WEBVTT - I'm Afraid of The Weight Loss Jabs 0:00:10.287 --> 0:00:13.047 You're listening to Amma mea podcast. 0:00:13.727 --> 0:00:16.767 Mamma Mere acknowledges the traditional owners of land and waters 0:00:16.767 --> 0:00:22.647 that this podcast is recorded on. Lean in close, friends, 0:00:23.087 --> 0:00:26.767 drop your voice. I'm going to talk about something we're 0:00:26.807 --> 0:00:29.727 not supposed to talk about in a way I wouldn't 0:00:29.807 --> 0:00:32.767 dream of doing if there were people under thirty round, 0:00:33.327 --> 0:00:37.247 or my teenage daughter, or even my very best self. 0:00:37.727 --> 0:00:39.967 But I've asked her to step out of the room 0:00:39.967 --> 0:00:43.327 for a moment so that I can be truthful, unvarnished 0:00:43.567 --> 0:00:47.847 about something we're really not supposed to say. I still 0:00:47.887 --> 0:00:51.567 struggle with my weight. You're laughing now. I can feel 0:00:51.567 --> 0:00:54.967 it because you're thinking, well, who doesn't. You're thinking, I've 0:00:55.007 --> 0:00:58.807 had years of that, decades of wasting hours and days 0:00:58.807 --> 0:01:02.967 of my life, probably worrying about the circumference of my thighs, 0:01:03.287 --> 0:01:06.327 the softness of my chin. How many roles can be 0:01:06.367 --> 0:01:10.367 tucked away into the waistband of a helpful g You're 0:01:10.367 --> 0:01:13.047 also laughing now because you're looking at whatever version of 0:01:13.127 --> 0:01:15.047 me you might have seen out there in the world, 0:01:15.367 --> 0:01:18.207 and depending on your own relationship with your own body, 0:01:18.527 --> 0:01:21.207 you're thinking I'm right or wrong to worry about it. 0:01:21.567 --> 0:01:24.687 You're holding yourself up against that imagined version, and you're 0:01:24.727 --> 0:01:28.607 making judgment calls because we all do that. We all 0:01:28.767 --> 0:01:31.967 still do that, We're just not allowed to say so. 0:01:32.967 --> 0:01:36.927 Generation X, I'm often told by my younger friends and colleagues, 0:01:37.047 --> 0:01:41.807 are toxic about weight. We were marinated in diet culture 0:01:41.847 --> 0:01:44.287 and cooked up in a world where women talked about 0:01:44.327 --> 0:01:48.527 being on a diet constantly, unthinkingly, as if it were 0:01:48.527 --> 0:01:51.967 a perpetual state of womanhood. We could tell you what 0:01:52.047 --> 0:01:54.807 Jennifer Aniston had for lunch for eight years straight, and 0:01:54.847 --> 0:01:57.247 what Oprah had to give up, which was eating by 0:01:57.287 --> 0:02:00.487 the way to drag that infamous wagon of fat across 0:02:00.527 --> 0:02:04.807 a TV soundstage, and we counted points and mercilessly cut 0:02:04.807 --> 0:02:09.007 out entire food groups. We lived through Kate Moss SI zero, 0:02:10.167 --> 0:02:12.527 just as our mothers had lived through the Dawn of Twiggy. 0:02:13.167 --> 0:02:16.127 We used words like slimming when it came to colors 0:02:16.167 --> 0:02:19.247 and cuts, and we positioned ourselves at the middle back 0:02:19.367 --> 0:02:22.887 of all group photos, safety in numbers when it came 0:02:22.967 --> 0:02:27.927 to hiding our true shape. Now we know better, We 0:02:27.967 --> 0:02:30.607 see the damage that it did. All that relentless self 0:02:30.647 --> 0:02:34.047 critique of being at war with our bodies, The vicious 0:02:34.087 --> 0:02:38.207 inner critic targeting our very flesh and the young people 0:02:38.647 --> 0:02:42.527 who have their own battles to fight against the perfect, filtered, smooth, 0:02:42.607 --> 0:02:46.047 shrunk bodies of Instagram, every bit as toxic as the 0:02:46.087 --> 0:02:49.687 airbrush magazine version, but now cloaked in the language of 0:02:49.727 --> 0:02:53.407 health and self care have taught us not to ever 0:02:53.607 --> 0:02:56.487 ever talk about it. But just as we know better 0:02:56.887 --> 0:03:00.807 and try to make friends with ourselves, a new era starts. 0:03:01.847 --> 0:03:05.527 Hormones shift and so does our shape. All those tricks, 0:03:05.567 --> 0:03:07.607 the good ones and the bad ones we've learned to 0:03:07.687 --> 0:03:10.487 keep ourselves in a bracket of fears. Okay about our 0:03:10.487 --> 0:03:15.007 bodies have stopped working, and a redistribution is upon us 0:03:15.927 --> 0:03:19.047 also now it really is about health. It's not a 0:03:19.087 --> 0:03:21.527 lie or a smoke screen to say that, somewhere in 0:03:21.647 --> 0:03:24.767 mid we realize that what we want to live long 0:03:24.887 --> 0:03:27.567 and well is a body we don't need to love, 0:03:27.647 --> 0:03:31.487 but we need to work all that. To say, in 0:03:31.527 --> 0:03:35.367 my hushed tones that it's okay, friends, that we're all 0:03:35.407 --> 0:03:38.447 a bit fucked up about this. It's okay that we're 0:03:38.487 --> 0:03:41.407 still figuring it out as proper grown up women. How 0:03:41.407 --> 0:03:44.927 to remove emotion and judgment from what really are merely 0:03:45.047 --> 0:03:51.927 numbers and facts. You're safe here. It's okay. Hello. I'm 0:03:52.007 --> 0:03:57.007 Holly Wainwright and I am Mid, Midlife, mid Family, mid Mouthful. 0:03:57.207 --> 0:04:00.607 Welcome back to Mid. This is season six, and we 0:04:00.647 --> 0:04:03.247 are so happy to have you with us. We're doing 0:04:03.287 --> 0:04:06.527 something a bit different this season on MID. We are 0:04:06.607 --> 0:04:09.847 unpacking your dilemmas. You might have heard me do an 0:04:09.887 --> 0:04:12.807 episode about this with Marian Keyes in season five, where 0:04:12.847 --> 0:04:15.967 basically you sent in your problems big and small and 0:04:16.007 --> 0:04:18.567 we unpacked them together. It was so popular and we 0:04:18.647 --> 0:04:20.567 enjoyed it so much that we decided to do that 0:04:20.767 --> 0:04:23.247 as our theme for episode six, but on lots of 0:04:23.287 --> 0:04:28.047 different topics, so all things sex and relationships and faces 0:04:28.087 --> 0:04:32.127 and family and today about weight. Some of these episodes 0:04:32.167 --> 0:04:33.607 are going to sound a bit different to the ones 0:04:33.647 --> 0:04:35.447 you might be used to. Some of them are going 0:04:35.487 --> 0:04:38.367 to have a big, long thinking introduction like today's because 0:04:38.367 --> 0:04:40.727 I just couldn't help myself, but that will pour out 0:04:40.767 --> 0:04:43.127 of me. But sometimes we're going to get right down 0:04:43.207 --> 0:04:46.607 to business. But always, this season of Mid is going 0:04:46.647 --> 0:04:50.007 to be all about you, You and us and Mid 0:04:50.487 --> 0:04:53.647 and as I just confessed, I am as messed up 0:04:53.687 --> 0:04:56.287 about my body. As the next woman, But I've been 0:04:56.327 --> 0:04:58.767 trying to make friends with her for the longest time, 0:04:59.327 --> 0:05:01.487 and there's a woman in my orbit who at times 0:05:01.527 --> 0:05:04.407 has helped me do that while never trying to turn 0:05:04.447 --> 0:05:07.807 me into someone else, that is, someone who doesn't like food. 0:05:08.567 --> 0:05:12.447 Susie bar is a dietitian, and a few years ago 0:05:12.727 --> 0:05:15.287 she helped me lose a significant amount of weight after 0:05:15.367 --> 0:05:17.927 my doctor told me I should Many many of us 0:05:17.927 --> 0:05:21.407 have been in that doctor's appointment, right. Susie has all 0:05:21.447 --> 0:05:24.167 the qualifications that a lot of people shouting about weight 0:05:24.207 --> 0:05:27.327 management on social media do not, and she also has 0:05:27.367 --> 0:05:32.047 a very agnostic, practical attitude to this topic. She also 0:05:32.167 --> 0:05:34.887 knows about all the new developments in food world. Yes 0:05:34.967 --> 0:05:38.207 we're talking about GLP one's the new world of weight 0:05:38.247 --> 0:05:42.247 loss medications. And she knows that most women don't have 0:05:42.407 --> 0:05:45.647 loads of time for meal prepping and would probably still 0:05:45.727 --> 0:05:47.487 like to have a glass of wine or a piece 0:05:47.527 --> 0:05:50.607 of cake or a plate of dips sometimes to make 0:05:50.647 --> 0:05:55.247 life a little less. So I knew that Susie was 0:05:55.287 --> 0:05:58.207 the phone a friend I needed to help us answer 0:05:58.287 --> 0:06:01.927 your dilemmas about body, food and weight at this stage 0:06:01.927 --> 0:06:05.607 of our lives. Of course, I need to tell you 0:06:05.647 --> 0:06:08.607 that as we answer these dilemmas, you should never embark 0:06:08.687 --> 0:06:11.527 on any sea significant change to your diet or make 0:06:11.567 --> 0:06:16.487 any decisions about medication, weight management, or otherwise without seeing 0:06:16.487 --> 0:06:20.287 your doctor. The information discussed in this episode is not 0:06:20.407 --> 0:06:24.687 intended to replace professional medical advice. And also, this conversation 0:06:24.807 --> 0:06:28.567 is general and does include a few numbers. If any 0:06:28.567 --> 0:06:31.527 of that is triggering or difficult for you, I will 0:06:31.527 --> 0:06:34.287 not be offended if you skip this episode and links 0:06:34.287 --> 0:06:37.287 to organization who can help with any disordered eating issues 0:06:37.527 --> 0:06:40.727 in our show notes. But if you are here for 0:06:40.927 --> 0:06:48.167 the honest body chat, welcome to the Dilemma Couch. Susie Burrell. Susie, 0:06:48.207 --> 0:06:50.527 I couldn't think of anyone better to answer these dilemmas 0:06:50.567 --> 0:06:52.287 with me, because you're the person I text when I 0:06:52.327 --> 0:06:53.927 have dilemmas about these kind of. 0:06:53.847 --> 0:06:57.967 Things happen occasionally. I'm always happy to help her. 0:06:57.967 --> 0:07:01.927 I'm always happy to help just occasionally. So our first 0:07:02.127 --> 0:07:06.687 question from a mid listener, she says, I've always been 0:07:06.767 --> 0:07:09.007 a little over the weight that my doctor would like 0:07:09.007 --> 0:07:11.727 to say see me at As I've gotten older, it's 0:07:11.727 --> 0:07:14.367 gotten harder to shift a few kilos or so when 0:07:14.367 --> 0:07:16.287 I need to well I think we all hear you 0:07:16.327 --> 0:07:19.927 there and the scales of creptop. Now friends are telling 0:07:19.967 --> 0:07:22.127 me to get on the weight loss jabs. Those are 0:07:22.167 --> 0:07:24.887 her words, the weight loss jabs. But here's the thing. 0:07:25.327 --> 0:07:27.967 I love food. I love little treats. I love a 0:07:27.967 --> 0:07:31.327 glass of wine. My appetite, while it's not out of control, 0:07:31.567 --> 0:07:34.527 is part of my personality. To me, I don't want 0:07:34.567 --> 0:07:37.327 to become a different person. I don't want to remove 0:07:37.327 --> 0:07:40.207 a pleasure from my life. There are few enough pockets 0:07:40.207 --> 0:07:42.727 of joy with caring for my family and working hard. 0:07:43.007 --> 0:07:45.927 But I feel like I'm being guilted into this option 0:07:46.167 --> 0:07:49.847 that everyone is talking about. I guess the first place 0:07:49.847 --> 0:07:53.967 we have to go there is here's a woman who 0:07:54.047 --> 0:07:57.287 sounds kind of very normal in inverted commas, and that 0:07:57.367 --> 0:07:59.207 it is harder for all of us to shift weight 0:07:59.207 --> 0:08:01.207 as we get older. And if you're someone who has 0:08:01.247 --> 0:08:05.087 always loved little treats, should she address this first of all? 0:08:05.127 --> 0:08:08.127 First of all, it's complicated, as so many things are. 0:08:08.327 --> 0:08:08.727 I think. 0:08:08.847 --> 0:08:11.287 First, the first thing I gleaned off that case study 0:08:11.367 --> 0:08:14.647 for whatever better word, is the focus on weight. Now, 0:08:14.767 --> 0:08:17.847 working with women, as I have for almost thirty years now, 0:08:18.367 --> 0:08:20.247 I really don't focus a lot on weight. I really 0:08:20.287 --> 0:08:23.367 focus on waste measurement because waste measurement is so much 0:08:23.367 --> 0:08:25.807 more telling about what is going on with your health, 0:08:26.287 --> 0:08:29.007 particularly as we move into our forties and fifties and 0:08:29.047 --> 0:08:31.247 beyond and we have key hormonal changes. 0:08:31.287 --> 0:08:35.047 Why Why is that? Because so you literally saying, instead 0:08:35.047 --> 0:08:37.407 of standing on the scale, get a tape measure. 0:08:37.647 --> 0:08:41.047 Absolutely, absolutely, because it removes that whole idea of a 0:08:41.127 --> 0:08:44.167 number weight. Can you know, differ by as much as 0:08:44.167 --> 0:08:46.447 two kilos in a single day, It's not a really 0:08:46.487 --> 0:08:49.567 great measure. If you're stronger, if you've got more muscle mass, 0:08:49.647 --> 0:08:52.007 you're a more muscular frame, you'll be a heavier person. 0:08:52.367 --> 0:08:54.607 So some of those sort of standards we grew up with, 0:08:54.647 --> 0:08:56.687 wanting to be fifty kilos a're just never going to 0:08:56.687 --> 0:08:58.127 be relevant for some people. 0:08:58.487 --> 0:09:00.447 Is that kind of why people have started to question 0:09:00.567 --> 0:09:03.527 the idea of your BMI because they're like, it's not everybody. 0:09:03.607 --> 0:09:06.487 There isn't an ideal weight. We're so different and that 0:09:06.527 --> 0:09:08.727 we're learning more about it. Is that why. 0:09:08.487 --> 0:09:12.087 BMI is a population based measure to infer public health. 0:09:12.167 --> 0:09:15.567 It's not overly relevant for individuals. So for my women 0:09:15.607 --> 0:09:18.367 and I am a clinician I see women every week. 0:09:18.727 --> 0:09:21.087 I'm looking at a couple of key measurements. I'm looking 0:09:21.087 --> 0:09:23.727 at what I call where your small waist is, because 0:09:23.767 --> 0:09:25.447 for anyone who's had kids, you'll know your kind of 0:09:25.447 --> 0:09:27.847 waiste drops down a little bit. So I'll do the 0:09:27.887 --> 0:09:30.527 sort of leanest, tightest part which in a younger female 0:09:30.567 --> 0:09:33.487 maybe rand your belly button still and I do ideally 0:09:33.567 --> 0:09:35.487 you want it to be less than eighty centimeters. So 0:09:35.567 --> 0:09:37.967 that's the first measure, and then I'll get my ladies 0:09:38.007 --> 0:09:39.447 to do a second, which is what I call your 0:09:39.487 --> 0:09:41.247 lower waist. Now, for some of us that may be 0:09:41.327 --> 0:09:43.087 a hip, it may be where if you've had a 0:09:43.087 --> 0:09:45.807 C section, your weight's kind of moved down to and 0:09:45.927 --> 0:09:48.087 really we do want that to be less than ninety 0:09:48.247 --> 0:09:51.527 So that straightaway tells me so much metabolically what's going 0:09:51.567 --> 0:09:55.087 on with my clients and indirectly can be linked to 0:09:55.127 --> 0:09:57.567 where the people may need medical weight loss support. 0:09:57.727 --> 0:10:02.727 Why does why are those numbers more important than a 0:10:02.807 --> 0:10:06.447 number on a scale, and also what does that tell you? 0:10:06.527 --> 0:10:09.527 What does that waste number tell you? As an expert? 0:10:09.247 --> 0:10:12.407 That is telling me how well your insulin and glucose 0:10:12.447 --> 0:10:15.407 regulation is, and what we know as you go through 0:10:15.447 --> 0:10:19.207 perry and menopause, as we naturally lose our estrogen or 0:10:19.207 --> 0:10:23.207 it declines, we're more likely to deposit weight centrally. It 0:10:23.287 --> 0:10:25.487 also is indicative of those who may be at higher 0:10:25.567 --> 0:10:28.887 risk of diabetes or insulin resistance, which would suggest weight 0:10:28.887 --> 0:10:31.967 loss may be more difficult and in turn maybe down 0:10:32.047 --> 0:10:34.687 the track or require medical weight loss support. So it 0:10:34.687 --> 0:10:36.527 tells us so much. It also tells you if you're 0:10:36.567 --> 0:10:38.847 losing body fat, if you are trying to lose weight, 0:10:39.247 --> 0:10:41.767 because you can go and be on a calorie deficit 0:10:41.887 --> 0:10:44.727 or starve yourself or have a low carb diet, and 0:10:44.767 --> 0:10:47.687 you see the scales going down, But if your waist 0:10:47.767 --> 0:10:50.207 isn't going down, you're probably wasting muscle mass, which is 0:10:50.247 --> 0:10:51.967 the worst thing we can do as we get older 0:10:52.047 --> 0:10:54.487 because we want more muscle mass. So if my clients, 0:10:54.527 --> 0:10:57.007 I don't care if the scales don't go down, and 0:10:57.087 --> 0:10:59.527 certainly I have clients who are weighing themselves. I don't 0:10:59.567 --> 0:11:02.167 weigh them. I do everyone virtually, so it's up to them. 0:11:02.567 --> 0:11:04.607 But I want the waist down because if the waist 0:11:04.727 --> 0:11:06.887 is down, it's indicative of body fat loss. 0:11:07.127 --> 0:11:07.967 So it's a much. 0:11:07.807 --> 0:11:09.807 Better measure of what's going on with your health and 0:11:09.847 --> 0:11:14.647 your metabolism and basically optimizing body composition, because that's what 0:11:14.647 --> 0:11:17.087 it is for women in our forties and beyond. It's 0:11:17.087 --> 0:11:20.647 about building a healthy body that is functional. As we 0:11:20.687 --> 0:11:23.567 get into our seventies, our eighties, our nineties. You know, 0:11:23.927 --> 0:11:27.847 these generations of women will hopefully live old. You know 0:11:27.887 --> 0:11:29.807 we're going to be around long time. We need these 0:11:29.807 --> 0:11:32.807 bodies to be functional. So it's not about a weight 0:11:32.887 --> 0:11:36.287 on the scale. It's about functional fitness where you carry 0:11:36.327 --> 0:11:39.567 your weight, if you're still mobile and protecting your joints, 0:11:39.687 --> 0:11:41.447 more than just a number on the scales. 0:11:41.607 --> 0:11:43.567 Can I just ask you before we move on to 0:11:43.607 --> 0:11:47.207 the more emotional side of our what our listeners asking us. 0:11:47.927 --> 0:11:50.767 Everybody says this about you as you get older, muscle 0:11:50.807 --> 0:11:53.487 mass really important? Don't lose muscle mass? Don't lose muscle mass? 0:11:53.767 --> 0:11:55.687 Why is it important? Like for the people like me 0:11:55.687 --> 0:11:59.567 who don't really understand science, maybe should have taken more 0:11:59.607 --> 0:12:03.447 biology at school, Like why and particularly as you get older, 0:12:03.567 --> 0:12:05.927 is it really important that you're not losing muscle mass? 0:12:06.007 --> 0:12:09.207 Muscle mass is our metabolically active tissue. It burns calor 0:12:09.447 --> 0:12:11.807 is basically so it keeps our body healthy, but it 0:12:11.887 --> 0:12:15.167 keeps our body strong because if you think about what 0:12:15.447 --> 0:12:17.967 issues as we get older, we fall over, we have 0:12:18.087 --> 0:12:20.847 brittle bones. If you've got more muscle mass, or preserve 0:12:20.887 --> 0:12:23.847 your muscle mass, your body will be stronger. You'll be 0:12:23.847 --> 0:12:26.207 able to eat more, as our listener is talking about, 0:12:26.287 --> 0:12:29.647 because it actually burns calories, whereas you can if fat 0:12:29.687 --> 0:12:31.967 mass doesn't do anything, it's just dead weight. Really now, 0:12:32.007 --> 0:12:35.127 we do need some, but it's not got the metabolic benefits. 0:12:35.167 --> 0:12:38.287 It basically burns and processes our glucose. So the more 0:12:38.367 --> 0:12:41.247 muscle mass you have, the better it is for hormone control, 0:12:41.447 --> 0:12:44.367 for burning more calories, for keeping our bodies strong, to 0:12:44.407 --> 0:12:46.767 be able to lift heavy things as we get older, 0:12:46.887 --> 0:12:50.007 to be able to climb stairs, go downstairs and not fall, 0:12:50.247 --> 0:12:51.887 you know, hold on to things. You know, if you 0:12:51.967 --> 0:12:54.007 go to fall and you've got a strong bone and 0:12:54.047 --> 0:12:55.967 a strong muscle, you're more likely to be able to 0:12:55.967 --> 0:12:57.127 protect yourself as you fall. 0:12:57.207 --> 0:12:59.247 All those little things which are much more important. 0:12:59.287 --> 0:13:01.327 One of the things I think about a lot as 0:13:01.447 --> 0:13:06.127 I'm moving into my fifties. You don't want to move 0:13:06.567 --> 0:13:08.567 like an old person and inverted comments, I mean even 0:13:08.687 --> 0:13:11.207 just like having to dash for something, not having to 0:13:11.207 --> 0:13:13.847 think twice about going upstairs or walking here or doing that, 0:13:14.007 --> 0:13:17.447 or just like moving in a fluid, fast kind of way. 0:13:18.047 --> 0:13:19.887 This is what we're talking about, right, is like being 0:13:19.927 --> 0:13:22.247 able to do all that for longer rather than being 0:13:22.887 --> 0:13:24.767 we can debilitated. 0:13:24.207 --> 0:13:27.327 Picking up your grandkids term you know, carrying heavy shopping 0:13:27.367 --> 0:13:28.927 bags and not having to worry and. 0:13:28.967 --> 0:13:30.647 Being able to keep doing things you like, like if 0:13:30.647 --> 0:13:33.367 you love running, for example, and heaps of women in 0:13:33.407 --> 0:13:36.567 our mid age bracket hair will be runners or whatever 0:13:36.607 --> 0:13:38.407 it is that they love doing, like being able to 0:13:38.407 --> 0:13:38.767 do that. 0:13:38.727 --> 0:13:41.567 For longer, travel and go hiking for days at a time, 0:13:41.687 --> 0:13:43.967 walking for long periods of time, being able to stand 0:13:44.007 --> 0:13:46.407 on one leg and put your stockings on right, So 0:13:46.487 --> 0:13:48.447 all of these functional. 0:13:48.047 --> 0:13:49.407 Movement, and that's what it's about. 0:13:49.447 --> 0:13:52.607 It's getting your body fitter and healthier as you move 0:13:52.687 --> 0:13:55.407 through the lifespan. So the weight, for me, it's not 0:13:55.447 --> 0:13:57.447 a massive factor. It's much more about what's going on 0:13:57.487 --> 0:14:00.607 in your body composition and getting you as functionally fit 0:14:01.007 --> 0:14:03.207 and lean in a way as possible so your body's 0:14:03.247 --> 0:14:05.607 better able to age gracefully. 0:14:05.687 --> 0:14:09.527 All right, Obviously, our listener wants to talk about weight loss. 0:14:09.567 --> 0:14:11.807 She's calling them, we will call them what they're correctly called, 0:14:11.807 --> 0:14:15.447 which is medical weight loss. Correct Now, everybody knows what 0:14:15.447 --> 0:14:17.207 we're talking about when we're talking about that. I'm going 0:14:17.287 --> 0:14:18.927 to say a couple of brand names here. If you're 0:14:18.927 --> 0:14:22.207 wondering why we're not just saying them, it's because the 0:14:22.327 --> 0:14:24.847 regulations around this are type as they should be. Right, 0:14:25.087 --> 0:14:28.327 we're talking about medical weight loss injections like o Zempic, 0:14:28.527 --> 0:14:31.447 like Manjaro. You would have heard about these right now. 0:14:31.487 --> 0:14:33.647 You know a lot about this, SUSI. So I'd love 0:14:33.687 --> 0:14:36.207 to know because a couple of years ago, if a 0:14:36.247 --> 0:14:39.487 woman is in her midlife like me, and you're thinking, 0:14:39.967 --> 0:14:42.287 I do want to reduce that waste size, I want 0:14:42.287 --> 0:14:43.847 to lose some weight, I want to get in better shape, 0:14:43.887 --> 0:14:46.647 whatever it is. We're talking about diet and exercise now, 0:14:46.687 --> 0:14:49.967 and this is what's happening to this listener. Everybody's telling her, 0:14:50.247 --> 0:14:52.967 like her mates are telling her, get yourself to the doctor, 0:14:53.247 --> 0:14:56.367 get yourself on the japs. That's what everybody's saying, right. 0:14:57.047 --> 0:15:01.407 And the thing is is I know that it's not 0:15:01.487 --> 0:15:03.927 I know that it's not that simple, but it's certainly 0:15:04.007 --> 0:15:06.487 much more mainstream and widespread than it was a couple 0:15:06.487 --> 0:15:11.687 of years ago. Our listener is worry that she'll suddenly 0:15:11.727 --> 0:15:12.847 not want to eat it at all, and it's a 0:15:12.847 --> 0:15:15.767 massive pleasure in her life now. I know because I've 0:15:15.807 --> 0:15:19.127 worked with you before, that you actually take into consideration 0:15:19.167 --> 0:15:20.967 when you work with women, like is it important to 0:15:21.007 --> 0:15:23.527 you to have little treats? Is it important to you 0:15:23.607 --> 0:15:25.367 that you have that glass of wine on a Friday night? 0:15:25.407 --> 0:15:28.127 Is it what? Blah blah blah. Our listener is almost 0:15:28.167 --> 0:15:30.407 worried that she's not going to be herself if she 0:15:30.567 --> 0:15:33.687 does try this medication. What's your experience. 0:15:34.247 --> 0:15:36.887 I think the thing about medical weight loss is we 0:15:36.887 --> 0:15:39.247 don't necessarily understand what it is. So I'll try and 0:15:39.327 --> 0:15:42.127 explain it in as simple terms as possible, because for me, 0:15:42.327 --> 0:15:45.687 it's very much linked to metabolic variables. It's not a 0:15:45.687 --> 0:15:48.087 decision of whether or not you should try it or 0:15:48.127 --> 0:15:51.087 want to, it's whether you need to. So the GOLP 0:15:51.287 --> 0:15:54.367 one range of medical weight loss are basically working in 0:15:54.407 --> 0:15:57.327 two key ways. They work on the hormonal system that 0:15:57.407 --> 0:16:00.727 regulates glucose and insulin metabolism in the body, and they 0:16:00.807 --> 0:16:04.327 control food noise and appetite due to changes in digestion, 0:16:04.487 --> 0:16:06.407 so they basically slow down the movement of food through 0:16:06.447 --> 0:16:07.247 the digestive track. 0:16:07.407 --> 0:16:12.207 You hear people saying I have always thought about food 0:16:12.247 --> 0:16:15.167 and it's been a battle, and suddenly it's just not there. 0:16:15.207 --> 0:16:17.367 That drive is not there. 0:16:17.407 --> 0:16:18.607 For those individuals. 0:16:18.647 --> 0:16:20.327 But it's not a matter of whether I want it 0:16:20.407 --> 0:16:21.887 or not. It's whether you, as I said, whether you 0:16:21.967 --> 0:16:24.287 need to. Because first of all, if you're looking at 0:16:24.287 --> 0:16:27.087 relatively small amounts of weight. Now, so for example, I've 0:16:27.087 --> 0:16:30.207 talked in waste measurement, if your wist is under ninety 0:16:30.367 --> 0:16:32.687 or you've got a handful of kilos five or ten, 0:16:33.567 --> 0:16:37.247 as a dietitian, I would not be even suggesting anything 0:16:37.327 --> 0:16:41.047 like that unless you were predisposed to diabetes, you'd had 0:16:41.127 --> 0:16:44.847 gestational diabetes or insulin resistance, which is a clinical issue 0:16:45.127 --> 0:16:49.127 that may require clinical management. But as a dietitian, I 0:16:49.127 --> 0:16:51.407 would always try and do it with diet and exercise 0:16:51.487 --> 0:16:55.767 calories in optimizing metabolism for all those things. Now, once 0:16:55.767 --> 0:16:58.807 you're getting too people with metabolic issues so pre diabetic, 0:16:59.047 --> 0:17:04.127 they have insatiable appetite, they're carrying twenty thirty forty kilos, 0:17:04.407 --> 0:17:07.407 it may be a viable option, but it's not just 0:17:07.447 --> 0:17:10.447 a decision you make overnight. Start because the thing people 0:17:10.447 --> 0:17:13.647 don't understand is not a matter of just taking a jab. 0:17:14.047 --> 0:17:16.647 You have to change your diet, exercise, or they don't work. 0:17:17.047 --> 0:17:19.647 They just mask appetite for short periods of time and 0:17:19.647 --> 0:17:21.687 then as soon as you come off them, you just 0:17:21.687 --> 0:17:24.207 go back to your old habits. So we always like 0:17:24.247 --> 0:17:26.847 to focus on diet and exercise and lifestyle first. And 0:17:26.887 --> 0:17:28.727 as you know, if you work with a great dietitian 0:17:28.767 --> 0:17:32.167 and I must stress, please pay and see the right professionals. 0:17:32.207 --> 0:17:34.687 You know, everyone's an expert. Every influence is out there. 0:17:34.727 --> 0:17:36.767 Please make sure you see. If you need a psychologist, 0:17:36.767 --> 0:17:39.247 see a psychologist. If you need weight loss support, see 0:17:39.247 --> 0:17:42.407 a dietitian. For this reason, because you're dealing with people 0:17:42.447 --> 0:17:45.567 who will create sustainable models. So for me, I know 0:17:45.647 --> 0:17:47.647 that my women love to have a glass of wine 0:17:47.767 --> 0:17:49.807 and like to have a cheeky chocolate every now and again. 0:17:49.887 --> 0:17:52.287 So my job is to formulate plans that suit them 0:17:52.287 --> 0:17:55.767 and are sustainable. Because people think seeing having a diet 0:17:55.927 --> 0:17:58.327 is about restriction, it's not. A good diet will be 0:17:58.327 --> 0:18:01.367 something you can follow forever and as such will factor 0:18:01.407 --> 0:18:03.447 in eating out, it will factor in wine and things 0:18:03.447 --> 0:18:05.847 that you like. So coming back to the listener, in 0:18:05.927 --> 0:18:08.887 terms of her dilemma, I think the question is more 0:18:08.887 --> 0:18:11.207 where where is she sitting? In terms of is it 0:18:11.247 --> 0:18:13.207 a few kilos, Well, you probably can see a good 0:18:13.247 --> 0:18:15.887 dietician and sort it out. If it's more serious than that, 0:18:15.967 --> 0:18:18.487 and there is some high insulance, some high glucose, your 0:18:18.527 --> 0:18:21.087 waist is over ninety or one hundred, you're carrying twenty 0:18:21.167 --> 0:18:25.207 thirty kilos, it is possibly something that you could consider, 0:18:25.607 --> 0:18:28.047 but not before you sort of started the journey. 0:18:28.567 --> 0:18:29.847 And there's other options. 0:18:29.887 --> 0:18:32.247 First, because ten years ago, when we didn't have all 0:18:32.287 --> 0:18:36.127 these golp one medications targeting these issues, there were other 0:18:36.167 --> 0:18:39.527 options we use with people that were not perhaps as aggressive. 0:18:39.567 --> 0:18:42.167 And you know, they're quite an investment financially as well. 0:18:42.247 --> 0:18:44.687 So you know, I've got all ranges of clients. I've 0:18:44.687 --> 0:18:46.727 got clients who have used them from the start. I've 0:18:46.727 --> 0:18:48.807 got clients who have lost five or ten and then 0:18:48.887 --> 0:18:51.727 started it for a short period of time. But ultimately 0:18:51.767 --> 0:18:53.607 they are all working on the same thing, which is 0:18:53.647 --> 0:18:57.527 developing a sustainable model of eating, with or without that support. 0:18:57.887 --> 0:19:00.687 And yes, in answer, they do kill the food noise 0:19:00.687 --> 0:19:04.207 a little bit They certainly mean that you don't feel 0:19:04.207 --> 0:19:06.247 like craving and governed by food. 0:19:06.647 --> 0:19:08.327 But it's not like you can't have a glass of 0:19:08.327 --> 0:19:09.687 wine or things like that if you don't want to. 0:19:09.767 --> 0:19:13.127 So she's not. It's funny because I think that because 0:19:13.127 --> 0:19:15.807 there is so much media out there about this at 0:19:15.847 --> 0:19:18.567 the moment, you're reading headlines all the time of like 0:19:18.927 --> 0:19:21.367 I became more successful, I became better in bed, I 0:19:21.407 --> 0:19:24.207 became listening or whatever. It is, like I suddenly didn't 0:19:24.207 --> 0:19:26.047 want to drink, I didn't want to do this, I 0:19:26.087 --> 0:19:27.967 didn't want to argue with my partner. I didn't want 0:19:27.967 --> 0:19:30.007 to do anything I would like. It's like everyone's talking 0:19:30.007 --> 0:19:33.527 about it like that. You're making it clear. You get 0:19:33.567 --> 0:19:36.247 back to the basics. This is a medication. You see 0:19:36.247 --> 0:19:38.927 a professional for it. It's not going to be a 0:19:38.967 --> 0:19:41.007 magic bullet. It's not going to turn you into someone else, 0:19:41.047 --> 0:19:42.687 but it might be helpful if you need it. Is 0:19:42.727 --> 0:19:43.847 that kind of what you're saying. 0:19:43.607 --> 0:19:45.687 One hundred percent, And I only ever used it as 0:19:45.727 --> 0:19:50.167 a tool as part of the process because in my experience, 0:19:50.207 --> 0:19:52.567 for every ten people who have had them, eight it's 0:19:52.647 --> 0:19:56.447 are unsuccessful because they haven't committed to the lifestyle. 0:19:56.527 --> 0:19:57.407