Conquer Your Weight

Dr. Sarah Stombaugh: Before we get into the episode, I am thrilled to announce we are launching an online course, The GLP Guide. The GLP guide is a must have resource for patients who have been prescribed any of the GLP medications such as Wegovy, Ozempic, semaglutide, Zepbound, Mounjaro, tirzepatide, Saxenda, liraglutide. There are a lot of them and this course is available for anyone to purchase. We often hear from people who haven't been given much information about their GLP medications. No one has told them how to handle side effects, what nutrition recommendations they should follow, or what to expect in the longterm. And it can be really intimidating and simply frustrating to feel like you're alone in your weight loss journey. With the GLP guide, you'll get access to all of the answers to the most common questions for patients using GLP medications, not sure how to use your pen, struggling with nausea, wondering how to travel with your medications. We've got you covered for only $97 for one year access. This is an opportunity you do not want to miss. The course is launching on October 1st. For more information and sign up, please visit www.sarahstombaughmd.com/glp. You don't have to be on this journey alone. We are here to guide you. And now for today's episode, this is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight podcast. Announcer: Welcome to the Conquer Your Weight podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hello everyone and welcome to this week's episode of the podcast. We are talking about the role of social support during our weight loss journey, and this is a topic that is often not discussed, but it ends up playing such an instrumental role in the way we show up. And it can be really surprising when certain relationships evolve over time, sometimes for the good where relationships are strengthened. Other times we can recognize that there are relationships in our lives that as a result of our weight loss journey, we start to realize that those relationships are not really serving us in the way that they thought that they were. So we're going to spend some time diving into this relationship piece about what to look out for with your friends, with your family, and how other people are showing up in your weight loss journey, deciding how you're going to handle that, and then talk about what can happen as relationships evolve over time. Before we get into that topic though, I would love to ask you for a birthday present. My birthday is right around the corner, and what would mean so much to me is if you could take a moment to leave me a rating or review wherever you listen to podcast. It's actually really, really easy to leave a rating. If you click in the upper right hand corner of Apple Podcasts for example, you can click to leave a rating, a five star box pops up and you can leave a rating just as quickly as that. And if you have been enjoying listening to my podcast, I would so appreciate if you could take a moment to leave me a rating or better yet a review as well because those are the tools that help get this podcast into the ears of even more listeners. It has been such a treat to watch those podcasts grow over the last couple of years and it is because of listener support like you and I so appreciate that when you share these episodes with your family, with your friends, with your patients, if you're in healthcare, that really means the world to me. And if we look at the way that podcast are distributed among Apple Podcasts or Spotify or any of the major podcast hosts, it's really based on ratings and reviews. And so if you've been listening and found that this podcast has been helpful for your journey, I would so appreciate if you could take just a moment to leave a rating and a review. Thank you, thank you, thank you. It means so much to me and I really appreciate you taking the time to do that. Now let's go ahead and dive into today's episode and talking about this role of social support during the weight loss journey because this is something that comes up honestly whether we like it or not, and a conversation that I have very often with people is about sharing their weight loss journey with others. And I will say because our society's obesity bias and stigma, there is often a desire not to share our journey with others. And I totally get that because it's our health and it's a very private thing, particularly some of the newer medications, people who are taking GLP medications or GLP GIP medications, there's a lot of people who have opinions about those medications, people who feel like it's cheating to take medications, that it's the easy way out. And if you tell them they're on medications, they will judge you that you are taking the easy way out. Or they'll start telling you about the horror story that they heard about on the news, for example, about someone who had a very rare side effect from those medications. But the reality is these medications are very safe, they're very effective, they make a lot of sense for the right person, and it's really nobody's business whether you are or are not taking a medication. So what I will often say is compare this to any other health conditions like high blood pressure, hypertension, like depression for example. Let's say you are taking a medication for the treatment of your high blood pressure or you're taking a medication for the treatment of your depression, the people in your life with whom you would share that information, those are the people that as a good rule of thumb, I would recommend sharing information like if you are taking a weight loss medication. Now again, you have to decide what makes the most sense with whom you're going to share this information, but most people, only their spouse or their closest friend would even know that they're taking an anti antidepressant medication, for example. And so those are the people with whom you may also share that you're on a GLP medication now the hardest thing or any other medication for that matter. So the hardest thing though is that our weight is worn on the outside of our body. So whether we are taking a medication to support our weight loss goals or whether we are engaging only in lifestyle behaviors or in any combination when our body changes sizes, people notice for good or for bad. And so people will have comments about your body size, the change in your body size, and for people who are close to you, they will often also have comments about your behavior change. And so if you're eating in a different way, maybe different foods, different timing, different amounts, they may have opinions about your behaviors. Of course our behaviors often proceed this number change that we see on the scale. And so the people closest in our lives will start to notice usually pretty early on that our food behaviors may be looking different compared to before we were actively on this weight loss journey. And so I want to talk about how different people show up both sort of the good, the bad and the ugly. So some people will show up as an encouraging role. Now generally this is a great role because it is someone who is going to be your cheerleader. It is someone who's going to be in your corner. It's the type of friend who asks, okay, how can I support you in this journey? If you're going out to dinner, hey, is this restaurant going to have food that fits in line with your goals? If they're coming over to your house, you're going to ask about the type of food that they're preparing for example, or making sure that they're helping to support your goals. Having this type of person in your corner is awesome. Now, I will say we sometimes confuse us with someone who would be an accountability partner or someone with whom we can share everything and recognizing that that may be the case, but we also need to use our judgment because there may be people for whom if they've never struggled with their weight before, they may be very positive about helping you in your health and weight goals, but they may not necessarily understand what it's like if they've never had chronic weight struggles. And so lean into that person, let them support you in your journey. But they may be, but they may not be your number one confidant in this journey. Having an accountability partner is someone who ideally is also a encourager, so someone who's encouraging you on this journey, but someone who's maybe also in their health and weight journey. Now I will say it doesn't necessarily have to be that they have the exact same goals or the exact same issues, but someone who's also working towards maybe their weight, maybe certain health goals and that you're talking to each other about goals that you have. Hey, I'm going to exercise this number of times. Hey, when we go out to a meal, let's choose this specific restaurant. Maybe that person in you instead of going out to a meal, is going to go for a walk or a hike, for example. And so someone with whom you can both share your journey, receive positivity from one another, encouragement from one another, but then also someone with whom you really can get into the details and can share challenges and help to workshop things. That is someone who is both an encourager, but ideally more of this accountability role. Now, there are people in your life who may not be positive. There are people in your life who may be skeptical. They may be trying to even support you. So being skeptical isn't necessarily a bad thing. You can imagine, even if you're very confident in this journey, if you showed up and said like, Hey, I'm going to dye my hair purple. Your friend may be very skeptical in that situation and talk you out of it, or are you sure? Have you really thought about that? Having friends in our lives who are skeptical is not necessarily a bad thing. And you may say, oh my gosh, yeah, I've been looking at all these pictures and I've decided that I'm going to dye my hair purple because it compliments my skin tone and my eyes and it'll fade over time. And you may have reasons or may be like, yeah, that's a crazy idea. That doesn't make sense. So someone who's skeptical in our life can be someone who's maybe overly realistic and someone who can be a good person with whom you have to either verbally or mentally defend your decisions. But someone who's like, are you sure? Is this safe? Is this healthy? You've done this before. Do you have good support? I'm worried about you. Is this just another diet? So someone who's skeptical, like I said, not always a bad thing, but when those questions are coming up, do you have the responses for them either of, Hey, I don't really want to talk about it with you right now depending on who that person is or does that, do you have a clear answer in your mind when they've asked you a question that you know what that response is? That skepticism over time, especially as you're getting further and further into your journey, can be really frustrating and you're like, Hey, I've got this. Leave me alone. And so that can be a behavior and a level of support that can over time cause a relationship to drift apart. Then finally, are people who really actively sabotage us. Sometimes it's unintentional. It's just a learned behavior over time. This can happen a lot, especially in families where families celebrate in certain ways or have certain traditions. This can also be someone who is just really actively trying to sabotage your journey for unclear reasons. And this especially the active is really something that will over time either derail you or will drive the relationship apart. And while for a lot of people driving a relationship apart can feel like a huge loss, it can actually be a pretty significant win because the type of people who are intentionally sabotaging us in our journeys are likely the type of people who are really not the most supportive of us in general anyway. And we may start to recognize that these are people with whom we cannot share the intimate details of our life with whom we cannot trust these things and with whom does not really have our best interest in heart. So I'd like to talk a little bit about as you're showing up in different situations, how the social support can play a role and then what that might look like over time. So peer pressure is something that often comes up. This can be active sabotaging more commonly it is just someone who is used to your traditional behaviors, maybe how you show up at event, the types of food that you eat, the amounts of food that you eat, for example. And so peer pressure may look like, Hey, do you want to try a bite of this brownie? I just baked them this morning? That does not necessarily have to be anything bad. It could really just be your kind next door neighbor who is an amazing baker and wants to give you the gift of a delicious brownie. And you can decide if you've decided in advance that at that event you're going to have a dessert, you can decide that, hey, I'm going to enjoy this brownie. And that can be that, yes, thank you so much, I would love a brownie. But you can also decide in that situation, if you were not planning to have a dessert, you were not planning on engaging in that, you could just say, no, thank you and no thank you is a simple but completely appropriate explanation. Now, it may come with some follow up questions like, oh, are you sure? And you can follow up with, thank you so much. I'm not hungry right now. It doesn't have to be a conversation that goes into deep the depth that talks about your health goals and your weight goals and what you're trying to do. It can be, and that may be appropriate if you're talking about someone who's really close to you in your life and it's someone with whom you want to share these details with. But it can also be something that's a pretty superficial no thank you. One thing that I often find is that in these situations, if we are not confident in the decisions that we're making, we are more likely to go into sometimes these really in depth or unnecessary explanations and we are having mind drama and we invite somebody else into our mind drama. And so it's important to recognize are you the problem or is the other person the problem? So let's go back to that brownie example and someone's like, Hey, I baked some brownies this morning. Would you like to have one? Now, I would not even necessarily consider that question phrased that way as food pushing. It's a gentle, generous offer. Hey, I made brownies. They're delicious. Would you like to have one? To which you can say, no, thank you, but let's say you're like, no, I probably shouldn't. When you say it with that tone of voice, the person who baked the brownies says like, oh, why not? And they've asked you this question and now you're like, well, I'm on a diet. I've been trying to not eat as much of these things, and my doctor said that because of my insulin resistance, I should be really limiting flour and sugar. Oh, but you're right. They do look really, really good. And this person now, the baker of the brownies is like, well, yeah, they are good. I baked them this morning. I mean, why don't you just try one? And you're like, well, no, I mean, oh, they do look good. And they're like, well, yeah, here, just try one. And there's this back and forth where you are insecure and feeling to make a decision and the person who's offering you the brownie feels like they need to rescue you from your back and forth indecision. And so they're like, here, just have one. It's not a big deal, it's just a brownie. Look, I cut 'em into small pieces so it's not even like a full brownie. It's just like a teeny bite, and that person is not necessarily even trying to push food on you. That person is just rescuing you from the mind drama that you are portraying. And so in these situations, I will invite you to say, am I the problem or are they the problem? Now while you may be the problem, and in the example that I just gave, certainly that person, you were the problem if you were speaking in that way, if you're having that mind drama that you're voicing out loud, but there's other times where the person is really, the brownie baker is really pushing you and they're like, oh, just have a bite. No thank you. Oh, but I cut them so it's small. They're so good. You have to try 'em where they're fresh. You know what? I'm not really hungry right now. No, thank you. Oh my gosh, you have to have one. These are famous and they just keep pushing and they just keep pushing and you're just like, no, thank you. I'm not hungry. No, thank you. I'll try one later. No thank you. No thank you, and you're giving straightforward answers and they're still pushing. Now, that is for sure a them problem. They are the food pusher, and you can decide in that situation, are you going to continue to engage or are you just going to disengage from that conversation? That may mean walking away from the conversation. It may be drawing a boundary. It will really depend on the relationship you have with this person. It's going to look a lot different when it's your spouse saying this to you versus if it's your neighbor from down the street at a block party with whom you engage with twice per year. The conversation there is going to be quite a bit different. And so you may find, if this is your friend, if this is a coworker that you would be celebrating with parties multiple times per year, for example, this is your family, you may find that this is a situation where you need to draw a boundary and say something like, Hey, I've been working to cut back on these type of foods. It looks really good. I'm sure that they're delicious, but I don't want to have one right now. Thank you so much. I'd appreciate if you don't offer one to me, or you don't even have to say that last part, but you can. And so when people are pushing, you can even call them out on the behavior, Hey, it really feels like you're pushing me to eat this food right now and it looks so good, but I'm not hungry right now. Thank you so much for offering. So deciding of where you're going to draw limits, deciding where you're going to draw boundaries, and does this make sense given my relationship with a person and given how they're showing up now, sometimes peer pressure is coming just from traditional beliefs and someone recognizing that you are showing up differently in a situation than you have in the past, or maybe everybody in your family celebrates a certain family or cultural tradition in a certain way, and you are choosing to engage in that behavior differently. Again, this is going to depend on your relationship with those individuals, whether they are aware of your journey, you may decide in advance to decide, Hey, just so you know, I'm not going to be eating X, Y, Z food this weekend. I'd appreciate if you didn't offer it to me, or you may decide that you just go into the party with the plan of, no thank you. I've been well served maybe later. Just simple sort of to the point agreements. It's very common that in certain families and certainly in certain cultures, that food is such a big part of how we celebrate and engage with one another, that turning down a food can often be seen in a very negative light. And so sometimes that is important to have a conversation. Both decide with yourself first, do I want to eat this food? Do I actually even like this food? Am I hungry for this food? Does it align with my goals? Does having a small amount of it align with my goals? And make that decision on your own first, and then decide if that's something that you need to relay to your family. Again, if it's a recurring pattern, it's probably something that's worth addressing, but if it's something that's coming up from time to time, these simple, no thank you. I'm not hungry right now. Maybe later, oh, I tried some already. You can even lie depending on how big the event is. For example, if people are mingling, you can say that you've tried it. Even so coming up with really short answers may be absolutely appropriate, and over time, your behavior changes start to shift also then into physical changes on your body and people will start making comments about that. Again, you can engage if you want to, but you absolutely do not have to. You do not owe anybody any sort of explanation about your body size, about your body shape, about the change in your body or how you achieved that change. It is completely private health information, and you are welcome to share that, and you absolutely do not have to either depending on the relationship that you have with this person. But commonly comes up is that we start to notice that relationships may shift over time, and you can imagine how this would happen depending on if we're engaging in different behaviors, particularly. So very commonly, the way we show up or if we show up to certain events may change over time, and so if your family or if your friends always gets together and eats food, it may look different if you start declining those invitations or if you're showing up differently. If you have a group of girlfriends that goes out for cocktail drinks, for example, and you decide not to go, you may stop getting invitations, and those relationships may change over time, but it may also be a relationship where other relationships or certain relationships grow stronger because people are inspired by the changes you're making. Maybe you can reach out and offer non-food or non drink options like, Hey, let's go bowling or shopping or go for a hike. A lot of people will find that while they're in the habit of engaging in eating behaviors or in drinking behaviors, that there are other social engagements that they can do, especially if it's one-on-one or just a small group of people, that they can change the nature of that engagement and still actually connect with that friend in a way that is sometimes and oftentimes much more intimate compared to the cocktail night where they were eating too much or drinking too much and not really engaging in conversation in the same way. It can be really challenging though because as our bodies change, as our behaviors change, there are people in our lives who do not change alongside of us, people who are insecure, people who are jealous, and that can come up in really challenging ways and relationships. Unfortunately, there are studies that look at people who've had significant weight loss, particularly in the setting of bariatric surgery because that's such a well-studied patient population, and there's a significant increased divorce rate for people who have had significant, significant weight loss, and it's not directly affected by the weight loss. But the reality is, if you start engaging in behaviors that are different, if you start thinking differently, if you start feeling differently, if your confidence and self-worth and other things are evolving alongside your body, that it's easy to see how relationships, particularly relationships with those closest to us are those that should be closest to us, how those can evolve over time. I've also seen though people who have gained so much clarity in their relationships and have become so much closer, whether it's with a spouse, whether it's with a friend, because they've worked on these health behaviors together, that they've decided to be accountability and partners and work together to better their health for themselves, but for each other. And I've seen some really cool examples, even whole family transformations where a husband and wife, for example, start eating differently and then that change affects their whole family. And it's really cool to see how one role model and how that can play such a significant difference in families, in friend groups. And so there's some really, really cool changes that can come from your health journey, from your weight loss journey when you include others when they are motivated and inspired, and there are some people for whom that is not going to be the case. They don't want to change, they're not ready to change. Seeing you change brings up a reflection of the things in their life that they're embarrassed by or the things that they're not proud of, and it can start to drive a wedge in the relationship. And so when that happens, it's usually best discussed in the context of your own specifics with a therapist, with a doctor that you trust, with someone who understands you, understands the relationship, and can help guide on what makes the most sense for moving forward with that. But one thing we can absolutely expect is that relationships do change for many reasons in our life. Our weight can be a significant one as we're working to change our health, but all sorts of things, whether it's our geography, whether it's our jobs, whether it is a other illness or diagnosis in our life, whether it's children, whether it's loved ones, so many different things impact our relationship, and this is just another one of those things, but it can be unexpected because like I said, it's not often talked about, and so I love to support my patients with this when it starts to come up for good or for bad, talking through how we can use relationships to best benefit us in our journey and to evaluate when there are challenges, how do we need to address those and how does it impact us in our weight loss journey? If you are looking for a doctor who can support you in this way, I would love to support you in your journey. I see patients in person in Charlottesville, Virginia, and by telemedicine throughout the states of Illinois, Tennessee, and Virginia. Thank you so much for joining me today. We'll see you all next week.