Why it’s harder for doctors to lose weight

Katrina Ubell, MD, listened with growing skepticism as the dietitian describe her weight loss plan. “You’re going to have to eat a snack in the afternoon,” she said. Ubell refrained from rolling her eyes. The afternoon was in the middle of the clinic. “I would never do that,” she tried to explain. “I can’t.”

Dr. Katrina Ubell

“Of course you can,” insisted the dietitian. “You shouldn’t think that way. It’s up to you.”

“She was right about that,” Ubell concedes years later. But the well-meaning dietician couldn’t understand the reality of life as a doctor. As a pediatrician, Ubell could visualize how his afternoon would go. “You’re already 40 minutes late. This mom has to come home to get her kid off the bus. This mom, her toddler is losing his mind because he needs a nap. You’re not going say, ‘Sorry, I need to eat carrots and hummus.’

Most of what the dieting field recommends for weight loss, Ubell found, only seems relevant to people with a consistent 9-to-5 schedule. That wasn’t his life. Nor was she seeking one of the many diets based on self-sacrifice and willpower. Having already lost and regained 40 pounds several times, she knew that these methods were not effective in the long term.

What were the other overweight doctors doing? she wondered. Someone must know how to help doctors lose weight. But his Google searches turned up…nothing. No one offered a helpful diet or exercise plan specifically for doctors.

Ubell’s search for answers led her into the world of life coaching, and she eventually became a certified life and weight loss coach, working exclusively with doctors who identify women.

The land is small. Very few weight loss programs are aimed solely at physicians, whose stress levels, unpredictable schedules, and high-performance mindset pose unique challenges. Of the ever-changing dietary fads, few would likely work for the surgeon confined to an operating room for 9 hours straight or the anesthetist who can’t even drink water during the work day.

Ubell set out to create a weight loss program rooted in the physical and mental demands of medical practice. In the process, she lost 45 pounds.

Step 1: Recognize that doctors are, unfortunately, human

Ubell’s approach to diet combines cognitive behavioral therapy concepts with personalized eating plans, coaching and support from a community of physicians.

This all stems from her own experience with emotional eating, which she says many doctors use to manage stress and burnout. According to her, this is a direct result of the need to suppress emotions while caring for patients, but the lack of guidance on how to manage these feelings outside of work.

“That kind of behavior, being what we call ‘professional’, but really emotionally closed off, is prized and valued in medicine,” Ubell says. “I’m not saying we should be open all the time. But we’re not given any tools to know what to do at the end of the day. In my case it was eating. For others it’s drinking more than they would like, spending money, playing the game, basically just numbing behavior.”

Ubell says only 20% of his work with clients revolves around what to eat. The other 80% is about dealing with the thoughts, beliefs and emotions that negatively affect their life, teaching them to cope “without food as a crutch”. Once the food issues are resolved, customers can start solving all the issues they used to hide the food.

“A lot of my clients really have to work on self-love, self-acceptance, self-compassion,” Ubell says. “They’re so successful, and often a lot of them think they’ve achieved so much by being tough on themselves and driving themselves hard. They think it’s causal, but it’s not. They need to learn, how can I be fulfilled while being kind to myself?

Step 2: Reassess your mindset

Ali Novitsky, MD, a physician specializing in obesity medicine and now a full-time life coach, calls this attitude the “heaven reward illusion.” Observed by renowned psychiatrist Aaron Beck, MD, this cognitive distortion involves imagining that hard work, struggle, and self-sacrifice must eventually pay off, as if suffering entitles us to compensation in the future. For physicians, who are steeped in a culture of selflessness and dedication to the health of others, this often means giving up on their own health and well-being.

Dr Ali Novitsky

For many, there is also a sense of secrecy and shame about health and fitness issues. As doctors, they are experts on the human body. They should already know how to lose weight. Right? And so, not knowing or being unable to muster the willpower for a diet while on night shifts or working 12-hour shifts feels like professional failure as well as failure. personal.

“As doctors, we are so afraid of failing,” says Novitsky. “It’s more comfortable not knowing. Maybe we failed before, or maybe we didn’t get the result we wanted, so now we can’t stand it happening again. C is just way too painful.”

Dr. Novitsky focuses on weight loss issues specific to the medical life.

Novitsky — who lost 50 pounds herself and kept it off for 20 years — offers weight loss, intuitive eating and fitness programs for female doctors. Its evidence-based approach aims to optimize body composition rather than hitting a number on a scale. Mindful of the physician lifestyle, it offers night and weekend meetups, sessions that can be replayed, and even an “on-call training” series designed to be in the call room.

Novitsky notices that many of his clients are stuck in an “all or nothing” mindset. If they can’t do something perfectly with full commitment, they’d rather not do it at all. With so many demands on their time and energy, something has to give, and prioritizing their health starts to feel selfish or hopeless. “I can talk about it,” admits Novitsky, “because I did it myself”

Like Ubell, Novitsky says “most of the things we coach on aren’t about their food. It’s about how they feel undervalued at work, how their relationships suffer, how they feel super guilty as parents. They feel like they look good on paper, but that’s not the life they signed up for.”

Stage 3: Life Change = Physical Change

Siobhan Key, MD, obesity medicine and family physician, sees her own struggle to lose weight as a symptom of an old lifestyle that, frankly, “sucked.”

Her grueling schedule and lack of self-care left her stuck in a “hamster wheel” of work and family responsibilities. There was no room for herself. She craved the dopamine burst of junk food and felt helpless to stop reaching for Wendy’s fries as a frequent reward. It took realizing that she was on the right path to developing type 2 diabetes to motivate her to change.

Where she lived also affected her struggle. Living in the small community of Prince George, British Columbia, local weight loss programs were difficult for Key. It was likely that she would meet some of her patients, which would not be a safe space to reveal her personal challenges. Finding an expert who could explain how to eat healthy meals while on call and then work out a full day afterwards also yielded no solutions.

Unlike Ubell and Novitsky, Key still practices medicine. But she is also a slimming coach. She takes an unconventional approach by not offering any specific rules or diets. Saying what foods you can and can’t eat is like trying to insert a square peg into a round hole, Key says. It will never work long term. Instead, she wants to help her clients use both their medical knowledge and their life experience to incorporate healthy eating into their lives.

“Let’s stop doing things that make our lives worse just to lose weight, because it’s never going to be sustainable,” says Key. “Let’s instead choose paths to weight loss and diet management that actually improve our lives. And those exist. They’re just not the classic diet paths we’ve been taught before.”

Key’s program also includes advice from other medical coaches on professional difficulties. For example, mapping is important, says Key. The pressure of filling out patient notes, often outside working hours, is a major source of stress that triggers a lot of meals.

Weight loss doesn’t happen in a vacuum, Key points out. It’s not the simple “eat less, exercise more” equation that doctors learned in medical school. “The reality is that weight loss and diet happens at the same time as the rest of your life,” she says.

Find ways to make your life easier and the benefits will follow, she says. “As your life improves, you feel more empowered. You feel less stressed. Your food choices start to be simpler and cravings start to decrease. You can’t have one without it. ‘other.”

Weight is just a symptom of a bigger problem

Ubell, Novitsky and Key all say they have seen dramatic transformations among their clients. They don’t just mean physical. Ubell remembers an ER doctor so miserable at work that she considered defaulting on her student loans. Novitsky remembers an anesthesiologist so insecure that she almost passed up a scholarship for a fitness program. Key saw customers so obsessed with what they should and shouldn’t eat that food dominated their thoughts every spare minute of the day.

All of these doctors, coaches say, have been able to regain control of their lives, rethink how they present themselves at work and at home, and even rediscover their joy in medicine.

These changes are less about body mass index and more about confidence and self-esteem. For weight loss to last, according to Ubell, Novitsky and Key, there must be permanent mental changes that redefine one’s relationship with food.

“There is no finish line when we talk about long-term weight maintenance,” Key tells doctors. “You have to be able to do this for the rest of your life.”

For more news, follow Medscape on Facebook, TwitterInstagram and YouTube.

About Chris Stevenson

Check Also

Gemma Collins insists ‘even the GC’ is worried about the cost of living

Gemma Collins worries about the cost of living (Photo: Joe Maher/WireImage) Gemma Collins is using …