may have missed it, but I haven’t heard you address it at all.” Yes, and that’s on purpose, but in this episode, I am going to address it. “I have been pretty fanatical about exercise. The Peloton bike is a lifesaver for a busy MD schedule, getting 30 to 60 minutes six days a week. It is how I cope with stress, personally, and I used to think it was keeping my weight down until I read The Obesity Code.

“After starting the Obesity Code type diet plan, about five to six days in, I immediately felt muscle cramps and body fatigue. Not mental fatigue. I’ve been so much more mentally awake without sugar when exercising. This went away after a few days. My exercise performance decreased and has been slow to improve. I have five weeks in now. I’m feeling like my performance is better, but not quite at pre-obesity code levels. I track my carbs for three weeks, and I am not eating a low-carb diet, but definitely lower. I got 100 to 150 grams carbs per day, mostly from oatmeal, vegetables, and fruit.

“For a future podcast, I would love to hear your overall thoughts on exercise and how it fits in, as well as the experience of this eating plan and how it affects exercise. I know some endurance athletes promote it, but they are often marathoners who benefit from accessing fat stores. Fat stores take slightly longer to access, so for someone doing a high intensity interval type workout, it may not work as well. There may be no solution, and I wouldn’t go back, but I’m curious about the topic. Thank you so much for your podcast. I have definitely been telling all my physician colleagues about it.”

Awesome. Thank you so much. This is really great. What I don’t know for you, the person who’s asking the question, is whether or not you need to lose weight, and that’s the difference. Let’s talk about, first of all, let’s talk about using exercise as a way to cope with stress. That is totally great, but I want to offer this idea to you, that you wouldn’t necessarily need to exercise so much if you were able to decrease your stress in other ways, including managing your mind, making sure you’re getting enough sleep, and some other active de-stressing mechanisms and things you can do such as meditation.

I often hear that from my clients that they don’t want to give up their really strenuous exercise plans because they say it’s how they stay sane, it’s how they cope with stress, it’s how they stay a nice person, things like that. What I want to offer is that you don’t necessarily need to exercise to that level always in order to be a nice person, in order to manage your stress, in order to manage your thinking.

If that works for you, that’s totally fine, but here’s the deal. There is a ton of research on exercise and how amazing it is for our bodies. It helps for some many things. It is fantastic, except weight loss, and that is one thing that everybody consistently can agree on is that exercise does not help you lose weight. If you’re exercising thinking you need to lose weight, then you need to stop that thinking. If it’s exercise that you like to do because you love it and it feels good to your body and it totally serves you, please, more power to you, please do it. That’s fantastic, but if you’re doing it and not really loving it but doing it because you think you’re going to lose weight, then you’re not going to.

This is what I find. People need to lose weight, then they come up with some eating plan, and they think they need to exercise a bunch, and they’re trying to get to the gym or trying to do these different exercise routines, and it’s taking up a bunch of time, it’s making them really frustrated, it’s making … It’s just not really even fitting into their lifestyle very well, and so then they throw everything out, so they’re not following their eating plan, they’re not following their exercise plan.

I really like my clients to focus on their food first because the food is what’s the most important by far. Following your eating plan 100% of the time is what we focus on first, and I always tell my clients that if they want to do some loving movement, so basically walking, Pilates, yoga, things that aren’t going to make your cortisol level shoot up high because they’re super intense and strenuous, that’s completely fine. I’m not saying you can’t ever move your body, but focusing on food first, not starting exercising if they haven’t been exercising up until this point, and then focusing on getting enough sleep and other active de-stressing.

At that point, when those things are all dialed in 100% of the time, then we can add some exercise in, but here’s the deal. Breaking down your body fat, especially when you have a considerable amount, puts in you a catabolic state. We need to get into a catabolic state to break that fat down. We want to break our bodies down. That is what we’re doing. When you are exercising, especially intensely, especially high intensity intervals or doing any kind of heavy weightlifting or long-term running or things like that, you are in an anabolic state.

Now, you might argue, well, you break your muscles down and rebuild them up, but it’s the rebuilding that puts you in that anabolic state, so you have these opposites, these polar opposites. You’re trying to lose weight and break your body down, but then at the same time, you’re trying to build your body back up again. Also, when you exercise, you get an insulin surge and cortisol surge, and those are both things that can prevent you from losing weight. Those are two things that we’re trying to reduce significantly when we’re losing weight.

In my opinion, there’s really no benefit to putting yourself into that anabolic state while you’re trying to lose weight. What I encourage my clients to do is to lose all of their weight and get flabby, and then tone it all back up so you’re in maintenance. Then, at that point, your food is totally dialed, you’ve done all this work on your mind, and you can start adding in some exercise that you love and gradually fitting it in in the places that you know work for your life and tone back up again, and then continue doing that for the rest of your life because it’s so great.

I’m certainly not saying don’t ever exercise. I’m just saying that while you’re losing weight, if you are already exercising, you want to choose a type of exercise that you love that you’re not doing because you think you’re going to lose weight, but just because it feels good to you and that is lower intensity. If you have not been exercising, then do not start. Just don’t even let that be a thing for you right now. Just work on the food first, and really spending time managing your thinking, working through why you’re on this plan in the first place, your commitment, what your obstacles are, all of that stuff, working through all of that and following the plan through is so much more important.

Then the other thing that I want to mention with exercise is that exercise can really make losing weight more uncomfortable. I think anybody who’s tried to do both will know what I’m talking about. First of all, exercise makes you hungrier. It definitely does, and it messes with your mind in terms of thinking that you can exercise off food that you ate earlier or you had dessert so, “It’s okay, I’ll just run a couple of extra miles,” or exercising in advance for food you know you’re going to overeat in the future.

That mindset comes from our old mindset of calories in, calories out, that I ate more calories than I needed. Now I’m going to burn them off with exercise, or I’m going to get into a net calorie deficit right now with exercise because I’m going to eat more food coming up here. That is not how our bodies work, but for many of us who’ve been thinking that way for decades, it’s really, really hard for us to undo that thinking, and we, almost subconsciously, still think that way when we’re exercise a lot and trying to lose weight.

It’s just a lot more uncomfortable. You don’t get to eat more, yet you’re hungrier. It makes it harder to lose weight because your insulin levels or cortisol levels go up. It takes time when you could be spending that working on thought downloads and models and changing all your thinking about things and planning your food and making your food totally dialed in. It’s not something that I’m against at all. If you feel like you’re at your goal weight and the Peloton is awesome for you and you’re absolutely loving six days a week, I think that’s fantastic, but just know that all of that is going to be coming up for you.

In terms of tracking your carbs, I don’t, I do not have, I was going to say I do not ask my clients to track their carbs. In fact, I ask them not to track their carbs because it’s just not something we really need to focus on, but in doing so, you know that you’re not eating super low carb, and yeah, what you’re saying, your performance might not be there as much. Well, right, because you’re not fueling your body with these super easy to utilize forms of sugar, but I would argue if you’re not a competitive athlete, what difference does it make if your overall performance is a little bit lower and a little bit slow to improve?

Not surprised at all you felt muscle cramps and body fatigue. That’s totally your body going like, “What the heck is this? I need to gluconeogenesis and create my own glucose? Come on. You’re changing the rules on me. This is not fair,” but doing a few weeks into that as you are now, you’re feeling a lot better, it’s totally fine, but yeah, you’re going to find that for something as intense as spinning like that, that, yeah, you probably won’t have as great of performance, and can that just be okay? It doesn’t really have to be a big deal.

I agree with you, I have heard of marathoners who literally only consume water and run an entire marathon not coming anything because they’re so fat-adapted that their bodies can access that. I think, yeah, sprinters are probably going to struggle with that a little bit more, but again, I mean, I think this comes down to just what level of athlete you are, what your goals are.

If you are not a competitive athlete and you’re just exercising for cardiovascular health and the mental benefits and things like that, I would just argue it doesn’t really matter if your performance is slow to improve. Just enjoy doing it, and you don’t really have to focus on that so much, and keep eating what you’re eating because that diet where you’re mostly getting your carbohydrates from oatmeal, vegetables, and fruit is going to serve your body so well. Your body is going to be so happy, even if it can’t do sprints on the spin bike quite as easily as it used to be able to. Totally fantastic. I love it. So good.

For exercise, you guys, just don’t even stress about. It’s not something that’s that super important while you are losing weight. I really should tell you this. I mean, from my own personal experience, I started my weight loss journey while I was doing high intensity intervals and heavy weightlifting. I was doing it about twice a week, so nothing crazy, but I lost weight for a little while, and then I got into a plateau that would not stop at all. I couldn’t get it to change up. Then I stopped exercising because I traveled for a while, and I just didn’t get back into it for a few weeks, and low and behold, I totally lose weight.

Then I got back on track with exercising and hit another plateau. Would not budge. Then I thought, “Hmm, this is interesting. I’ve heard that this can be a problem.” Stopped with exercise. Totally lose the rest of my weight. Totally fascinating, and I’ve seen it with my clients as well now.

It’s really just something that, I mean, if you’re exercising and you’re loving it and you’re losing weight, more power to you. If you’re exercising and you’ve loving it and you’re able to maintain your weight loss, and you’re right where you want to be at your permanent natural weight, love it. Keep doing it, but if you are exercising thinking it’s going to help you lose weight and you’re not losing weight, then definitely it’s something to take a look at.

Whew, this is a long one for you guys today. Super fun. If you have questions and you want me to address them, please go to the comments on the show notes pages for these podcasts. You can find all the podcasts at katrinaubellmd.com/podcast. For this episode, you can go to katrinaubellmd.com/42, number 42, and in the comments, leave your comment or question for me, and I might address them on a future podcast.

So great, you guys. Fantastic. I love it. Can’t wait to talk to you next week. Take care. Bye-bye.

Announcer:         Thanks for joining us on Weight Loss for Busy Physicians. Now, take the next step and go to katrinaubellmd.com to download just what you need, the Busy Doctor’s Quick-Start Guide to Effective Weight Loss. Join us again next week for more support to keep you in control and on the path to freedom around food.

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Showing 4 comments
  • Regan

    Thank you for this podcast. I have a 9-week old and gained #50 this pregnancy and still held onto #20 from my last pregnancy (my older daughter is 4.) I am breastfeeding exclusively and starting working out at about 2 weeks postpartum and now at 9 weeks I am exercising almost everyday because I on maternity leave and have a ton of time. I was pretty frustrated because, despite changing my eating habits as well, I was not seeing a lot of weight loss. I have started to see a little bit more and am not giving up or letting myself become disheartened because the weight isn’t flying off like I hope.

    I laughed when you said you only lost #13 after delivery, I lost #0.5! Most women don’t lose much by the time they get home from the hospital because of all of the IV fluids they pump into us in the hospital! It takes time to diurese.

    The thing I am struggling with is the sleep part. I get exhausted working out and my sleep is terrible (b/c of the baby and a 4 year old who is not known for her excellent sleep habits.) I don’t know if you have any ideas. I know sleep is important for so many aspects of my body and mind function but I am not sure how to solve this problem.

  • Regan

    I am laughing because I wrote this after listening to the first part of the podcast and I just listened to the second part. I LOVE the way exercising makes me feel. This is a huge roadblock for me to think of exercising as something I should dial back on until I lose the baby weight. I know that exercise doesn’t help with weight loss but wow, this blew my mind.

  • Laura g ob

    I loved the discussion about exercise and found your ideas so interesting and frankly liberating. I’ve been a lifelong slave to exercise- swimming, spinning and running 6 of 7 days for the purpose of staying in shape. So fascinating to take off the pressure of exercise now that my eating is cleaned up and on plan. Would love even more info on this.

  • Cindy jemelka

    Love Love Love your podcasts. I’m not a md my daughter is, she shared with me this amazing site.
    You pegged me with the story of the sister /brother story. Except I am filling in the blank with my husband. So, I get it that they are grown adults and we need to accept them for who they are, but I’m going to need help in changing the thoughts swirling in my head. Maybe a download of thoughts would help me turn off my feelings associated with those thoughts. I have to find some new thoughts on the subject. It’s just been really hard to think differently. Any suggestions ???

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