I rode an Uber last week to work, as my husband’s car is out of commission and he and my son needed to get to a golf tournament early. As I settled into my share-ride, and established my destination, which is at the Weight Loss Center, my sweet driver asked me, how do I stay tiny. She states that she has struggled with her weight for as long as she could remember. As I thought about it right there and then, there really is no simple reply. So I said, my race and genetics. Which is the truth. Some of it anyway. Because truly, obesity is a disease process with its own metabolic and hormonal influences, along with genetic factors. Lifestyle definitely plays a role too. But it’s just a piece of the puzzle. But just like any type of puzzle or problem, there are several ways to approach it.
When patients get to the point of scheduling an appointment with me as an obesity medicine specialist, I find that they have in the past lost the weight. Only to gain it back over and over again. So really, they know the hows. They have been there. They’ve done it a lot of times. The information is out there. The different diets, exercise programs, diet pills. The weight loss industry is up to 58 billion in 2021! The issue with diet or exercise programs are that there is usually a deadline. “Lose weight in 6 weeks!” “Bikini body in 12 weeks!” Often times the changes are drastic and are not sustainable in the long run.
How do you then make it sustainable? Before we do get to the hows off losing weight and maintaining it. We need to get to the “big why”, the reason why you wanted to lose weight in the first place. Coming up with your big why, something that is non-negotiable so then you’re able to reach your goal, and stay there, no matter what.
Going back to her question. Why I stay “tiny”. Besides race and genetics, I do work at my health intentionally. I do all the things. I pay attention to my numbers (blood pressure, heart rate, weight, amount of sleep), I eat intentionally, make time for physical activity intentionally. I prioritize sleep intentionally. I reduce stress intentionally by finding the delicate work and family life balance. I do not do it perfectly but I try to be intentional about all of it. I still do enjoy pizza, hamburgers, ice cream. I enjoy the occasional glass of wine or my favorite mimosa for brunch. And even though I am the sleep police in our household, I myself have stayed past midnight on some weekends bingeing on Stranger Things, Bridgerton, Ozarks, just to name a few. Most days, however, I adhere to a predictable routine.
My why? My big why is, so that in 10-20 maybe 30 years, I would be in the best health I could possibly be, because I made the lifestyle choices today.
I have been in primary care a long time. I have seen the many versions of what chronic disease could look like. What it takes to manage it, to prevent or slow down progression or complications. Sometimes it’s straightforward and there is a pill or pills for it. Most of the time it’s a lot of inconvenience and suffering. Genetically, for sure I have been lucky. Some just have the set of genes that predisposes them to some diseases. For the things that are in my control, however, I do something about. We call them modifiable risk factors.
The physician philosopher Dr. Jimmy Turner, as I was writing this offered this thought as I was listening to his podcast: “I can be disciplined today so I can enjoy tomorrow.” You can listen to this podcast here. https://podcasts.apple.com/us/podcast/the-physician-philosopher-podcast/id1528870400?i=1000558569049
Knowing what I know, as a primary care physician and obesity medicine physician, I have naturally gravitated towards prevention. I have personally developed what’s called a future focus. What would future Lea say to Lea today?
So applying those principles to lasting weight loss: knowing and having your big why, and being future-focused. When you have something to work towards, then you take the necessary steps to get there. Sometimes, you’ll hit an obstacle. It’s ok, you’ll figure it out, you work the puzzle. You don’t stop half way. You work the work and hopefully enjoy the journey. You don’t stop. Ok, so right now as you’re reading this and you suddenly have a thought that “wow, I don’t stop? That is exhausting!” What if I told you that that is a thought, and thoughts are optional? You can change your way of thinking that will give you the result that you want. What I can offer for you to think instead is that, “well, it could be challenging but I’m up for it.” Because you have your big why. Your non-negotiable. It is challenging in the beginning. Eventually it becomes your lifestyle.
You develop the lifestyle change until they become your habits.
How can we make this actionable today?
Know your why. Why do you want to lose weight? Write down all the reasons why you want to lose weight. From the mundane to the most compelling reasons for you.
Understand your motivation or your non-negotiables. Your no-matter-what.
Set your goals. Short term goals and long term goals. If you have corporate experience, you may already be familiar with SMART goals. Specific, Measurable, Achievable, Relevant and Time-bound. If in the past you have just stated “I want to lose weight to be healthy.” A SMART goal would look something like “I want to lose 25 pounds in 6 months and keep it off to get my A1c down to 7.” My hope is that in 6 months you would have developed the habits to help you keep the weight off for good and that A1c in good control for a long time.
Make a plan. Have a plan that is sustainable for your own lifestyle now. That you can keep up with in the long run. Say, you try out a Keto diet. Keep in mind that you will effectively lose weight with it but that you will also effectively regain the weight and more if you stop.
Have a support system. A friend, a family member, your primary care clinician. Find online resources that resonates with you.
Finding your why is a powerful practice. You can apply it to a lot of goals, not just weight loss. In the process you may actually find yourself and what’s valuable to you. Maybe in the process you find a way to live intentionally and with purpose.
DISCLAIMER: Lea Famularcano, MD is a medical doctor, but she is not your doctor, and she is not offering medical advice on this website. If you are in need of professional advice or medical care, you must seek out the services of your doctor or health care professional.