May 30, 2024 • 30 mins
Join e Dr. Maria Iliakova and Tammie Lakose, as they delve into the intricate web of factors that shape our weight. From genetics to the hustle of daily life, they explore the complex influences on what we eat and how it affects our weight. Forget the age-old advice of "eat less, move more"—their discussion will lead you on a journey through the often-overlooked aspects of weight management that go far beyond calorie counting.
Strap in for a candid talk about the harsh economics of eating well, as we navigate through the paradox where processed foods often pinch our wallets less than fresh produce. The struggle is real when time and money dance in a tango of compromise, affecting not just meal choices but our collective well-being. Maria and Tammie venture further and discuss the surprising connections between obesity, nutrition, and the quality of your slumber. Ever considered how the climate you live in, or your financial literacy could play pivotal roles in your health? They dissect these factors and more, leaving no stone unturned.
Closing the loop, Maria and Tammie share their personal encounters with the real-life hurdles that complicate weight management, such as work stress, familial patterns, and the inevitable curveballs life throws their way. Whether it's navigating the challenges of sleep apnea or hormonal changes, or debunking misconceptions around conditions like COPD, they lay it all out on the table. This episode isn't just about shedding light on the issues—it's about empowering you with understanding and strategies for a healthier lifestyle, one informed choice at a time.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Core Bariatrics Podcast hosted by
Bariatric Surgeon Dr MariaIliapova and TMA LaCose,
bariatric Coordinator and apatient herself.
Our goal is building andelevating our community.
The Core Bariatric Podcast doesnot offer medical advice,
diagnosis or treatment.
On this podcast, we aim toshare stories, support and
(00:22):
insight into the world beyondthe clinic.
Let's get into it, alright,maria.
Again, it is just eat less,move more.
There's nothing else thatfactors into weight.
Speaker 2 (00:34):
Duh.
What else do I think factoredin?
Speaker 1 (00:38):
I feel like there needs to be a little bit more,
because me and you pretty muchate the exact same thing while
we were in Florida together.
True, and I'm not your size yet, yeah it's an overnight thing,
by the way.
Speaker 2 (00:53):
It's in and out and it's overnight and no matter
what you do, it's the same foreveryone.
Yeah, exactly, okay, sorry,heavy dose of sarcasm there.
Speaker 1 (01:01):
Yes, absolutely.
I think people are alreadycatching on to our I'm hoping
that's the case.
Absolutely.
Speaker 2 (01:08):
Just in case for everyone in the back and for me.
Sometimes too, if I'm, it's aslow day.
Like you just said, we've hadreally busy weeks and I
personally am in Cedar Rapidsright now.
I'm in a hotel room, as you cansee, and my life is actually a
little chaotic.
I'm on call right now.
Hopefully there will not beanything that disrupts us today,
but there may always be.
Speaker 1 (01:24):
Surgeon life.
Speaker 2 (01:26):
Surgeon life.
Speaker 1 (01:26):
Can I just start off by saying that your hotel room
looks like a whole apartment.
It is.
Speaker 2 (01:33):
It has a whole kitchen and a whole.
Yeah, it's a whole.
They set me up pretty good.
Speaker 1 (01:37):
Party at Maria's hotel room.
Speaker 2 (01:39):
Exactly, party at the holiday in Anyway.
Speaker 1 (01:43):
Literally All right, all right.
Speaker 2 (01:45):
So anyway, yeah.
So what we're going to talkabout today, though, tammy, is
very prescient to your questionabout isn't it just calories in,
calories out, and we're alldoing the same thing and eating
the same thing.
Why aren't we the same size?
There's a lot of factors thatgo into weight, and I think we
really downplay that.
So I'm curious Absolutely I'mcurious what do you think
factors into weight for people?
Speaker 1 (02:06):
I really think that, again, I still don't know the
difference between genetics andepigenetics, so you'll have to
get there.
But family, if your parents areheavier, chances are I feel
like the kids are heavier.
Us going to Florida, I realizedfood, like where you are, has
to have something to do with itbecause, look, we ate pretty
(02:29):
well.
Granted, we were at restaurantsand stuff, but I feel like
there's more options where wewere.
Oh yeah, then I come back toIowa where it's cold and I had
lasagna and I'm like no, I feellike poop it was.
It tastes good.
But also, I think we both canrelate to this because even
though you are a surgeon, youhaven't always you have not come
(02:51):
from money.
Clearly, your mom worked veryhard to give you what you had,
but I think money obviously hassomething to do with it.
Oh yeah, there's a lot, there'sso much.
Speaker 2 (03:03):
Absolutely, absolutely.
So yeah, I think we're catchingonto the fact that pretty much
everything in our lives affectshow we eat and how our body and
our weight and things like that.
I think you're absolutely ontothat.
You're totally right.
I remember when we were inFlorida.
Like you said, there's a lotmore access to fresh fruits and
vegetables.
That's more accessible yearround.
That's a little bit moreencouraged and available.
(03:23):
Even when you go out to eat,it's always there.
And I actually have been seeingpeople here at the hospital this
week and one of the guysactually came in and we were
talking about what kinds ofthings contributed to what he
was, what problem he was having,which is actually a colon
problem, not related to weightor anything like that.
And I said, good, healthy diethigh in fiber can definitely
help this process down the road,and having a diet low in fiber
(03:46):
can actually make this worse.
If he's in Ireland, you don'tburn in Ireland.
Where am I supposed to findgood food?
And that's not heavilyprocessed and that's not, and so
you're obviously right, thelocation where you are and where
you spend your time, or if youtravel a lot, for instance, if
you're not in a regular place,that can be a huge factor in
whether or not you're able tomaintain your weight and eat
purposefully what you want toeat.
Speaker 1 (04:10):
Yeah, absolutely.
And I know exactly where MountVernon is because my best friend
lives there and he got bar food.
Speaker 2 (04:18):
Bar food.
Hey, there's bar food andthere's bar food.
Okay, some places have reallyamazing healthy options, and
then some places you are right,yeah, yeah, really don't.
So, yeah, but you're also ontosomething with the family and
it's actually I'm impressed thatyou remember genetics and
epigenetics.
That's already a win in mybooks that we when we covered
that episode that's coming up.
But, yeah, so there's anelement to weight which
(04:41):
definitely is inherited.
We definitely see people'sweight being either high or low
and that seems to run infamilies, at least to some
extent.
We certainly don't know any onegene that's responsible for
that.
In fact, over 60 genes havebeen affiliated with weight
management and metabolism, butthat's 60.
Okay, that's not like we cantarget one and all of them Right
(05:02):
.
We've treated everything.
No, that's not the case.
So it really is complex.
Only culture and how you wereraised and what was normalized
in your family, like, forinstance I'm curious, actually
in your family what was the goto meal when you came home from
school?
Speaker 1 (05:19):
Chicken casserole, which involved noodles, cream of
chicken, soup, chicken, so Ihad good stuff in it, but it was
still pasta.
Honestly, I'm not a good personto ask, because I didn't have
the sit down and eat mom cookingdinner or even dad cooking
dinner type of thing.
We were always on our own thing, but yeah.
Speaker 2 (05:42):
Honestly, I think that's really common and I don't
think we I think we idealizeour families as oh, we sit down
and we cook and we eat dinnerand like we do all these things
together.
I don't think most people havethat in their lives, I think.
Speaker 1 (05:54):
I try to because I did not have it.
I very much tried to do thatwith my boys for sure.
Speaker 2 (06:00):
Does it work out?
Speaker 1 (06:02):
No, especially this week.
My flight was delayed.
I got home a day late.
By the time I got home I was soexhausted because I slept in an
airport.
We did have dinner that night,but then I've been at work the
last three days and yeah, so itdoesn't always work out.
Speaker 2 (06:20):
But we try, and that's the thing is.
People make do, and so when weare making do especially with
busy lives and busy schedulesand family that still needs to
be fed and ourselves that stillneed to be fed, I do what's
convenient.
And if what's convenient is prepackaged, pre processed, maybe
healthy, maybe not, it's whetheror not you're going to have
good fresh food or homemademeals or things like that.
Speaker 1 (06:43):
Exactly.
Speaker 2 (06:44):
So that's a big factor.
And I notice the same thing,like when I travel I eat really
differently than when I do athome, when it's purposeful and I
can have all my all the foodsthat I want to have, rather than
the foods that are available.
It's a much.
It's much easier to stay ontrack, I think, for everyone in
that situation.
Speaker 1 (07:00):
I don't know.
See, I'm a little backwardsbecause when we were out I had
the options and I had theoptions up the tip of my finger
and I did not have to cook themever since having surgery, I
actually dislike cooking morebecause obviously cooking takes
time and then I can eat half myplate or whatever.
My portion is obviously muchsmaller.
(07:20):
So it sounds enjoyable to eator to cook, because you don't
really sit down and enjoy verymuch, I should say.
Speaker 2 (07:31):
I actually I hear you because I think when we
sometimes it's like the pinkelephant in the room or
something, don't think about thepink elephant, don't think
about it.
And when we're overthinkingwhat we're going to cook and how
we're going to cook it and allthe stuff that goes into that,
and especially if it's if youare on a diet that's different
than the rest of the populationor maybe then your family or
your kids or something are, itbecomes a chore or it can.
Speaker 1 (07:53):
Yeah, Absolutely so.
Speaker 2 (07:55):
I'm curious how do you deal with that on a daily
basis?
Speaker 1 (08:00):
Again, I do struggle a lot.
So we may sit down and eat, butwe don't always eat the same
thing.
Because my kids are obsessedwith, of course, chicken,
niddies and fries.
Mine just looks a littledifferent.
Sometimes our dishes just looka little different.
Right, and I can.
Especially my six year old doesnot want to supply him with the
chicken, so it's easier for mejust to grab string cheese or
(08:24):
yogurt and whatnot.
So my kids are still,unfortunately, eating a lot of
convenient things for the mostpart, especially the three days
that I work a week, sometimesmore.
Yeah, convenience is so hard.
Speaker 2 (08:38):
Do you?
If you had convenient let's sayyou had a fruit and vegetable
stand in your neighborhood orsomething Do you think you would
be?
Would that be convenient enough?
That would be included more inthe food, especially that the
kids were eating, because I knowit's tough to not only do
something that's not necessarilyconvenient but then to convince
someone else to eat it.
Speaker 1 (08:55):
So luckily, my kids actually love fruits, obviously,
and somehow my six year old.
All the things he dislikes heloves, like green beans, so I'll
take that as a win.
But I always say that we alwaysask ourselves if you could pick
one thing, would you want tonever worry about money?
Would you never want to dolaundry again?
(09:15):
Would you never want to?
Whatever Mine would be, if Icould get a chef, I would eat
perfect constantly.
Honestly, because as long asit's there available for me just
to grab and eat, I'll beperfect, so perfect, like I'm.
We had those options even in ahotel room.
I could get a string cheese, Icould get you grab some, some
(09:37):
nuts.
So just as long as it's thereand easily grabbable, eating
better is easier.
But it's, yeah, it's theconvenience aspect of it.
Speaker 2 (09:47):
Honestly, it makes me think and I know we've talked
about this before but that thereneed to be convenient things
almost home delivered, or justboxes, or something available
for people who have hadbariatric surgery.
Just so that it's not aguessing game, because I know a
lot of people like a lot of thephone calls that we get, or even
a lot of the questions that wegot from people was can I eat
this, can I eat this, can I eatthis?
And that is a constant, fromwhat I understand, for like
(10:09):
years ahead.
You're constantly questioninglike what about this thing?
What about that thing?
Is it good, is it not?
Speaker 1 (10:14):
Is it going to?
Speaker 2 (10:15):
make me hurt?
Is it going to give me bad gasor diarrhea or other problems?
Does that sound relatable toyou?
Speaker 1 (10:22):
Absolutely, and we have tried things like Hello
Fresh and it is great, becausethen my husband can make it,
doesn't even have to think,right, it's all there, it tells
you what to do, it don't have tomeasure anything out and all of
that.
Speaker 2 (10:34):
That's not sponsored by Hello Fresh, but we are
certainly open.
Speaker 1 (10:36):
No, yeah, oh yeah, no , no sponsors yeah, sorry, but
that's something we utilize fora little bit.
But it did get pricey becauseobviously they have to make
money while also giving good,fresh produce and someone has to
package up or measure it up andput it in a package and so it's
definitely out there.
(10:57):
It's just still it's notaffordable.
It yeah.
So there's options and even inthe airport I realized that they
had those fresh vendingmachines.
I was actually shocked at thesalads in the jar and pastas
that you can go and warm up andstuff like that.
So I was impressed there.
I didn't try it because I don'teven know why, but because it
(11:20):
was probably expensive.
Honestly, that little thing ofsalad was probably 15 bucks.
I can almost guarantee it.
Speaker 2 (11:25):
So we're getting there.
Speaker 1 (11:29):
I think I spent $10 on a big bottle of water.
Yeah, what is that?
Speaker 2 (11:33):
easily.
Speaker 1 (11:35):
And my Stanley was in my luggage, so I couldn't fill
up a water bottle.
Speaker 2 (11:40):
You could become homeless very quickly me too,
actually, and going to, I agreebut actually you bring up a good
point, which is money.
And I think money is a hugepart of the equation for what's
accessible to people, becausebasically, with enough money,
anything becomes convenient,anything becomes accessible,
whether it's personal trainer,nice, or schedule at work, or
the ability to not worknecessarily or to do work you
(12:00):
want to do rather than work youhave to do to make money.
The ability to eat where youwant to, how you want to have a
Chef, have hello fresh orwhatever else is it?
Money is really a really bigpart of this equation.
It actually even came up,really in a way that made it
super obvious to me when we hadsome patients who relied on food
Pantries and to think about howon earth you eat Healthily or
(12:23):
in any way that you intend toeat, if you're relying on what's
in a food pantry.
Speaker 1 (12:28):
Yeah, yeah, absolutely, because I've been
there, done that and most of it.
Sure, you probably get one ortwo Protein options like chicken
or something, but most of it is.
Here's some macaroni here some,because you need the food to
keep yourself alive and that'sunfortunately what you get.
Speaker 2 (12:47):
Yeah, it's pretty and I would say honestly, it's not
very different from how a lot ofpeople eat, period, because,
again, it's the most convenientand readily accessible and
certainly the most affordable toa lot of people, which to me is
crazy.
Because, if you think about itI'm not trying to start
conspiracy theories or anythingbut shouldn't a vegetable be
cheaper than a processed food?
In theory, like that thinggrows out of the ground, yeah,
(13:08):
you would think, essentiallypre-packaged already and is
shipped and things like that.
I understand things are.
Obviously you can't eat fruitsand vegetables as they don't
stay as fresh for long, for aslong, but it just drives me
crazy that it's more expensiveto eat something that is fresh
rather than something that ispre-processed and pre-packaged.
That may actually put.
Speaker 1 (13:28):
At the same time, it takes more maintenance.
I know like organic stuff youcan't use, like the chemicals
and stuff, but you there'speople out there that have to
Make sure things are watered,make sure things are weeded,
make sure, but whatever.
And then, yeah, there is a lotof.
You need to hurry up and quick,get those strawberries from
Florida or wherever to Iowa,because we're not getting
(13:50):
strawberries very much in Iowa.
Speaker 2 (13:52):
No, at least not right now, not in the winter
time.
They do it a little bit sadright now, that's true.
And then another thing too iswe've talked a little bit about
schedule and things like that,and I think it's really tough if
people have a busy schedule andthey don't have other resources
like either a lot of helparound them, a lot of cultural
background or other support thatreally makes it possible for
(14:14):
people to sit down and eattogether and cook and things
like that it's essentiallyimpossible to work out and to
not drive to work.
That's another big thing too,like we're constantly in our
cars from things, whether it'spicking kids up from school or
going to and from work, and Ifyou don't, if you have a busy
schedule, you have to do thething that makes it, that
enables you to be busy and tonot miss things.
(14:36):
And, yeah, I, it really impactshow we like when we were in
Florida, for instance, we werewalking Right a lot of places
that we went.
We even, I think, went to likedown a mile or so to a
restaurant and then came back,and that's never something
almost getting hit by a car yeahright, I would never do that at
home, because at home I'malways go.
Speaker 1 (14:58):
Now, does that?
Does location not only justobviously a fresh foods are
available, but does locationwhen it comes to you, what am I?
Oh my goodness, I lost my trainof thought.
Speaker 2 (15:11):
Do you mean, like in different locations, wait,
weights of obesity, or there'sdifferent rates of?
Speaker 1 (15:15):
there we go.
See you just know my brain.
Speaker 2 (15:17):
I know your brain by now, tammy, we've heard.
No, actually it's a goodquestion and there's some
interesting data on that.
Obviously, obesity isconsidered a sort of modern
Problem more than it is an olderproblem.
In part, that's because of alot of things like we we drive
instead of walk, our food isprocessed instead of fresh, we
(15:38):
have really busy schedules thatlead to a lot of stress where we
used to live lives that were alot less stressful and it's a
bit dense, in a way, like we'reover.
We overdo everything, includingour own schedules and our minds
and things like that.
In terms of the variability inWeather and things like that.
It's tough to say becauseactually Colorado, like one of
the colder states in the country, has the lowest rate of obesity
(16:02):
in the country and they don'tprobably because everybody has
to work so hard to breathe.
Speaker 1 (16:08):
This is coming from respiratory therapists that
knows that, like my COPDpatients going out to Colorado
really Struggle, and so I thinkanother thing is just education
too is yeah, people don't knowhow.
I didn't know how to eat untilI taught myself.
Speaker 2 (16:22):
Yep I.
Speaker 1 (16:24):
Like and people don't .
I even talked to a man todaywho was really struggling to
breathe.
I did a breathing test on himand he does have a large belly.
But I told him.
I said look, I'm not tellingyou to eat protein just to lose
weight or anything.
I'm telling you to use proteinbecause it stays in your body
longer, it satisfies you longerand with your lung disease you
(16:45):
need something that's sustained.
And so the light bulb went offfor him.
Yes, I know protein is good,but why?
Speaker 2 (16:55):
And I think a lot of people really need to understand
the why and when we do.
I mean, if you even had anutrition class in school I'm
not sure I did in my gradeschool or high school or
anything no, I didn't.
Speaker 1 (17:06):
I learned how to make cookies and decorate a cake.
Speaker 2 (17:11):
Yeah, and I went to a bougie high school and I don't
remember having a sugar,whatever.
I was the kid on my scholarship, so don't judge me.
Speaker 1 (17:18):
Right.
Speaker 2 (17:20):
And even in med school.
This is the crazy thing, but inmed school, on average, it's
less than a few hours of anykind of education on nutrition
out of thousands of hours thatwe get on education in terms of
how the body works anatomy,physiology, microbiology, all
kinds of things, pharmacologybut in terms of nutrition it's
less than a few hours, which isbonkers to me again, because
(17:40):
that underpins a lot of how thebody works or why it works well,
why it doesn't work well.
And then it's no shocker to methat people get all this not so
great advice from theirhealthcare providers, because
their healthcare providers don'tknow much more, on average at
least, than the average patientabout nutrition, that's not to
say that.
Speaker 1 (17:58):
And so, just like nutrition, super important.
Just like bunny, how much moneyclasses did you get?
I learned how to balance acheckbook which is not even
relevant anymore.
I feel sitting sketching outyour why put.
I wrote this check whatever.
I feel like even money wise.
If we were taught how toutilize our money and whatnot,
(18:19):
maybe less people would bebankrupt go bankrupt.
And yeah, it's just.
I feel like our education isbackwards.
Speaker 2 (18:27):
I know I agree, and we don't seem to focus on life
skills so much as we do on.
It almost seems like we'rebeing educated for a world that
exists 30 or 40 years ago,rather than the one that's
frustrating in a number ofreasons.
Yeah, because I think if we hadbetter financial education, if
we had better like here's how tolive in a household, here's how
to have relationships, here'show to deal with work or a
(18:48):
schedule, or functional things.
I bet I would bet a millionbucks, maybe more that our
weight management would also beeasier as a country and we'd
probably have less of a problemoverall, because we would all be
.
We would all have less stress,we would all be able to live our
lives a little easier and we'dbe able to be more mindful about
what we did with our bodies ona regular basis.
Speaker 1 (19:10):
Yeah, absolutely, and so I just want to.
I am like sleep deprived.
I feel like, and I can tellit's killing my mood and I can
kill.
I can tell it is like killingmy want to eat anything healthy.
I want the cupcakes I want.
So I just want to touch base onA.
I come from a sleep clinic aswell, with a pulmonary, so I was
(19:31):
with a sleep doctor who I hopewe can get on here soon.
But I just want to talk abouthow sleep is really important,
not just get your eight hours ofsleep, blah, blah, blah.
But if you're not getting goodenough sleep, you are tired,
your body is tired, and whenyour body is tired, your body
doesn't.
You don't want to go work out,you don't want to cook dinner.
Honestly, how many of us afterwork are just like I don't want
(19:53):
to cook dinner?
Me.
That's me today.
And then my mood and my mentalhealth is just trash, trash.
Those go hand in hand.
And then again, if I'm notfeeling happy and whatnot, I
don't want to.
I just want to binge watch someTV while eating some ice cream.
Speaker 2 (20:09):
Honestly, oh yeah, yeah, I agree.
Sleep, mood, mental health, allthose things really go together
if we're not getting.
And the funny, there areactually some interesting
studies around sleep.
Not everybody needs the sameamount of sleep.
Some people correct.
Speaker 1 (20:22):
That is very correct, right.
Speaker 2 (20:24):
And then there are things that affect how well we
sleep, even if we're sleepingfor a certain amount of time, if
it's the wrong temperature orif it's not a restful and like,
for instance, I sleep when I'mon call, but that sleep is
interrupted.
It's not the same as good sleepwhen I'm not on call.
Speaker 1 (20:37):
Yeah, you subconsciously know that your
phone can go off at any time andyou know you need to be awake
and ready to go.
Yeah, I'll be dealing with thatsoon too.
Speaker 2 (20:45):
And like how many people have kids, for instance,
young kids, for whom, also, ifthey get woken up in the middle
of the night, it's not like youcan just ignore that.
You do have to deal with that.
Yeah, exactly, yeah, you'reright.
Or even having sleep, medicalconditions that affect their
sleep, like sleep apnea, or evenCOPD, can affect your sleep.
There's lots of differentthings that can.
Or getting too much narcolepsy,things like that.
There's a lot of impacts on ouroverall ability to manage our
(21:09):
weight.
And the thing is, I know we'regoing through a laundry list
here of family issues and workissues and stress and sleep and
mental health and all of thesethings.
I don't mean that to beoverwhelming.
Hopefully I mean it to be.
Oh my gosh, there's a lot offactors here and it's not simple
.
So, one, we can't judge peopleso easily.
And then, two, there's actuallya lot of ways that we can start
(21:30):
to address this problem andeven small changes can have a
big impact if they're made toany of these things.
Speaker 1 (21:37):
And I feel like we I want to normalize some of the
things that other peoplestruggle with.
So, like some of these things,just us talking about it and it
coming from, if there is aperson out there that hasn't had
such a supportive bariatricsurgeon that it's coming from a
bariatric surgeon's thing Look,let's be honest, everybody in
the medical field is exhaustedand just we're all hot messes,
(22:00):
pray for us all, but coming froma surgeon that's caring and
just sometimes that's all aperson needs to just be okay
with what's going on in theirlife and how they are struggling
and being like I'm normal, thisis normal.
Speaker 2 (22:15):
Oh yeah, oh yeah.
And, like I personally havestruggled with all of these
things, not a single one of themhas not been a struggle for me.
So I can very much relate and,to be honest, this is also what
we discuss when people come in,when they come in the first time
they come in.
We talk about all of thesedifferent things that impact
their current state, where weare now and where we want to be,
and how that's different andwhat kinds of things we can
(22:36):
change potentially, because somethings you can't.
It's not like you can changethe number of kids you have or
like the job you have veryeasily necessarily right.
Speaker 1 (22:44):
You're so right some days I'm with.
Speaker 2 (22:45):
But oh, they know, they know this, and sometimes
you can't change your mood oryour mental health very easily.
These this is not to say thatany of these things, even if
they are changeable in some way,are easy to change, but there
are some.
Definitely it makes a bigimpact and even some other
things that we've talked aboutlike smoking, alcohol, other
(23:09):
medications that people may betaking or other medical
conditions that they may havecertainly humongous hormonal
changes like pregnancy ormenopause, or even for men.
Men don't go through menopausetechnically, but they go through
what's called hormonalsenescence, which is just a
really fancy term, for theirhormones also get downregulated
and also get affected, and thatdoes have an impact on men too.
(23:32):
I think we have this idea ofthe older man with the kind of
pop belly, skinny legs in ourheads.
Speaker 1 (23:36):
We've all heard that that's honestly, that's what I
was just thinking and I wasthinking does that tend to
happen?
I feel like I don't knowexactly and you can help me.
One menopause happens for women, but I feel like the manopause
that you're talking aboutbecause I'm not gonna be able to
say that word is that later onin life for men.
Do you think?
Speaker 2 (23:56):
yeah, so it seems like we we go actually.
So there's a misconceptionaround.
Even menopause, there arechanges in our hormone levels
that happen gradually and happenmore than in one period in our
lives.
Definitely, menopause isconsidered to be when we no
longer, when we transition frombeing fertile to not fertile
anymore, like not being able tohave babies at all.
For men, it's also spread outevent, and may actually be
(24:19):
happening more than once intheir life, that their hormone
levels are changing considerably.
There are definitely things thatyou can do to improve it.
This is not to say I don'trecommend everybody running out
and getting testosteroneinjections or anything like that
.
That's not safe, but don't dothat.
Some people need it for certainreasons, but for the majority
of people it's not a great idea.
But, yeah, so there's a lotmore to it than just, oh, this
(24:42):
is something you can easily fix,and there's one one reason that
someone is having issues.
It's probably a good ideaactually to talk to someone who
is experienced in weightmanagement, like you or me or
anyone else in our community,because you start to see all of
this web of different thingsthat are relating to each other
and how to address it, ratherthan just saying, oh, this is
(25:04):
because of one, one specificthing, like my long commute or
my poor sleep or something alongthose lines yeah, it just made
me think that people think thatclpd patients, so chronic
obstructive lung diseasepatients, are usually smokers.
Speaker 1 (25:21):
So actually just a pulmonary function test on
myself and I have mild COPD.
Never smoked a day in my life,but I grew up in a house that
windows were closed.
Smoking was around me, so youknow.
But people don't realize likeCOPD patients actually tend.
Sometimes our factory workers,our housekeepers around the
chemicals are especially farmersbecause of that, all that dust
(25:44):
and all that.
Speaker 2 (25:45):
So this is the same exact thing that there's so much
more to weight than just eating, just like there's so much more
to lung disease than justsmoking and so when you put it
all together, it's there's dripsfrom a faucet, but ultimately,
if you have enough drips from afaucet, it'll still fill a sink,
the idea being like it doesn'ttake a massive one source.
(26:08):
It doesn't take a massivechange or a massive reason for
someone to have difficulty withweight management.
It takes small things and smallthings over time really add up
right and then at some point itbecomes really difficult to lose
weight, even if you're eatingright and exercising and doing
all the quote unquote rightthings.
Our bodies do not like to loseweight and keep it off.
(26:30):
That is not how humanmetabolism and human bodies are
structured to, to exist, intofunction.
That just isn't how it works.
Speaker 1 (26:38):
Ain't that the truth?
And in our one episode with DrJessica Smith, she just stated
how women tend to be on allthese diets and actually it gets
harder and harder to loseweight.
I've explained this to somepeople and their mind was blown
as much as mine was, and so,yeah, this is educating me so
much and that I tell otherpeople and I'm glad that I have
(27:00):
the opportunity to do thatbecause it's mind-blowing to
them for the exact reason ofthem knowing it's not just you,
it's not, you're doing somethingwrong right yeah, yeah yeah,
and it is helpful to reach outand start to have these
conversations and, like you said, just start to normalize that.
Speaker 2 (27:18):
maybe there's more to it than blaming a person and
maybe there's things that we cando as a community to help
people and maybe there's waysthat we can Band together to
make it easier for families toget together and eat and to have
easier access to food that wewant.
We want people to eat, orbetter sleep, or better mental
health access, or Absolutelyyeah, the ability to actually
(27:41):
treat smoking addictions.
People even support peopleduring hormonal changes in their
life like menopause.
I don't think I've ever as anadult, had a single conversation
with somebody out aboutmenopause outside of my mom,
outside of a medical settingwith one of my patients, woman
in her 30s.
I have never, with a friend orwith a with any like person
(28:06):
outside of a patient of mine,had a conversation about
menopause.
I think it's a point.
Yeah, I think it's.
Yeah, I think it's.
Maybe what we're doing isradical in a way, because we're
asking people to talk aboutsubjects that are taboo.
We're like told, basically, orwe're made to believe, that
we're not supposed to talk aboutthese things, but if we don't
(28:27):
talk about them, it makes it somuch harder to deal with and so
much harder to know where to goto for advice and support and
legitimate information about it.
So, again, education, and weall deal with this.
It's not just people who have acertain BMI, it's not just
people who come into a medicaloffice seeking help or people
(28:48):
who treat them, or people in ourdistinct community, as we
define it.
It's literally everybody who isaffected by these, these
factors.
Yep absolutely no.
Alright, friend, I think we areboth needing a little nap or
something else to catch up forthe rest of our day.
In fact, I'm actually headingto the or here shortly.
Speaker 1 (29:10):
I was about to say a little nap, you're going to the
war, I'll take it a little nap.
Speaker 2 (29:13):
no, I'm kidding, but so I'm gonna leave you with some
food for thought, maybe, and sothink about and one of our
coming episodes we're going totalk a lot more about sleep and
how it works better, because Ithink a lot of people are really
curious about the link betweensleep and weight and overall
health.
Speaker 1 (29:31):
Yes, absolutely so, everybody.
Thank you for listening.
Don't forget to follow if yourplatform allows you to rate or
comment or anything like that,please do.
We appreciate it so much.
I also can head over toInstagram.
That's my, our, main platformright now, until I'm still
learning the tech stuff and, andso we just appreciate if you
want to reach out to uscorbariatrics on Instagram.
(29:54):
Let us know if you want to talkabout something or if you want
to come on with us.
So well, maria, enjoy yoursurgery, because I know that is
your who's up place.
Speaker 2 (30:02):
Who's so?
Let's go bye to me.
See you soon, bye, bye.
Welcome to Core Bariatrics Podcast hosted by
Bariatric Surgeon Dr MariaIliapova and TMA LaCose,
bariatric Coordinator and apatient herself.
Our goal is building andelevating our community.
The Core Bariatric Podcast doesnot offer medical advice,
diagnosis or treatment.
On this podcast, we aim toshare stories, support and
(00:22):
insight into the world beyondthe clinic.
Let's get into it, alright,maria.
Again, it is just eat less,move more.
There's nothing else thatfactors into weight.
Speaker 2 (00:34):
Duh.
What else do I think factoredin?
Speaker 1 (00:38):
I feel like there needs to be a little bit more,
because me and you pretty muchate the exact same thing while
we were in Florida together.
True, and I'm not your size yet, yeah it's an overnight thing,
by the way.
Speaker 2 (00:53):
It's in and out and it's overnight and no matter
what you do, it's the same foreveryone.
Yeah, exactly, okay, sorry,heavy dose of sarcasm there.
Speaker 1 (01:01):
Yes, absolutely.
I think people are alreadycatching on to our I'm hoping
that's the case.
Absolutely.
Speaker 2 (01:08):
Just in case for everyone in the back and for me.
Sometimes too, if I'm, it's aslow day.
Like you just said, we've hadreally busy weeks and I
personally am in Cedar Rapidsright now.
I'm in a hotel room, as you cansee, and my life is actually a
little chaotic.
I'm on call right now.
Hopefully there will not beanything that disrupts us today,
but there may always be.
Speaker 1 (01:24):
Surgeon life.
Speaker 2 (01:26):
Surgeon life.
Speaker 1 (01:26):
Can I just start off by saying that your hotel room
looks like a whole apartment.
It is.
Speaker 2 (01:33):
It has a whole kitchen and a whole.
Yeah, it's a whole.
They set me up pretty good.
Speaker 1 (01:37):
Party at Maria's hotel room.
Speaker 2 (01:39):
Exactly, party at the holiday in Anyway.
Speaker 1 (01:43):
Literally All right, all right.
Speaker 2 (01:45):
So anyway, yeah.
So what we're going to talkabout today, though, tammy, is
very prescient to your questionabout isn't it just calories in,
calories out, and we're alldoing the same thing and eating
the same thing.
Why aren't we the same size?
There's a lot of factors thatgo into weight, and I think we
really downplay that.
So I'm curious Absolutely I'mcurious what do you think
factors into weight for people?
Speaker 1 (02:06):
I really think that, again, I still don't know the
difference between genetics andepigenetics, so you'll have to
get there.
But family, if your parents areheavier, chances are I feel
like the kids are heavier.
Us going to Florida, I realizedfood, like where you are, has
to have something to do with itbecause, look, we ate pretty
(02:29):
well.
Granted, we were at restaurantsand stuff, but I feel like
there's more options where wewere.
Oh yeah, then I come back toIowa where it's cold and I had
lasagna and I'm like no, I feellike poop it was.
It tastes good.
But also, I think we both canrelate to this because even
though you are a surgeon, youhaven't always you have not come
(02:51):
from money.
Clearly, your mom worked veryhard to give you what you had,
but I think money obviously hassomething to do with it.
Oh yeah, there's a lot, there'sso much.
Speaker 2 (03:03):
Absolutely, absolutely.
So yeah, I think we're catchingonto the fact that pretty much
everything in our lives affectshow we eat and how our body and
our weight and things like that.
I think you're absolutely ontothat.
You're totally right.
I remember when we were inFlorida.
Like you said, there's a lotmore access to fresh fruits and
vegetables.
That's more accessible yearround.
That's a little bit moreencouraged and available.
(03:23):
Even when you go out to eat,it's always there.
And I actually have been seeingpeople here at the hospital this
week and one of the guysactually came in and we were
talking about what kinds ofthings contributed to what he
was, what problem he was having,which is actually a colon
problem, not related to weightor anything like that.
And I said, good, healthy diethigh in fiber can definitely
help this process down the road,and having a diet low in fiber
(03:46):
can actually make this worse.
If he's in Ireland, you don'tburn in Ireland.
Where am I supposed to findgood food?
And that's not heavilyprocessed and that's not, and so
you're obviously right, thelocation where you are and where
you spend your time, or if youtravel a lot, for instance, if
you're not in a regular place,that can be a huge factor in
whether or not you're able tomaintain your weight and eat
purposefully what you want toeat.
Speaker 1 (04:10):
Yeah, absolutely.
And I know exactly where MountVernon is because my best friend
lives there and he got bar food.
Speaker 2 (04:18):
Bar food.
Hey, there's bar food andthere's bar food.
Okay, some places have reallyamazing healthy options, and
then some places you are right,yeah, yeah, really don't.
So, yeah, but you're also ontosomething with the family and
it's actually I'm impressed thatyou remember genetics and
epigenetics.
That's already a win in mybooks that we when we covered
that episode that's coming up.
But, yeah, so there's anelement to weight which
(04:41):
definitely is inherited.
We definitely see people'sweight being either high or low
and that seems to run infamilies, at least to some
extent.
We certainly don't know any onegene that's responsible for
that.
In fact, over 60 genes havebeen affiliated with weight
management and metabolism, butthat's 60.
Okay, that's not like we cantarget one and all of them Right
(05:02):
.
We've treated everything.
No, that's not the case.
So it really is complex.
Only culture and how you wereraised and what was normalized
in your family, like, forinstance I'm curious, actually
in your family what was the goto meal when you came home from
school?
Speaker 1 (05:19):
Chicken casserole, which involved noodles, cream of
chicken, soup, chicken, so Ihad good stuff in it, but it was
still pasta.
Honestly, I'm not a good personto ask, because I didn't have
the sit down and eat mom cookingdinner or even dad cooking
dinner type of thing.
We were always on our own thing, but yeah.
Speaker 2 (05:42):
Honestly, I think that's really common and I don't
think we I think we idealizeour families as oh, we sit down
and we cook and we eat dinnerand like we do all these things
together.
I don't think most people havethat in their lives, I think.
Speaker 1 (05:54):
I try to because I did not have it.
I very much tried to do thatwith my boys for sure.
Speaker 2 (06:00):
Does it work out?
Speaker 1 (06:02):
No, especially this week.
My flight was delayed.
I got home a day late.
By the time I got home I was soexhausted because I slept in an
airport.
We did have dinner that night,but then I've been at work the
last three days and yeah, so itdoesn't always work out.
Speaker 2 (06:20):
But we try, and that's the thing is.
People make do, and so when weare making do especially with
busy lives and busy schedulesand family that still needs to
be fed and ourselves that stillneed to be fed, I do what's
convenient.
And if what's convenient is prepackaged, pre processed, maybe
healthy, maybe not, it's whetheror not you're going to have
good fresh food or homemademeals or things like that.
Speaker 1 (06:43):
Exactly.
Speaker 2 (06:44):
So that's a big factor.
And I notice the same thing,like when I travel I eat really
differently than when I do athome, when it's purposeful and I
can have all my all the foodsthat I want to have, rather than
the foods that are available.
It's a much.
It's much easier to stay ontrack, I think, for everyone in
that situation.
Speaker 1 (07:00):
I don't know.
See, I'm a little backwardsbecause when we were out I had
the options and I had theoptions up the tip of my finger
and I did not have to cook themever since having surgery, I
actually dislike cooking morebecause obviously cooking takes
time and then I can eat half myplate or whatever.
My portion is obviously muchsmaller.
(07:20):
So it sounds enjoyable to eator to cook, because you don't
really sit down and enjoy verymuch, I should say.
Speaker 2 (07:31):
I actually I hear you because I think when we
sometimes it's like the pinkelephant in the room or
something, don't think about thepink elephant, don't think
about it.
And when we're overthinkingwhat we're going to cook and how
we're going to cook it and allthe stuff that goes into that,
and especially if it's if youare on a diet that's different
than the rest of the populationor maybe then your family or
your kids or something are, itbecomes a chore or it can.
Speaker 1 (07:53):
Yeah, Absolutely so.
Speaker 2 (07:55):
I'm curious how do you deal with that on a daily
basis?
Speaker 1 (08:00):
Again, I do struggle a lot.
So we may sit down and eat, butwe don't always eat the same
thing.
Because my kids are obsessedwith, of course, chicken,
niddies and fries.
Mine just looks a littledifferent.
Sometimes our dishes just looka little different.
Right, and I can.
Especially my six year old doesnot want to supply him with the
chicken, so it's easier for mejust to grab string cheese or
(08:24):
yogurt and whatnot.
So my kids are still,unfortunately, eating a lot of
convenient things for the mostpart, especially the three days
that I work a week, sometimesmore.
Yeah, convenience is so hard.
Speaker 2 (08:38):
Do you?
If you had convenient let's sayyou had a fruit and vegetable
stand in your neighborhood orsomething Do you think you would
be?
Would that be convenient enough?
That would be included more inthe food, especially that the
kids were eating, because I knowit's tough to not only do
something that's not necessarilyconvenient but then to convince
someone else to eat it.
Speaker 1 (08:55):
So luckily, my kids actually love fruits, obviously,
and somehow my six year old.
All the things he dislikes heloves, like green beans, so I'll
take that as a win.
But I always say that we alwaysask ourselves if you could pick
one thing, would you want tonever worry about money?
Would you never want to dolaundry again?
(09:15):
Would you never want to?
Whatever Mine would be, if Icould get a chef, I would eat
perfect constantly.
Honestly, because as long asit's there available for me just
to grab and eat, I'll beperfect, so perfect, like I'm.
We had those options even in ahotel room.
I could get a string cheese, Icould get you grab some, some
(09:37):
nuts.
So just as long as it's thereand easily grabbable, eating
better is easier.
But it's, yeah, it's theconvenience aspect of it.
Speaker 2 (09:47):
Honestly, it makes me think and I know we've talked
about this before but that thereneed to be convenient things
almost home delivered, or justboxes, or something available
for people who have hadbariatric surgery.
Just so that it's not aguessing game, because I know a
lot of people like a lot of thephone calls that we get, or even
a lot of the questions that wegot from people was can I eat
this, can I eat this, can I eatthis?
And that is a constant, fromwhat I understand, for like
(10:09):
years ahead.
You're constantly questioninglike what about this thing?
What about that thing?
Is it good, is it not?
Speaker 1 (10:14):
Is it going to?
Speaker 2 (10:15):
make me hurt?
Is it going to give me bad gasor diarrhea or other problems?
Does that sound relatable toyou?
Speaker 1 (10:22):
Absolutely, and we have tried things like Hello
Fresh and it is great, becausethen my husband can make it,
doesn't even have to think,right, it's all there, it tells
you what to do, it don't have tomeasure anything out and all of
that.
Speaker 2 (10:34):
That's not sponsored by Hello Fresh, but we are
certainly open.
Speaker 1 (10:36):
No, yeah, oh yeah, no , no sponsors yeah, sorry, but
that's something we utilize fora little bit.
But it did get pricey becauseobviously they have to make
money while also giving good,fresh produce and someone has to
package up or measure it up andput it in a package and so it's
definitely out there.
(10:57):
It's just still it's notaffordable.
It yeah.
So there's options and even inthe airport I realized that they
had those fresh vendingmachines.
I was actually shocked at thesalads in the jar and pastas
that you can go and warm up andstuff like that.
So I was impressed there.
I didn't try it because I don'teven know why, but because it
(11:20):
was probably expensive.
Honestly, that little thing ofsalad was probably 15 bucks.
I can almost guarantee it.
Speaker 2 (11:25):
So we're getting there.
Speaker 1 (11:29):
I think I spent $10 on a big bottle of water.
Yeah, what is that?
Speaker 2 (11:33):
easily.
Speaker 1 (11:35):
And my Stanley was in my luggage, so I couldn't fill
up a water bottle.
Speaker 2 (11:40):
You could become homeless very quickly me too,
actually, and going to, I agreebut actually you bring up a good
point, which is money.
And I think money is a hugepart of the equation for what's
accessible to people, becausebasically, with enough money,
anything becomes convenient,anything becomes accessible,
whether it's personal trainer,nice, or schedule at work, or
the ability to not worknecessarily or to do work you
(12:00):
want to do rather than work youhave to do to make money.
The ability to eat where youwant to, how you want to have a
Chef, have hello fresh orwhatever else is it?
Money is really a really bigpart of this equation.
It actually even came up,really in a way that made it
super obvious to me when we hadsome patients who relied on food
Pantries and to think about howon earth you eat Healthily or
(12:23):
in any way that you intend toeat, if you're relying on what's
in a food pantry.
Speaker 1 (12:28):
Yeah, yeah, absolutely, because I've been
there, done that and most of it.
Sure, you probably get one ortwo Protein options like chicken
or something, but most of it is.
Here's some macaroni here some,because you need the food to
keep yourself alive and that'sunfortunately what you get.
Speaker 2 (12:47):
Yeah, it's pretty and I would say honestly, it's not
very different from how a lot ofpeople eat, period, because,
again, it's the most convenientand readily accessible and
certainly the most affordable toa lot of people, which to me is
crazy.
Because, if you think about itI'm not trying to start
conspiracy theories or anythingbut shouldn't a vegetable be
cheaper than a processed food?
In theory, like that thinggrows out of the ground, yeah,
(13:08):
you would think, essentiallypre-packaged already and is
shipped and things like that.
I understand things are.
Obviously you can't eat fruitsand vegetables as they don't
stay as fresh for long, for aslong, but it just drives me
crazy that it's more expensiveto eat something that is fresh
rather than something that ispre-processed and pre-packaged.
That may actually put.
Speaker 1 (13:28):
At the same time, it takes more maintenance.
I know like organic stuff youcan't use, like the chemicals
and stuff, but you there'speople out there that have to
Make sure things are watered,make sure things are weeded,
make sure, but whatever.
And then, yeah, there is a lotof.
You need to hurry up and quick,get those strawberries from
Florida or wherever to Iowa,because we're not getting
(13:50):
strawberries very much in Iowa.
Speaker 2 (13:52):
No, at least not right now, not in the winter
time.
They do it a little bit sadright now, that's true.
And then another thing too iswe've talked a little bit about
schedule and things like that,and I think it's really tough if
people have a busy schedule andthey don't have other resources
like either a lot of helparound them, a lot of cultural
background or other support thatreally makes it possible for
(14:14):
people to sit down and eattogether and cook and things
like that it's essentiallyimpossible to work out and to
not drive to work.
That's another big thing too,like we're constantly in our
cars from things, whether it'spicking kids up from school or
going to and from work, and Ifyou don't, if you have a busy
schedule, you have to do thething that makes it, that
enables you to be busy and tonot miss things.
(14:36):
And, yeah, I, it really impactshow we like when we were in
Florida, for instance, we werewalking Right a lot of places
that we went.
We even, I think, went to likedown a mile or so to a
restaurant and then came back,and that's never something
almost getting hit by a car yeahright, I would never do that at
home, because at home I'malways go.
Speaker 1 (14:58):
Now, does that?
Does location not only justobviously a fresh foods are
available, but does locationwhen it comes to you, what am I?
Oh my goodness, I lost my trainof thought.
Speaker 2 (15:11):
Do you mean, like in different locations, wait,
weights of obesity, or there'sdifferent rates of?
Speaker 1 (15:15):
there we go.
See you just know my brain.
Speaker 2 (15:17):
I know your brain by now, tammy, we've heard.
No, actually it's a goodquestion and there's some
interesting data on that.
Obviously, obesity isconsidered a sort of modern
Problem more than it is an olderproblem.
In part, that's because of alot of things like we we drive
instead of walk, our food isprocessed instead of fresh, we
(15:38):
have really busy schedules thatlead to a lot of stress where we
used to live lives that were alot less stressful and it's a
bit dense, in a way, like we'reover.
We overdo everything, includingour own schedules and our minds
and things like that.
In terms of the variability inWeather and things like that.
It's tough to say becauseactually Colorado, like one of
the colder states in the country, has the lowest rate of obesity
(16:02):
in the country and they don'tprobably because everybody has
to work so hard to breathe.
Speaker 1 (16:08):
This is coming from respiratory therapists that
knows that, like my COPDpatients going out to Colorado
really Struggle, and so I thinkanother thing is just education
too is yeah, people don't knowhow.
I didn't know how to eat untilI taught myself.
Speaker 2 (16:22):
Yep I.
Speaker 1 (16:24):
Like and people don't .
I even talked to a man todaywho was really struggling to
breathe.
I did a breathing test on himand he does have a large belly.
But I told him.
I said look, I'm not tellingyou to eat protein just to lose
weight or anything.
I'm telling you to use proteinbecause it stays in your body
longer, it satisfies you longerand with your lung disease you
(16:45):
need something that's sustained.
And so the light bulb went offfor him.
Yes, I know protein is good,but why?
Speaker 2 (16:55):
And I think a lot of people really need to understand
the why and when we do.
I mean, if you even had anutrition class in school I'm
not sure I did in my gradeschool or high school or
anything no, I didn't.
Speaker 1 (17:06):
I learned how to make cookies and decorate a cake.
Speaker 2 (17:11):
Yeah, and I went to a bougie high school and I don't
remember having a sugar,whatever.
I was the kid on my scholarship, so don't judge me.
Speaker 1 (17:18):
Right.
Speaker 2 (17:20):
And even in med school.
This is the crazy thing, but inmed school, on average, it's
less than a few hours of anykind of education on nutrition
out of thousands of hours thatwe get on education in terms of
how the body works anatomy,physiology, microbiology, all
kinds of things, pharmacologybut in terms of nutrition it's
less than a few hours, which isbonkers to me again, because
(17:40):
that underpins a lot of how thebody works or why it works well,
why it doesn't work well.
And then it's no shocker to methat people get all this not so
great advice from theirhealthcare providers, because
their healthcare providers don'tknow much more, on average at
least, than the average patientabout nutrition, that's not to
say that.
Speaker 1 (17:58):
And so, just like nutrition, super important.
Just like bunny, how much moneyclasses did you get?
I learned how to balance acheckbook which is not even
relevant anymore.
I feel sitting sketching outyour why put.
I wrote this check whatever.
I feel like even money wise.
If we were taught how toutilize our money and whatnot,
(18:19):
maybe less people would bebankrupt go bankrupt.
And yeah, it's just.
I feel like our education isbackwards.
Speaker 2 (18:27):
I know I agree, and we don't seem to focus on life
skills so much as we do on.
It almost seems like we'rebeing educated for a world that
exists 30 or 40 years ago,rather than the one that's
frustrating in a number ofreasons.
Yeah, because I think if we hadbetter financial education, if
we had better like here's how tolive in a household, here's how
to have relationships, here'show to deal with work or a
(18:48):
schedule, or functional things.
I bet I would bet a millionbucks, maybe more that our
weight management would also beeasier as a country and we'd
probably have less of a problemoverall, because we would all be
.
We would all have less stress,we would all be able to live our
lives a little easier and we'dbe able to be more mindful about
what we did with our bodies ona regular basis.
Speaker 1 (19:10):
Yeah, absolutely, and so I just want to.
I am like sleep deprived.
I feel like, and I can tellit's killing my mood and I can
kill.
I can tell it is like killingmy want to eat anything healthy.
I want the cupcakes I want.
So I just want to touch base onA.
I come from a sleep clinic aswell, with a pulmonary, so I was
(19:31):
with a sleep doctor who I hopewe can get on here soon.
But I just want to talk abouthow sleep is really important,
not just get your eight hours ofsleep, blah, blah, blah.
But if you're not getting goodenough sleep, you are tired,
your body is tired, and whenyour body is tired, your body
doesn't.
You don't want to go work out,you don't want to cook dinner.
Honestly, how many of us afterwork are just like I don't want
(19:53):
to cook dinner?
Me.
That's me today.
And then my mood and my mentalhealth is just trash, trash.
Those go hand in hand.
And then again, if I'm notfeeling happy and whatnot, I
don't want to.
I just want to binge watch someTV while eating some ice cream.
Speaker 2 (20:09):
Honestly, oh yeah, yeah, I agree.
Sleep, mood, mental health, allthose things really go together
if we're not getting.
And the funny, there areactually some interesting
studies around sleep.
Not everybody needs the sameamount of sleep.
Some people correct.
Speaker 1 (20:22):
That is very correct, right.
Speaker 2 (20:24):
And then there are things that affect how well we
sleep, even if we're sleepingfor a certain amount of time, if
it's the wrong temperature orif it's not a restful and like,
for instance, I sleep when I'mon call, but that sleep is
interrupted.
It's not the same as good sleepwhen I'm not on call.
Speaker 1 (20:37):
Yeah, you subconsciously know that your
phone can go off at any time andyou know you need to be awake
and ready to go.
Yeah, I'll be dealing with thatsoon too.
Speaker 2 (20:45):
And like how many people have kids, for instance,
young kids, for whom, also, ifthey get woken up in the middle
of the night, it's not like youcan just ignore that.
You do have to deal with that.
Yeah, exactly, yeah, you'reright.
Or even having sleep, medicalconditions that affect their
sleep, like sleep apnea, or evenCOPD, can affect your sleep.
There's lots of differentthings that can.
Or getting too much narcolepsy,things like that.
There's a lot of impacts on ouroverall ability to manage our
(21:09):
weight.
And the thing is, I know we'regoing through a laundry list
here of family issues and workissues and stress and sleep and
mental health and all of thesethings.
I don't mean that to beoverwhelming.
Hopefully I mean it to be.
Oh my gosh, there's a lot offactors here and it's not simple
.
So, one, we can't judge peopleso easily.
And then, two, there's actuallya lot of ways that we can start
(21:30):
to address this problem andeven small changes can have a
big impact if they're made toany of these things.
Speaker 1 (21:37):
And I feel like we I want to normalize some of the
things that other peoplestruggle with.
So, like some of these things,just us talking about it and it
coming from, if there is aperson out there that hasn't had
such a supportive bariatricsurgeon that it's coming from a
bariatric surgeon's thing Look,let's be honest, everybody in
the medical field is exhaustedand just we're all hot messes,
(22:00):
pray for us all, but coming froma surgeon that's caring and
just sometimes that's all aperson needs to just be okay
with what's going on in theirlife and how they are struggling
and being like I'm normal, thisis normal.
Speaker 2 (22:15):
Oh yeah, oh yeah.
And, like I personally havestruggled with all of these
things, not a single one of themhas not been a struggle for me.
So I can very much relate and,to be honest, this is also what
we discuss when people come in,when they come in the first time
they come in.
We talk about all of thesedifferent things that impact
their current state, where weare now and where we want to be,
and how that's different andwhat kinds of things we can
(22:36):
change potentially, because somethings you can't.
It's not like you can changethe number of kids you have or
like the job you have veryeasily necessarily right.
Speaker 1 (22:44):
You're so right some days I'm with.
Speaker 2 (22:45):
But oh, they know, they know this, and sometimes
you can't change your mood oryour mental health very easily.
These this is not to say thatany of these things, even if
they are changeable in some way,are easy to change, but there
are some.
Definitely it makes a bigimpact and even some other
things that we've talked aboutlike smoking, alcohol, other
(23:09):
medications that people may betaking or other medical
conditions that they may havecertainly humongous hormonal
changes like pregnancy ormenopause, or even for men.
Men don't go through menopausetechnically, but they go through
what's called hormonalsenescence, which is just a
really fancy term, for theirhormones also get downregulated
and also get affected, and thatdoes have an impact on men too.
(23:32):
I think we have this idea ofthe older man with the kind of
pop belly, skinny legs in ourheads.
Speaker 1 (23:36):
We've all heard that that's honestly, that's what I
was just thinking and I wasthinking does that tend to
happen?
I feel like I don't knowexactly and you can help me.
One menopause happens for women, but I feel like the manopause
that you're talking aboutbecause I'm not gonna be able to
say that word is that later onin life for men.
Do you think?
Speaker 2 (23:56):
yeah, so it seems like we we go actually.
So there's a misconceptionaround.
Even menopause, there arechanges in our hormone levels
that happen gradually and happenmore than in one period in our
lives.
Definitely, menopause isconsidered to be when we no
longer, when we transition frombeing fertile to not fertile
anymore, like not being able tohave babies at all.
For men, it's also spread outevent, and may actually be
(24:19):
happening more than once intheir life, that their hormone
levels are changing considerably.
There are definitely things thatyou can do to improve it.
This is not to say I don'trecommend everybody running out
and getting testosteroneinjections or anything like that
.
That's not safe, but don't dothat.
Some people need it for certainreasons, but for the majority
of people it's not a great idea.
But, yeah, so there's a lotmore to it than just, oh, this
(24:42):
is something you can easily fix,and there's one one reason that
someone is having issues.
It's probably a good ideaactually to talk to someone who
is experienced in weightmanagement, like you or me or
anyone else in our community,because you start to see all of
this web of different thingsthat are relating to each other
and how to address it, ratherthan just saying, oh, this is
(25:04):
because of one, one specificthing, like my long commute or
my poor sleep or something alongthose lines yeah, it just made
me think that people think thatclpd patients, so chronic
obstructive lung diseasepatients, are usually smokers.
Speaker 1 (25:21):
So actually just a pulmonary function test on
myself and I have mild COPD.
Never smoked a day in my life,but I grew up in a house that
windows were closed.
Smoking was around me, so youknow.
But people don't realize likeCOPD patients actually tend.
Sometimes our factory workers,our housekeepers around the
chemicals are especially farmersbecause of that, all that dust
(25:44):
and all that.
Speaker 2 (25:45):
So this is the same exact thing that there's so much
more to weight than just eating, just like there's so much more
to lung disease than justsmoking and so when you put it
all together, it's there's dripsfrom a faucet, but ultimately,
if you have enough drips from afaucet, it'll still fill a sink,
the idea being like it doesn'ttake a massive one source.
(26:08):
It doesn't take a massivechange or a massive reason for
someone to have difficulty withweight management.
It takes small things and smallthings over time really add up
right and then at some point itbecomes really difficult to lose
weight, even if you're eatingright and exercising and doing
all the quote unquote rightthings.
Our bodies do not like to loseweight and keep it off.
(26:30):
That is not how humanmetabolism and human bodies are
structured to, to exist, intofunction.
That just isn't how it works.
Speaker 1 (26:38):
Ain't that the truth?
And in our one episode with DrJessica Smith, she just stated
how women tend to be on allthese diets and actually it gets
harder and harder to loseweight.
I've explained this to somepeople and their mind was blown
as much as mine was, and so,yeah, this is educating me so
much and that I tell otherpeople and I'm glad that I have
(27:00):
the opportunity to do thatbecause it's mind-blowing to
them for the exact reason ofthem knowing it's not just you,
it's not, you're doing somethingwrong right yeah, yeah yeah,
and it is helpful to reach outand start to have these
conversations and, like you said, just start to normalize that.
Speaker 2 (27:18):
maybe there's more to it than blaming a person and
maybe there's things that we cando as a community to help
people and maybe there's waysthat we can Band together to
make it easier for families toget together and eat and to have
easier access to food that wewant.
We want people to eat, orbetter sleep, or better mental
health access, or Absolutelyyeah, the ability to actually
(27:41):
treat smoking addictions.
People even support peopleduring hormonal changes in their
life like menopause.
I don't think I've ever as anadult, had a single conversation
with somebody out aboutmenopause outside of my mom,
outside of a medical settingwith one of my patients, woman
in her 30s.
I have never, with a friend orwith a with any like person
(28:06):
outside of a patient of mine,had a conversation about
menopause.
I think it's a point.
Yeah, I think it's.
Yeah, I think it's.
Maybe what we're doing isradical in a way, because we're
asking people to talk aboutsubjects that are taboo.
We're like told, basically, orwe're made to believe, that
we're not supposed to talk aboutthese things, but if we don't
(28:27):
talk about them, it makes it somuch harder to deal with and so
much harder to know where to goto for advice and support and
legitimate information about it.
So, again, education, and weall deal with this.
It's not just people who have acertain BMI, it's not just
people who come into a medicaloffice seeking help or people
(28:48):
who treat them, or people in ourdistinct community, as we
define it.
It's literally everybody who isaffected by these, these
factors.
Yep absolutely no.
Alright, friend, I think we areboth needing a little nap or
something else to catch up forthe rest of our day.
In fact, I'm actually headingto the or here shortly.
Speaker 1 (29:10):
I was about to say a little nap, you're going to the
war, I'll take it a little nap.
Speaker 2 (29:13):
no, I'm kidding, but so I'm gonna leave you with some
food for thought, maybe, and sothink about and one of our
coming episodes we're going totalk a lot more about sleep and
how it works better, because Ithink a lot of people are really
curious about the link betweensleep and weight and overall
health.
Speaker 1 (29:31):
Yes, absolutely so, everybody.
Thank you for listening.
Don't forget to follow if yourplatform allows you to rate or
comment or anything like that,please do.
We appreciate it so much.
I also can head over toInstagram.
That's my, our, main platformright now, until I'm still
learning the tech stuff and, andso we just appreciate if you
want to reach out to uscorbariatrics on Instagram.
(29:54):
Let us know if you want to talkabout something or if you want
to come on with us.
So well, maria, enjoy yoursurgery, because I know that is
your who's up place.
Speaker 2 (30:02):
Who's so?
Let's go bye to me.
See you soon, bye, bye.
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