EPISODE 55: AMA | Tracking Weight, Overeating, Regain and Sleep

The transcript below has been edited for readability, conciseness, and clarity.

Should I be weighing myself, and how often? I’ve heard that you should weigh yourself daily, weekly, or not at all.

Michelle Kennedy 1:46
We’ve heard all those things, too. It’s confusing.

Dr. Simonds 1:52
It depends on what kind of person you are. For example, if you’re overly obsessive-compulsive, maybe weighing every day is not a good idea.

I’m a fan of weighing when you get out of bed, before putting on any clothing, and before eating or drinking. That tells you where your progress is.

Many of our patients have had a negative relationship with their scale. So when losing weight, they can see that it’s working… it’s positive motivation.

It is excellent feedback and a good psychological tool for many people. So if you obsess about things, do it once a week.

Michelle Kennedy 3:20
It’s very individualized. The majority of individuals do need to track their weight. And we know that from looking at research, we have information on individuals who can lose weight and keep it off and what characteristics they have.

One characteristic is weighing in every single day. They are very diligent because that accountability and that feedback are critical. So if you like numbers, you’re data-driven. So step on the scale every morning and get your “true” weight (after you use the restroom, before eating or drinking with no clothes).

We cannot recreate that in the office. So it can be very confusing when scales return with different numbers. That’s okay. We can gain weight throughout the day from eating, drinking, and retaining fluid.

I am a fan of daily weights. But weekly is a good option if you feel like you get too nitpicky with yourself daily. When I recommend weekly weight-ins, Wednesday morning is a good time. It’s far enough from the weekend on either end.

If you are gonna ignore the scale together, you still need another means to measure yourself. We have patients with a particular dress, a pair of jeans, or shorts they use as their measuring tool. It would be best if you had something to look at other than the mirror because we can perceive things differently.

Dr. Simonds 6:24
Ignoring the scale altogether is not a good idea.

Sometimes I end up overeating, and I feel a lot of guilt. So I skip the next meal and end up hungry and overeating. How do I break the cycle?

Dr. Simonds 6:45
This idea of overeating and then skipping a meal, I don’t mind. Neither one of us do. But we don’t like skipping meals if it leaves you hungry. And then you make bad decisions and eat a bunch of stuff. Not only a lot, but it’s awful stuff. It’s even worse.

This is the story of Jacob and Esau from the Old Testament. Esau was the hunter, and Jacob was more of a mama’s boy. So Jacob’s at home cooking, and Esau is out on a three-day hunt. Esau can’t find anything. He comes back starving.

This sometimes happens to some people when they skip meals. He smells Jacob’s cooking, and he makes a terrible decision. He trades his inheritance for that bowl of stew.

This illustrates what can happen when you get famished.

As discussed in the first question, get to know yourself and admit who you are. We don’t mind that you skip meals as long as when you do eat, it’s the correct amount and the correct type of food. The point is to avoid overeating at one meal once you skip meals; this is eating like usual.

Make a plan and prepare. It’s going to happen, right? One of the things that I do, I buy these meals from Elite Prep Meals. We have them in the refrigerator in our office. I order from them every week and get my order delivered on Monday. They’re perfectly portioned, and they’re balanced with the proper macronutrients. I might season them a little bit or sprinkle a little cheese.

But the bottom line is they’re transportable. Pop them in the microwave, and you’re ready to go. It’s all done for easy, and I won’t get famished.

Michelle Kennedy 11:33
I often recommend to folks to set timers or reminders so they remember to eat.

Dr. Simonds 11:43
That’s an excellent point because it happens at the same time every day.

Michelle Kennedy 11:46
Exactly. If I skip breakfast, I am in the break room, gorging on doughnuts and coffee by noon. So set the alarm for 11 o’clock and have a protein shake. Then those donuts don’t look as good.

You have to foresee your pattern and then break that pattern. Technology is a great thing to use to help you. It’s what it’s there for.

I would love to talk about where that drive is coming from. For many of us, I know fasting is very big. But many people find that their brain is just driving them to eat, especially when they start fasting. A reason this happens is we would die without food.

Why are we driven? Why can’t we skip meals and be totally fine?

Dr. Simonds 12:50
Many of the patients we see are overweight and have this disordered biology. Biology is not protecting them from obesity. It protects them from starvation. So chemically, what’s happening is your body is trying to get to the highest weight possible. No one wants to gain this weight. But this biology is driving them to do it.

This is why we look for correctable things. We’re trying to treat that with diet, exercise, behavioral change, and medications so we can bring things under control. Your brain is not always telling you that. We’ve got weapons and tools to do it.

I always caution people about the advice they get from others, whether they’re medical professionals, personalities, or whatever. Anyone who says, “Suck it up. Behave yourself.”

Michelle Kennedy 15:19
It’s like telling a person, don’t drink water. You should be fine. No, you need water to live. So it’s just with food, we have these parts of our brain that light up this reward center that lights up. And when we go too long without eating or have something else that stresses us out, there’s a reason why we go after foods that light up our brain, and most of that is processed junk.

Dr. Simonds 15:48
You basically have a part of your brain, the anxiety part. It’s doing its job of banging a loud cymbal in your head. This triggers this limbic system, which releases the pleasure moment and stops the banging cymbal.

Some people do that with alcohol. And other people do it with street drugs. Others do it by gambling, having sex, etc.

The food manufacturers know what to put in there, and they get how to get that texture right. So it lights up the center of your brain, doing the same thing as drugs. So it will help with that anxiety for a certain period before it wears off, and then you’ll crave it again.

These are the reasons we give people medications, they work, and they’ll tilt this stuff in your favor.

Michelle Kennedy 17:52
We use one of the oldest medications to treat this. Phentermine was approved in 1959. And it’s been widely used ever since very successfully and safely.

When people ask, “What’s the Phentermine going to do for me?” My response is it will take away those intrusive thoughts of food. So it’s a very successful medication.

Depending on your needs, we can also use other medications, such as Topiramate, Topamax, Metformin, Contrave, and Saxenda. So you don’t have to do it by yourself. The medicine helps to take some of that burden off.

Does timing of when I eat matter?

Dr. Simonds

I want to touch on the timing of eating regarding circadian rhythm. So I talk a lot to people about how we should eat most of our calories when the sun is up and not when the sun is down. And there’s actual biology related to that.

There’s a lot of research on shift workers and when they’re awake and eating during the night and asleep during the day. They are at risk for a lot more metabolic conditions and psychological conditions. We should be asleep when the sun’s down and awake when the sun’s up as much as possible. We understand that’s not possible for everyone. Our world runs 24/7.

But we should keep in mind that as far as eating goes, once the sun sets, we should be done. So if you can squeeze your calories into a smaller window when the sun is up, there is a benefit.

Timing absolutely matters, but this can vary by person and circumstance.

I’ve lost weight and I always regain it. How do I lose weight and keep it off for good?

Dr. Simonds 21:43
Biology is trying to take you back to the highest weight. Once you’ve lost weight, your biology is trying very hard to make you gain it back.

When you’re talking about keeping weight off, it’s a long-term proposition. It’s a nutrition plan, a physical activity plan behavior modification, which is lifelong. And then whether or not you need medication, it’s okay to take long-term medication to keep weight off.

Michelle Kennedy 23:58
We don’t do that with blood pressure medicine. We don’t put you on blood pressure medicine, watch your blood pressure, get normal, and then say, all right, you’re good, and take medicine away. Your blood pressure is gonna go back up. Same with weight.

There’s no such thing as it being over. You can’t return to eating a certain way.

And that’s the diet culture. We’re told the diet is this many days, this many months. In reality, it is figuring out how to get the weight off and then how to keep it off.

Those can be different. But for many of our successful patients, they are similar, if not the same thing.

It’s common to lose and regain. Your body wants it back. So it’s going to do anything it can to get it back.

Does the brain ever stop trying to find that lost weight? Unfortunately, the answer is no.

Dr. Simonds 25:55
It’s that mindset.

Michelle Kennedy 26:34
And it can be easier because the whole point of coming to see us is for support. And it’s because we’re helping you with tools and changing behaviors, and changing patterns and learning to plan and learn what foods you know to do well for you and don’t. So you can eventually click into something where it doesn’t feel like work every minute of every day.

The goal is long-term.

I’ve heard sleep is important to weight loss. What does sleep do that helps with weight loss?

Michelle Kennedy 27:27
It does a lot. Sleep research is big right now, and we are learning so much.

Dr. Simonds 27:33
There are a lot of intricacies to it. But the bottom line is your REM sleep is the good kind of sleep, and the more you get, the easier it is to lose weight.

If you deny yourself this REM sleep, you will find it’s harder to lose weight. And if you get plenty of REM sleep, you will find this easy.

Does weightlifting help with weight loss?

Dr. Simonds 28:39
Don’t rely on weight lifting for weight loss. It is a good exercise to help prevent weight regain. But there’s not a lot of evidence that lifting weights are good for weight loss. Changing your diet is very good for weight loss.

I believe in lifting weights for many reasons, including your mobility, strength, and agility. I wouldn’t make it the cornerstone of your weight loss program.