Demystifying Nutrition and Bariatric Weight Loss: Protein, Carbs, Fats, and More
Welcome back to The Weight Loss Collab! In this episode, Dr. Dovec and registered dietitian Hannah Schuyler dive deep into the essentials of nutrition for weight loss—especially for those navigating bariatric surgery or weight loss medications. With so much buzz (and confusion) on social media around topics like Ozempic, protein intake, and muscle loss, Hannah helps us separate fact from fiction using the latest science and her practical expertise.
The conversation covers everything you need to know about reading nutrition labels, setting protein and carb goals, and making your diet both nourishing and realistic after bariatric surgery. Hannah breaks down macronutrients, demystifies dreaded seed oils, and offers real-world strategies for making sustainable changes (without demonizing any food group). Plus, Dr. Dovec asks the hard questions about diet sodas, fast food, intermittent fasting, and the role of food in celebrating life’s special moments.
Whether you’re on a weight loss journey, supporting someone who is, or just curious about building a healthy relationship with food, this episode is packed with insights that will empower you to fuel your body, protect your muscle, and enjoy your food. Let’s jump in!
Transcript
She's a doctor. Hi, I'm Dr. Dovec and she's a dietitian. Hey,
Speaker:I'm Hannah Schuyler and together we are the Weight Loss
Speaker:Collab. And today the star of our
Speaker:show will be Hannah Schuyler, registered
Speaker:dietitian. We are going to break down all things nutrition.
Speaker:Yes, weight loss nutrition, specific to bariatric surgery.
Speaker:Talk a little bit about even the weight loss medications in here and how to
Speaker:fuel your body. There's so much stuff actually in social
Speaker:media right now. Right. Really negatively targeting
Speaker:the Ozempic, Webgo,
Speaker:Zeppelin, Tirzepatide, Semaglutide, basically weight loss medication,
Speaker:the GLP1s and nutrition. And losing muscle mass. Yes.
Speaker:That is a huge thing. And that's. Honestly, it's not wrong
Speaker:to be worried about that. And I think that's something that we should all focus
Speaker:on and that, I mean, talk about just like jumping into it.
Speaker:Like, that's what we're talking about when we talk about protein intake after
Speaker:bariatric surgery. So things about when you have excess body
Speaker:weight, basically you have stores of energy in
Speaker:that. And our body can kind of use two different things. It can use fat
Speaker:for energy or it can use muscle for energy.
Speaker:Now that's not what we want. We want to use the fat stores. Right.
Speaker:And that's the best store. Right, That's. And that's what people want to lose.
Speaker:Well, when we're losing weight, first of all, some amount of muscle
Speaker:mass loss is pretty much inevitable, especially if you are losing
Speaker:significant amounts of weight. You just. It just breaks
Speaker:down. And so that's fine. I think the goal is that we don't want that
Speaker:to like, outpace you. Don't want that to be where all of your weight loss
Speaker:is coming from. We want to lose the fat and then just have some of
Speaker:that muscle that can't prevent it. But. Okay,
Speaker:so we're. I'm going to get sciencey for a sec. It's been a minute since
Speaker:I've done a little bit of sciencey thing. I already know. I'm just going to
Speaker:say so when we think about what is muscle, it's made
Speaker:up of something called amino acids. And you probably heard that before,
Speaker:like complete proteins and amino acids. Amino acids. Or maybe you take an amino acid
Speaker:supplement or, you know, whatever it might be. So
Speaker:our body is. That's what our muscles are made of. It is also what all
Speaker:proteins are made out of. So when
Speaker:our body also needs amino acids to functions in.
Speaker:In different ways, so they act in different pathways Chemical
Speaker:pathways in our body, they help with blood production. And
Speaker:just literally how you're functioning is all amino acids. So
Speaker:if you're not getting them from the diet, your body will then
Speaker:turn to your muscle stores to get what it needs.
Speaker:And so we have this like needing of calories, needing
Speaker:of just overall energy, and then also these amino acids, it
Speaker:will just break down your muscles to get that. So what we have to do
Speaker:is we have to feed it to our body instead. So you have to get
Speaker:it from the diet and that way you're protecting that muscle as
Speaker:best as possible. Um, and so then hopefully we're
Speaker:gonna turn to those fat for this, that extra energy that you need.
Speaker:When you are on a reduced calorie diet, which is ultimately what
Speaker:somebody who is on a weight loss journey, whatever it is, you need to be
Speaker:on a low, lower calorie diet than what your body expects in a day.
Speaker:That's how you lose weight. Um, now something like bariatric surgery,
Speaker:you're gonna end up on a very low calorie diet early on especially. I
Speaker:mean, I see people in the first couple weeks who are on maybe 800
Speaker:calories a day and you think like, well, aren't they going to starve? Like,
Speaker:no, because they have this excess storage of energy. So your body's going to
Speaker:use that. Same with the weight loss meds, they may not get as low of
Speaker:a calorie deficit because it's not the same process.
Speaker:And so that is really like why protein is so important.
Speaker:And the research, the oldest, like kind of what we've always gone off of
Speaker:the standard has been poor. 0.8 grams of kil of protein per
Speaker:kilogram of body weight. So someone who I'm
Speaker:just gonna use 220 pounds because it's gonna be the easiest math to do. So
Speaker:if somebody is 220 pounds, they would be 100
Speaker:kilograms. And so for them, 80
Speaker:grams of protein would be what we're recommending. 0.8 grams per
Speaker:kilogram. That is kind of like the older
Speaker:stuff. More and more research is showing that that's the, the minimum that you
Speaker:really need. Okay. And then so a lot of people are now
Speaker:recommending more in like the 1 to 1.2. I've seen some people who are
Speaker:doing 1.4 to 1.6. Other factors are going to play into
Speaker:this. Like if you have any other chronic diseases. So we
Speaker:talked in another episode about kidney disease. Like fat is one where you limit protein.
Speaker:So like there are certain times when you're going to limit protein versus having
Speaker:an excess. But for the most part, you're not gonna overdo it.
Speaker:I mean, I don't think anybody out there really needs 200, 400 grams of
Speaker:protein a day. People get it, but I don't. And people recommend that
Speaker:VCI trainers and stuff recommending nourishment advice.
Speaker:I don't think eventually it's just calories. Protein has
Speaker:calories. So it's just, you know, you're getting calories from one place or another.
Speaker:So. And then the other issue with that, that specific
Speaker:calculation, and this is why I use height as a marker, is if somebody has
Speaker:a lot of excess body weight. And so say somebody is now
Speaker:440 pounds, right. So they would
Speaker:be 200 kilograms. Well, now all of a sudden we are recommending,
Speaker:yeah, 200, 250, 300 grams of protein a day. And
Speaker:you just, again, you don't really need that. So I look at what some. I
Speaker:use height to kind of estimate what your lean body mass would be and
Speaker:then do a calculation. Again, it's always quick and dirty. I kind of have
Speaker:ranges that I follow based on height. And again, most people, I say fall
Speaker:between that 70 to 100 gram range. Some people are gonna be a little.
Speaker:I generally don't tell people less than that. You know, maybe my
Speaker:4 foot 11 women, like maybe they need 65 or something like
Speaker:that. But most people are able to get into that kind of at
Speaker:least 70 to 100 range with that.
Speaker:So as we're jumping into, we see that protein
Speaker:foundational fundamental to any diet, period.
Speaker:If you want to be healthy, if you want to lose weight. And
Speaker:that's what we're really going to be talking and focusing on today is
Speaker:spoiler. The secrets to weight loss. And it always kind
Speaker:of starts with nutrition. I would say it's the most important thing, definitely more
Speaker:important than even movements or any of the other things, even
Speaker:sleep, all of it. It all comes down to really just good
Speaker:nutrition. So let's pick it up. So you talked about
Speaker:protein. This is one of the macronutrients. And then backing it up even further, you
Speaker:also mentioned calories. So let's start by like, if it has a
Speaker:label, read a label. How do you that, like break that down really
Speaker:simplistically? Because I feel like the American Dietetics
Speaker:association is constantly like changing the game and like
Speaker:serving sizes, all these different parameters. Yeah, it's kind of funny.
Speaker:So a couple years ago, I mean now it's probably
Speaker:been five or seven years maybe at this Point. And
Speaker:before that they had this whole plan to update the nutrition label.
Speaker:And then it kept getting pushed back because there was
Speaker:just capitalism basically. But corporations
Speaker:were pushing back on not wanting to change the labels on things. And
Speaker:so, you know, it depends on who's in charge and all of that. This is
Speaker:all fda, USDA type things. So like that's where a lot of that came
Speaker:from. But it did get changed finally that that legislation went through.
Speaker:Everyone had to abide by a certain date, whatever that was maybe five or
Speaker:so years ago. And it did change some of the emphasis.
Speaker:It changed serving size. That was a big one. That that changed. Now something that's
Speaker:interesting with serving size and if we're talking about looking at
Speaker:a label, if you have one near you, I can even just. I'm just going
Speaker:to kind of talk through because I kind of know it from the top down
Speaker:into your mid May really is. And I use one, I use one
Speaker:that I show, I share my screen with patients sometimes to walk through it and
Speaker:I have one save, it's USDA and so it's on their website and I just
Speaker:use one of their sample ones. But so the first thing that you do see
Speaker:on that label is going to be a serving size. Now what is a serving
Speaker:size? What does that mean? So what it actually is is
Speaker:what is kind of expected for somebody to eat
Speaker:in one serving. And that's why they changed some of them recently. So
Speaker:a lot of servings got bigger because they saw that on average
Speaker:people more often were eating more than that. So like cereal is a really good
Speaker:example of that. So it was always like a serving of cereal was like
Speaker:2/3 of a cup. No one is eating that. Everyone is eating
Speaker:one to one and a half cups of cereal or whatever it is. So they
Speaker:up, they boosted that to be like again, what you just would expect somebody
Speaker:to eat. They also did on some foods, like a pint of
Speaker:ice cream, for instance, will now tell you what is one serving and then what
Speaker:is the nutrition if you're going to eat the entire container. Yeah, because
Speaker:oftentimes people are eating the whole pint of ice cream. They're not
Speaker:scooping out a serving and having that. So that was one of the differences.
Speaker:So I think sometimes people can get kind of hung up on a serving size
Speaker:of like, either I need to eat exactly that much or I
Speaker:can't eat more than that. Or like it has to just be like
Speaker:that. That it's not really. And especially again when you're looking at
Speaker:somebody who is undergoing like some sort of treatment for obesity.
Speaker:So they've had surgery, they've had their other medications. A lot of times you're probably
Speaker:not. You might not eat a whole serving of something, and that's okay. Like,
Speaker:what it does is it tells you exactly what everything else below it is
Speaker:all just based on that serving size. So if it has a serving size of
Speaker:one cup and it has 10 grams of protein in it, if you only
Speaker:eat half a cup, you would just count 5 grams of protein. So you just
Speaker:have to do the little bit of math. If you're not going to eat the
Speaker:serving size, alternately, if you eat two cups, you're going to get 20 grams of
Speaker:protein, you know, so it just depends on what it is and where you are
Speaker:in your journey. So that's my serving size. Kind of like, thoughts? Okay.
Speaker:Um, so as you go down the nutrition label, the next thing that this change
Speaker:did was it made the calories actually bigger. Right. So it's bigger and
Speaker:bolder. Um, because people eat too many calories in
Speaker:general, in. In the United States, we have just an excess calorie
Speaker:consumption. And so they tried to make it kind of a bigger focus.
Speaker:Really focused too much on calories. I know, because I. So to me, there's just
Speaker:too many things to try to count and do. And if you can keep a
Speaker:couple of things in line, most likely your calories are not gonna be
Speaker:an issue. Like, they're gonna fall in line behind it.
Speaker:And so I wanna say, and especially again with, like, bariatric patients,
Speaker:they're never eating too many calories early on. They're not let
Speaker:later down. Sure. If you kind of let things get away from you, maybe you're
Speaker:overdoing it on calories. And then maybe we have that conversation of like, let's
Speaker:track it and see where you are. And maybe we just need to do like
Speaker:a 10% reduction in calories or something like that. But again, it's not my main
Speaker:focus. So whatever they made a figure, it's there. But when people are so
Speaker:relentless and they're like. And we're like, well, we don't really, you know, we don't
Speaker:really do that. We want you to focus on your grams of protein and these
Speaker:other parameters. And if you do that. But I need my calorie goal
Speaker:again. That has been something that has been so pushed on us. And bigger,
Speaker:bolder letters now on this label. So, like, what do you tell somebody?
Speaker:Like, whether they are post surgery or even on a weight loss
Speaker:medication, I. Mean, there's calculators that you can use to
Speaker:estimate. Again, I will kind of look at like, all right, I don't know. Let's
Speaker:go for first. Actually, a lot of times I'll tell people, trap what you're currently
Speaker:doing and see. So we have a baseline because whether we
Speaker:need to go up from there. Sometimes that's the case. I have people that are
Speaker:getting way too few calories. I'm like, no, you're actually just not eating enough. Um,
Speaker:and then of course, sometimes bracket. Then an app. I
Speaker:mean, we use like very. We have patients who a lot of times who's like,
Speaker:very tastic or old school. My fitness pal, which I think
Speaker:they've taken away, like all their free features. So there's other ones out there.
Speaker:Rheometer, I don't know. There's multiple.
Speaker:If you just search in your app store, you can find it.
Speaker:So that's one way. There's calculators that you can do. There's different.
Speaker:You know, I had to learn all of these, like formulas back in school, like
Speaker:Mifflin St. Jour versus this one. Like, I don't remember any
Speaker:of them because they're very long, complicated things. And there's calculators that you just put
Speaker:in the numbers, but they'll take into account your height, your weight, maybe your age
Speaker:or gender, something like that. So you can do
Speaker:that and then again, kind of based on your goal. So
Speaker:I'm going to go somewhere, jump all over the place here. So your basal metabolic
Speaker:rate. Bmr. Yes, that is the rate. That is the amount of
Speaker:calories that it takes you to just be a human. If you were to
Speaker:just lay still 24 hours a day, existing,
Speaker:that's how many calories you would burn. Okay, so we all have that. So
Speaker:when people talk about their metabolism, that's really what they're talking about, is
Speaker:that phasal metabolic rate. And what we
Speaker:want to do is kind of try to increase that. And this is also where
Speaker:muscle comes into play and protein comes into play. So it's all going to come
Speaker:back to that. Um, so when you say your metabolism is slowed down, it basically
Speaker:just means that you're not burning as many calories at rest. Um, so
Speaker:this is where you mentioned earlier, like exercise or movement is not
Speaker:the big driver of weight loss, because ultimately, if you're exercising,
Speaker:maybe you get an extra 200 calories that you're burning. 300.
Speaker:You know, if you're a really high intensity, a lot, you know, it could be
Speaker:a lot more than that, but most people are not. If they're going for a
Speaker:daily walk, you're not burning a huge amount of calories. So that's not going
Speaker:to be enough to be that like deficit or you can very easily out eat
Speaker:that deficit. So anyway, I
Speaker:feel like I'm like ping ponging here because there's so much to this. No, but
Speaker:anyways, that's important to know. Everybody wants to burn more
Speaker:calories at rest. I want my metabolism to be
Speaker:boosted. Yes. And people really look at all these different
Speaker:functions and how they can do that. They look at their thyroid, they take their
Speaker:labs, they look at. Like you said, your exercise might play. A role, but
Speaker:yeah, I think ultimately it's making sure that you're keeping that,
Speaker:that muscle mass kind of built up. Okay. And yeah,
Speaker:there's no special supplement you can take to boost your metabolism. So stop wasting
Speaker:your money on those like guys. Yes. Just don't worry about them.
Speaker:Okay. So that's calories. So again, if you
Speaker:wanted, we could figure out a calorie goal for you. Okay. Do some math. We
Speaker:kind of see what's going on. But ultimately I think there's better ways to do
Speaker:it. Okay. That are going to be less stressful because, like, who wants to count
Speaker:calories? No, you think you do, but you really don't.
Speaker:It really, like, I don't know, maybe it's me, but I feel like I have
Speaker:never been successful in. Yes, there's these apps and it's very
Speaker:tedious and we talk a lot about that. Working for some and not others. Yeah,
Speaker:it's very tedious and it's really inaccurate. People are really
Speaker:bad at estimating how much they're eating. That's the other thing. Like
Speaker:there's been studies on this that people really just, they think
Speaker:they're doing one thing and they don't. And sometimes that's why tracking can help because
Speaker:it adds a little bit of accountability more than anything. I
Speaker:think I've told this story before, but when I was a
Speaker:freshman or sophomore in college, whatever, I was in my like first intro nutrition
Speaker:class and one of our assignments was we had to track our,
Speaker:our intake for I think it was four days. Like one
Speaker:day had to be a week at. Or something. And this was.
Speaker:I don't even know if like we had. If we use like an app or
Speaker:if we just. I think it was pen and paper kind of thing and we
Speaker:had to do it. And I remember going to the library and there was a
Speaker:little Starbucks in the first floor of the library. Building and I
Speaker:got a Starbucks cookie and like my coffee or whatever.
Speaker:And you know, it was one of those days I was on campus all day
Speaker:and I didn't eat like probably regular meals. I was 19, you know, like just
Speaker:doing whatever 19 year olds do. And I remember that
Speaker:cookie being the highest calorie thing that I ate that day. It
Speaker:was like 400 and something Cal, 50 calories for this cookie. And I was
Speaker:like, I don't think I have since then eaten an entire Starbucks cookie on,
Speaker:on its own. And it's like it shook you. It shook me. But it's almost.
Speaker:And I'm like, it's, it's good for accountability, but also like it's a, what a
Speaker:disordered thing to think about. Like it's just all messed up, right? Like, so it
Speaker:really also really mess you with your head to try to do it. So know
Speaker:thyself, if it works for you, fine. I think it's great. We can
Speaker:figure it out. But don't, don't worry if you don't want to count calories.
Speaker:Yeah. Wow. Okay. So calories is a big one.
Speaker:We're trying to shift the focus away even though everybody else is trying to make
Speaker:it bigger and they wants on there. So the next thing that you're going to
Speaker:come to on the nutrition label is going to be the fat section.
Speaker:So we kind of come to some of our nutrients in this main
Speaker:middle section of your. Of the label. So
Speaker:fats are important. Again, like when we're looking at it, I always
Speaker:take people like they kind of come along for the ride. So fat
Speaker:is going to be found in our protein foods.
Speaker:It's going to be found to be cooked with fat. You know, we use fat
Speaker:for flavor, so that's like going to come into our diet. Even some vegetables
Speaker:and things like avocado for instance, or coconut, like those are going to be higher
Speaker:fat plants and things like that. So
Speaker:I always tell people like, don't stress. Now if you're somebody who does a lot
Speaker:of like keto type things, be cautious with that
Speaker:because the hallmark of a keto diet is actually it's a high fat diet.
Speaker:And so if you're somebody who's grabbing like keto bars or
Speaker:bites or something like that, a lot of times they are crazy high at fat
Speaker:and you just don't need that for, for our purposes,
Speaker:okay. If you're on a true keto diet and that's your thing, like that's your
Speaker:thing, but not what I recommend. So go on. For most people, so
Speaker:Anyway, that's kind of the, the fat. And. And if so, another
Speaker:funny thing. So you know we use Nutri Health, right? Yes. So when all
Speaker:of this legislation came around at around the same time,
Speaker:trans fats were taken out of our food system. You
Speaker:can't add trans fats into the United States, into American food system
Speaker:anymore because they were found to have such negative, negative health outcomes. What?
Speaker:Yes. And so there's something called partially hydrogenated oils, and
Speaker:that's where trans fats were mostly found. They were added to candies. They were
Speaker:added to like margarine. Like, that was how like margarine was originally made.
Speaker:So they are like, like not liquid. They're not as like hard of a solid
Speaker:at room temperature. It's like a whole. It's just a food science thing. Well, they
Speaker:found out, right? These are horrible for us. So in new Tri Health, there's this
Speaker:huge emphasis on trans fats because it happened before, like
Speaker:it came out before this day, 2018. And so people bring up trans
Speaker:fats to me all the time and they're like, yeah, always look on the nutrition
Speaker:label for trans fats. And I'm like, well, you're actually not going to find them
Speaker:on there. Wow. Yeah, you taught me something. I didn't know
Speaker:that. Yeah. So it's just one of those things that they like stepped in and
Speaker:said, hey, this is really bad for us. So. Yeah. Talk about trans saturated,
Speaker:unsaturated. Like, not all fats are the same. Not all fats are the same. So.
Speaker:Right. So the transition fat basically is when the molecule, it's
Speaker:like they're on the same side. Okay. Or no, it's on the opposite
Speaker:side. It's kinked. CY is the same trans opsin. So it's like a kink
Speaker:kind of module molecule. And so it like clogs up your,
Speaker:your. Not your pores, it clogs set up your. Your arteries and stuff like that.
Speaker:So just really bad heart health outcomes. Got it. With trans fats,
Speaker:the place that you can find it is that it naturally occurs. So it.
Speaker:You'll find a little bit of trans fats and foods. But especially if you're like
Speaker:reusing an oil, like a frying oil. So like a fast food french
Speaker:fry or something could potentially have some trans fats in it because they use
Speaker:that oil so much that that process, that transification actually
Speaker:happens. Oh, my God. But they can't add it to the food. I was like,
Speaker:they can replicate it. Can replicate? Yeah, yeah. Raise around it to get it
Speaker:transferred back in yeah, hook it in. That's just a side effect of frying
Speaker:foods. But, but anyway, so then there's
Speaker:saturated fat and that is where like the molecule is saturated with little
Speaker:hydrogens. And, and that again is going to be the thing that kind of clogs
Speaker:you up. And so that is going to be fats that are solid at room
Speaker:temperature. So thinking like butter, lard and coconut oil,
Speaker:that solid fat that you're going to find in animal products. So
Speaker:like really, really fatty meats, chicken skin,
Speaker:that's where you're going to find a lot of that like saturated fat. And that's
Speaker:kind of what we want to minimize. Again, it's not something that I'm like, here's
Speaker:a level that you're going to go for for saturated fat. Don't ever go over
Speaker:it. Keep it to a minimum. If you can swap in an oil for
Speaker:a solid fat, then do that. You know, if you're cooking with
Speaker:something, swap an oil and that's fine. So that's, that's kind of where the
Speaker:unsaturated fat is, is except fats that are liquid at room temperature. So
Speaker:our olive oil, canola oil, vegetable oil, all those things
Speaker:which I'm in a soapbox for a second on those, go for it. I haven't
Speaker:talked enough yet. Everybody online talks about
Speaker:seed oils and toxic seed oil. They're fine, they are
Speaker:safe, they are healthier for you than animal or
Speaker:saturated fats. If there are so many
Speaker:scientific studies that show that if you replace a
Speaker:saturated fat with an unsaturated fat from something like a canola
Speaker:oil, a vegetable oil, rapeseed oil, whatever, there's different, there's a bunch
Speaker:of different ones. They're all very similar neutral oils. You have
Speaker:improvement in heart health outcomes and reduction
Speaker:in death. Like it's literally, it's, it's like the science is just
Speaker:so overwhelming on this and all these social media
Speaker:fear mongerers who are selling some stupid product and
Speaker:want to take your money are going to tell you that you need to
Speaker:use beef tallow instead of vegetable oil. And
Speaker:it's not true. Don't listen to them. And they're not toxic.
Speaker:You know, it's funny, I'm just thinking about what comes on my feed and
Speaker:I've never even heard of what you're saying. Mine's all Luigi Mangione, Britney
Speaker:Spears and her meltdowns, and probably the Kardashians mixed in.
Speaker:Want count yourself lucky I'm not seeing these
Speaker:debates To be fair, I do have a full dietitian
Speaker:Instagram account. And so I follow a lot of, you know,
Speaker:nutrition people and other PhD doctors
Speaker:and things like that who talk about these. Oh, I know. Jessica
Speaker:Knurick. If anybody wants a good nutrition doctor,
Speaker:she's a Ph.D. in nutrition. I love her stuff. Dr. Jessica Knurick.
Speaker:Oh, cool. She's great. And she debunks all of these things
Speaker:eloquently, but she gets a little mad, too. I like it. We love edgy. She
Speaker:doesn't pull her punches. I love that. Yeah. So we try to. We try
Speaker:to do it, too. We try to break down someone. That's not a sense that
Speaker:it exists. All the sense. And it scares the heck out of people. They're like,
Speaker:I can't eat that. It's got toxic seed oils in it.
Speaker:I know. Like write in the chat. If you guys have heard of this toxic
Speaker:seed oil thing. But yeah, okay, so we got that. So that's another macro. There
Speaker:we go. We talked a little bit of talk about proteins, fats, and the different
Speaker:types. Yes. Third type is our next. Our next macro.
Speaker:Now, really quick before we go on to. Because I'm just now thinking through down
Speaker:the label. So we go fats. The next thing is going to be sodium and
Speaker:cholesterol. Okay. Those for my bariatric. That's okay. Why would you know
Speaker:that? I didn't realize my label. Yeah. For my bariatric patients.
Speaker:Again, those are things that I don't focus too much on because your overall intake
Speaker:is going to be so much lower. You're choosing less highly processed foods that are
Speaker:going to have that, like, really high sodium levels. So I don't really worry
Speaker:about it. Same with cholesterol. Cholesterol. They used to always think if you
Speaker:ate more cholesterol, your cholesterol would go up. No, if you eat more saturated fat,
Speaker:your cholesterol goes up. So, like, focus on that. So I don't know. They're
Speaker:there. Look at them. If you have heart problems,
Speaker:focus more on those. But I know. And there was so many things to look
Speaker:at. Totally. And I. I think I completely agree with you about the sodium. And
Speaker:I know that it's controversial. Like, you're a doctor, you. How much
Speaker:sodium should I get? And I'm like, who cares? At. Yeah, that is
Speaker:not the problem. It's not. And for some people. So obviously, like, sodium's issue is
Speaker:that it, like, can raise your blood pressure. And so some people do well with
Speaker:a low sodium diet. If you have high blood pressure but there are some people
Speaker:who have no reaction to sodium. So it doesn't matter if you have high blood
Speaker:pressure or not like, or you have a normal blood pressure and you can eat
Speaker:8,000 milligrams of sodium a day and it doesn't affect you. Like, go on,
Speaker:Queen. I don't know. I know I put
Speaker:ridiculous, probably gross amounts of salt on things.
Speaker:Everything. All good. Okay, so there's these little guys I didn't even remember that they
Speaker:slipped in there. And then. Are we onto the carbs? And this is the
Speaker:absolutely the most confusing section of the whole label. Okay, guys? And
Speaker:so again, if you have one nearby, pull it out, look
Speaker:at it. Whenever I do this, like I said, I'll pull this up and share
Speaker:the screen with patients. I swear I ask like 12 times, like, does that make
Speaker:sense? Does it? Are you. Do you got it? Do. Okay. You understand? Okay. Does
Speaker:that make sense? They probably hate me by the end of it. So it's. Yes,
Speaker:it makes sense. I'm not saying six and it's like, no, but it gets really
Speaker:confusing. It is. So what you're gonna see first is total
Speaker:carbohydrates. I always say that's the quick and dirty
Speaker:carbs. If you have four seconds to look at a nutrition label and you
Speaker:wanna know how many carbs it is, just look at the total carbs. Don't worry
Speaker:about the rest. The rest is all included in that total.
Speaker:So that is going to be inclusive of everything below it. So you'll see total
Speaker:carbohydrates. That it's gonna be indented. So all of those
Speaker:indented things are included. The first thing is going to be dietary fiber.
Speaker:Now, fiber. We love her. She's the best. No one's eating enough
Speaker:fiber. Again, sad American diet. It's real standard American
Speaker:Diet, we call it sad. But no one's getting enough fiber. Like,
Speaker:90% of people aren't meeting fiber needs. And that's
Speaker:not weight loss. That's the full population. Yeah. Let's say
Speaker:it's really hard. So women should be Getting Amy for
Speaker:25, about 25 grams of fiber a day. Men, it's
Speaker:38. 31, it's higher. Maybe it's
Speaker:30. Sorry, Ben, I forgot that it's more than you're getting.
Speaker:I did tell you. Yeah. So this is where
Speaker:that net carb really starts to come into play. So I'll get there,
Speaker:though. So underneath fiber is going to be the total
Speaker:sugars. And this is what really trips people up. A
Speaker:sugar. Sugar is a type of Carbohydrate. So
Speaker:again, if you are trying to figure out what's going on in your diet and
Speaker:you're worried about everything, focus on carbohydrates. And that's gonna take care
Speaker:of the sugar for you because it's counted in that total.
Speaker:So it's total carbohydrates, including fiber, including
Speaker:sugar. Then you're gonna indent again under that sugar and
Speaker:it's gonna say included added sugars. So this is where
Speaker:you may wanna be a little bit more. Just careful with it. But again, it's
Speaker:still gonna be counted in that carb. So there's total sugars.
Speaker:And then of that, how many were added by the food company for whatever
Speaker:purpose, whether it's to make something sweeter, whether it' Whether
Speaker:it's for bulk. Like sugar is used for different things. Obviously, mostly we
Speaker:think of it to. For sweetness or something. Right.
Speaker:And there's going to be times where there's like a gram of added sugar, like
Speaker:spaghetti sauce or something. Okay. There's a gram of added sugar. It's just to
Speaker:balance out the acidity of the tomatoes. Whatever. It's not a huge deal. Now, if
Speaker:you're looking at something like a can of Coke that has 52 grams
Speaker:of added sugars, we're looking at a different story. Um, but it
Speaker:also has 52 grams of carbs. So if you're counting your carbs, you're
Speaker:counting your sugar. See, so that's where we kind of want to minimize that.
Speaker:But what gets people really confused is products that have naturally occurring
Speaker:sugar in them. So something like fruit or a dairy product,
Speaker:those are going to have naturally occurring sugars in them. And I don't want you
Speaker:to be discouraged from having those great types of food in your diet because they
Speaker:have that sugar on the label. Yeah. Again, it's a type of carbohydrate. So if
Speaker:we're counting that carb, you're counting that sugar. Again, if you're looking so yogurt,
Speaker:for instance, look for one that's low in added sugar or no added sugar,
Speaker:but it's still gonna have some sugar in it because it's dairy. So
Speaker:carbs are not all evil. No, they're not
Speaker:all evil. And really, no carb is. No food is evil, I don't think.
Speaker:But, like, you know, everything just has a different purpose
Speaker:and a different value. So
Speaker:then the next thing that would be on that in this last. In this section
Speaker:is the last thing is going to be sugar, alcohols. And so that's.
Speaker:We're gonna find those in things like
Speaker:protein bars or sugar free candies or
Speaker:something that is inherently like a diet food kind of thing.
Speaker:Because basically sugar alcohols are incredibly sweet. And so you
Speaker:use such a small amount of them and like our body doesn't like
Speaker:absorb them that there's no calorie impact
Speaker:from them, but they're counted as a type of carbohydrate, so they're counted
Speaker:in that total. And so you may also see
Speaker:something like it might say erythritol or a different, like different
Speaker:type of sugar. There's different names for them, but sometimes it just says sugar
Speaker:alcohols. So it depends. What I will say on products with those is
Speaker:they're probably going to put the net carb somewhere on the box on the label,
Speaker:because that's a selling point for them. So usually if it has sugar alcohols in
Speaker:it, you don't even need to do the math because they're going to do it
Speaker:for you. Yep. So what is the math? So the math is going to
Speaker:be that total carbohydrates and we're going to subtract out the fiber
Speaker:because again, just like the sugar alcohols, fiber doesn't impact our body like
Speaker:other types of carbohydrates do. It kind of drags everything through.
Speaker:It doesn't spike up our blood sugar like another type of carbohydrate.
Speaker:It's kind of neutral in that sense. So we can subtract it out
Speaker:of that total and not count it towards it. And then same with the
Speaker:sugar alcohols, you subtract those out too. So you would take your total
Speaker:minus your fiber minus any sugar alcohols that might be present. A lot
Speaker:of products that will just be total minus fiber
Speaker:that's going to be in like beans for instance, is a great example.
Speaker:So using that, So a serving of beans has about 15
Speaker:grams of carbohydrates. Hit it. If you were to look at that total carb, it
Speaker:has about 8 grams of fiber. So you would then you do
Speaker:15 minus 8 is 7 grams of net
Speaker:carbs. And that is what you're going to count towards your day. Okay.
Speaker:And so we tell our bariatric patients less than 50 grams of net
Speaker:carbs. And so maybe their total carb is 75
Speaker:and they're getting 25 grams of fiber like they're supposed to be. And so their
Speaker:net is 50. And so that's where, you know, I talk about fiber,
Speaker:high fiber foods. And I think people get scared of them sometimes too because,
Speaker:yeah, like fruit has a Lot of fiber in it. It's got the sugar. Oh
Speaker:my gosh. About the sugar. Okay. It's fine. Beans are another one
Speaker:that, like. Wait, I can eat beans? Like. Yeah, they're amazing for you. They're gonna
Speaker:help you meet that, that fiber goal. Nuts and seeds are another
Speaker:one that have some carb, but a lot of it comes from, I mean, chia
Speaker:seeds, I think all their carb cups from fiber. So like the zero net
Speaker:carb, I guess, food product, whatever it is,
Speaker:Seed. Got it. Yeah. Wow. So. So
Speaker:bariatric patients need less than 50. Yeah. What about
Speaker:other types? I mean, I think that
Speaker:realistically, somewhere in the probably
Speaker:75ish range, it gets gonna just be different
Speaker:based on the person and how. What their goals are and. And how low they
Speaker:can go. Um, I do think activity level can play a
Speaker:role in carb management, even though we don't talk about calories as
Speaker:much when it comes to the activity. But somebody who is exercising
Speaker:more than, you know, an hour at a time, their carb needs are
Speaker:probably higher just to support that exercise, support their recovery type thing.
Speaker:Um, but, you know, I think finding, you know,
Speaker:cutting back on the simple carbs, the starchy foods like we talk about, you
Speaker:know, the rice, potatoes, bread, pasta, peas, corn, if you can kind of
Speaker:avoid or really limit those to a very small portion, focus
Speaker:on getting your. Your protein, focus on getting your non starchy vegetables,
Speaker:getting those higher fiber foods and kind of getting more of your carbs from that,
Speaker:I think is ultimately the thing that really helps people.
Speaker:Yeah, no, I think that. And it makes you feel better. Full
Speaker:fiber obviously helps immensely with constipation,
Speaker:which is a whole nother thing. You know, people ask all the time
Speaker:about what I can do. They take a lot of over the counter
Speaker:remedies, obviously staying more hydrated. But I think the real stable of that is
Speaker:fiber. Fiber. And if you have diarrhea, actually it helps both.
Speaker:So, you know, fiber's magic like that. Yes, it is. Because now
Speaker:there's. We could get into that. We're not going to, but there's two different types
Speaker:of fiber. Oh my gosh. Yeah. So many different categories and
Speaker:subcategories and sub. Sub categories and justice. So, okay,
Speaker:did we nail the label or is there. Well, the last thing on the bottom
Speaker:is protein. So we already talked about it, but it technically comes after the
Speaker:carbohydrates. And luckily you go from the most complicated section to the easiest
Speaker:one, protein. It just says protein and then a number of grams and that's it.
Speaker:Something Else I do tell bariatric patients and I think for most people is really
Speaker:just ignore the percentage column on the right hand side because
Speaker:that's based on that 2000 calorie diet. So again, if you're a bariatric patient, we're
Speaker:gonna be well, well below that threshold. So, like, that percentage doesn't make
Speaker:sense anymore. We're giving you different goals anyway, so you could just really
Speaker:ignore that. That's a great point. You know, like, I don't even think. They should
Speaker:have that because who precisely is gonna be 2,000 calories? Yeah. And
Speaker:like, what, what, what is it based on? What recommendation is that? You
Speaker:know, like, I don't know. I think there's just things you
Speaker:can you just ignore it. And then underneath that there's a section that's got four
Speaker:micronutrients. Ooh, zinc,
Speaker:selenium is iron. I think iron is on there.
Speaker:Vitamin B, calcium. There is a
Speaker:couple. They don't more. I know. They did change that one too.
Speaker:In that label re redesign a couple years ago, they changed
Speaker:which nutrients. I do think iron is on there because like
Speaker:iron deficiency anemia in babies is so common. So they wanted to make sure that
Speaker:like, you're getting high iron foods. Wow. I only know that from being
Speaker:mom. Like, I don't know that from professional. Wow. Not a
Speaker:very true. Yeah, yeah. These labels are used for all types of foods, including dairy
Speaker:foods. Right. And that's. And that's the other thing with them. Like, these are just,
Speaker:it's just information, you know? And so. And that's also where we
Speaker:talk about, like, I don't think any food is evil because different foods are going
Speaker:to serve different people differently. Right. So another example of
Speaker:like a food that most people would be like, oh, that's a bad food. Right.
Speaker:Is Doritos. Okay. Okay. Personally, I love Doritos.
Speaker:They're delicious. The orange ones especially. So kids with cystic
Speaker:fibrosis need high calories and a high
Speaker:sodium diet. And as part of their fake thing, he's like insane
Speaker:number of calories too, but like, it's just high above those. Doritos are an
Speaker:excellent choice for kids with cystic fibrosis. Yeah. I remember, like in
Speaker:my internship, we did a rotation, like a peds rotation. And it was, it was
Speaker:interesting because the clinic did both obesity and CF
Speaker:and they had these very different Hudson goal
Speaker:posts. Yeah. So they were like, okay, well, Doritos on one half of the clinic,
Speaker:no Doritos on the other half. But it was like, yeah. So that is One
Speaker:of the ways that I feel like we don't want to like demonize foods because
Speaker:sure, Doritos for me every single day is not going to be the best choice
Speaker:in my life. But who am I to tell that kid who's got stick
Speaker:fibrosis to not eat his Doritos, right? You know, wow, that is an
Speaker:interesting example. Well, Doritos do have several
Speaker:purposes there. Okay, so mash the label.
Speaker:We talked about really trying to stick for a protein. Fats are coming along
Speaker:for the ride. Trying to want to minimize those net carbs, especially
Speaker:the added sugars, but we don't want to limit the fiber because
Speaker:we do need all of this sort of thing. Okay, so that's kind of
Speaker:a general, high level overview. And when you're talking to somebody,
Speaker:maybe somebody that really hasn't looked at
Speaker:this sort of like breakdown or is not really educated, everybody I
Speaker:think absolutely has some sort of thought about, oh, I know
Speaker:nutrition, I know what works for me. I know my body.
Speaker:I mean, you've been on earth, you've eaten, you know, multiple times a day, every
Speaker:day for every single moment you've been here. So like, how do you even
Speaker:like broach sometimes? Like changing behaviors to
Speaker:kind of try to tell them, like, what, what is it? How do you like
Speaker:kind of go about this? I think for me, like always looking
Speaker:at a current like diet recall is really helpful, even if
Speaker:it's just a snapshot. And people sometimes just, we have like a questionnaire.
Speaker:So when I see them, they've like hopefully have filled out their questionnaire and it
Speaker:will be like, you know, do your normal breakfast, normal lunch, dinner, snacks kind of
Speaker:thing. And some people literally just write varies, varies, varies. And I'm like, I understand
Speaker:it varies. That doesn't help either of us here. I'm going to have to now
Speaker:ask you again these things, which is fine. I don't mind walking through it obviously
Speaker:with somebody. But yes, we know there's going to be variety. But give me some
Speaker:examples of what you might normally eat for breakfast. Give me something. Or if you
Speaker:skip it, give me some examples of what you might normally eat for lunch or
Speaker:what did you have yesterday? You know, whatever it is that works out that
Speaker:gives you that like starting point. Similar to like just how tracking can kind of
Speaker:just give you that baseline of like, where are we starting from?
Speaker:And so I'll go through that and I, it's like, okay, here are the
Speaker:things that you're doing well right now for yourself. Maybe you're coming in and you're
Speaker:really good about eating three meals a day. Great. We don't have to worry about
Speaker:that. We don't have to, you know, focus on, okay, how are we going to
Speaker:add in breakfast always, you know, how are you going to do that?
Speaker:So we'll kind of look at what's, what's going well. And then it's like, okay,
Speaker:well, where are some things that we can start to change? And some people, it's
Speaker:very little, you know, and, and they just have struggled with their weight and it's
Speaker:a metabolic problem. And the surgery, like, they're just, they just need the help.
Speaker:Some people, it's portion and again, surgery really helps with that.
Speaker:But we can talk about pre op. What, what can we do to minimize, you
Speaker:know, to reduce that to an appropriate portion.
Speaker:And a lot of people, it's the high carb, the starchy foods or the fast
Speaker:food, or they're drinking a lot of sodas or whatever it might be. So
Speaker:I kind of go through and say, all right, these are the areas we'll, you
Speaker:know, have that conversation of, like, these are the areas that we, we should start
Speaker:to focus on. And depending on where they are, their journey as
Speaker:well, you know, they've got a couple months before surgery. It's like, okay, well let's
Speaker:take this gradually. If it's not, it's like, all right, these are things you got
Speaker:to kind of work on because you're just not going to be able to do
Speaker:them afterwards. It's not even a matter of wanting to do it. It's just like,
Speaker:you're not going to feel good if you do these things. And so
Speaker:I started to look and say, okay, well, of those things, like, what is the
Speaker:thing that you feel like would be the easiest to make? What's the low hanging
Speaker:fruit right now? I would say sugary drinks
Speaker:tends to be one for people that they're like, oh, you know, I've done it
Speaker:before. I stopped drinking soda three years ago. And then one
Speaker:day, you know, I had one on an airplane or whatever and snapped back
Speaker:to, I'm having four cans of soda a day or whatever it is.
Speaker:It's like, okay, great. Soda is one of the few things that I'm like, just
Speaker:cut it cold turkey. But some people can
Speaker:wean off if they can do it, whatever. Again, however they want to approach that.
Speaker:If they say, I've got a case of my, my soda, I'm going to finish
Speaker:it and I'm going to be done perfect, then you're done with it. Like, be
Speaker:Finished with it. Sometimes it's that weaning off. I'm going to cut down to two
Speaker:a day. I'm going to cut down to one a day like and then have
Speaker:none. Great, if that works for you, that's fine. So kind of that
Speaker:pathway of like, what's that? Okay, what's the. And then once you start
Speaker:to work on that, are you gonna work on two things at once? You wanna
Speaker:work on a couple things like what's the next thing? Okay, we're gonna start cutting
Speaker:back again on the portion of the starchy foods in the diet. We're gonna increase
Speaker:the number of vegetables that we're eating. We're going to, you know, start
Speaker:looking at maybe meal planning or meal prepping on the weekends so that we're
Speaker:reducing the number of times that we're going to through the fast food line,
Speaker:you know, because there's just not a plan in place. So it's really just working
Speaker:on that individually and I think everybody can really do, take stock
Speaker:of themselves and, and do that check like, okay,
Speaker:I'm looking to have my three meals a day, protein at each meal,
Speaker:cutting back on the starchy foods or, or eliminating them kind of
Speaker:depending on, on you and your lifestyle and all of that.
Speaker:What's the thing that I want to tackle? You know, okay, what am I doing?
Speaker:Well, always give yourself that credit. Yeah, I have
Speaker:protein at every meal. A lot of people do that. One is honestly usually
Speaker:especially again lunch and dinner, most people are having some source
Speaker:of protein at those meals. It's pretty standard.
Speaker:Breakfast is always the hit or miss one. But looking at that and
Speaker:then, and kind of doing that, that check of yourself and saying, okay, well what's
Speaker:one thing I could change and do it for two weeks and then I'll go
Speaker:and say, okay, great, now I'm going to start to make the second change and
Speaker:do that for two weeks and then just snowball it that way.
Speaker:Let me ask you some hot takes on a few
Speaker:edgier things. Is Diet
Speaker:Coke, diet sodas good thing, bad thing,
Speaker:neutral? I think they're neutral. I don't, I. All of the research
Speaker:I obviously everybody sees again, this is like another social media. Like it
Speaker:was maybe a year ago now, but some new research came out about aspartame
Speaker:and it was causing, you know, cancer in rats like it always does. And it's
Speaker:like, okay, those rats had an equivalent of like 19 Diet
Speaker:Cokes every day for, you know, six months or
Speaker:whatever. And they're rats, they're not humans and they
Speaker:Got cancer. So don't drink 19 Diet Cokes a
Speaker:day. Maybe if you have one every so often, that's fine. I
Speaker:agree. What do you think about
Speaker:fast food eating? Are there any fast food restaurants that are
Speaker:okay and if so, what would you say are like maybe the top three
Speaker:or if you can't come up with three, maybe the top one? I would say
Speaker:yes. I think that you can fit fast food into your lifestyle and
Speaker:ultimately because I also want people to live in reality. Right. Like live
Speaker:within your. Your actual life. Chick Fil A probably has some
Speaker:good, decent options. Grilled nuggets. They have the little kale side
Speaker:salad. They have other really good salads and things like that.
Speaker:Wendy's with their chili. It's a big, big
Speaker:popular one. Again, they also have some decent salads. I think the other
Speaker:ones you can get like a bunless burger type of thing. Even like the
Speaker:kids meals now you can get them with like the apple slices on the side.
Speaker:So maybe get that instead of like a french fry or whatever it might be.
Speaker:So I think it's more about the choices that you're actually making at each one.
Speaker:Then if you're going like fast casual, like Chipotle is a great option
Speaker:because it's so customizable. Yeah. You can get a salad bowl
Speaker:you can do again if you're not doing starches, get no rice. You can get
Speaker:the beans, you can get the meat, you can get the fajita veggies, the cheese,
Speaker:the guac, like the salsas. All those are great options.
Speaker:So, you know, I would say that's a go to and that
Speaker:style of kind of like food, you know that, that like
Speaker:really customizable counter service. Yeah, there's a lot of
Speaker:places that have that option. You're not going to sell me on Chipotle. I know
Speaker:We go there way too much. I'm like their number one fan. Yeah. Our rewards
Speaker:card is constantly rewarding me. Then that's. That's kind of a.
Speaker:It's V's favorite too. Me and
Speaker:V are really. We're too peas in a pod. We really are. Okay.
Speaker:What do you think about intermittent fasting? Not a fan
Speaker:again. I want you to eat three meals a day. It makes it really difficult.
Speaker:I think people put this like time restricted eating. And again,
Speaker:especially if you're a bariatric person, like patient. I don't want you intermittent fasting.
Speaker:You're just not going to be able to get what you need in that window.
Speaker:I just think you can't. I don't know. I Just don't like not a fan.
Speaker:What would you define intermittent fasting as typically? What is it? I think most
Speaker:people do like a 16 hour fast and an 8 hour eating
Speaker:window. So like maybe you don't eat pill and dude,
Speaker:and then you stop at 8. Okay.
Speaker:There's nothing magic that happens outside of those hours that changes how
Speaker:your body functions with food. And so I think too people get so stuck on
Speaker:it that like again, life happens. Right. So what happens if
Speaker:you're not able to get your meal in before 8pm? Do you just
Speaker:completely skip that and go to bed completely hungry and then the next day you're
Speaker:like, I just, I don't know. There's again, there's already so many restrictions on
Speaker:it. Why are we restricting it by time? The time that I tell people
Speaker:to try to do as best as they can is to be done eating their
Speaker:big meal out two hours before bedtime.
Speaker:And again, if it's something that life happens and it's later than that, don't stress
Speaker:and don't skip that meal, but just try that. It helps to keep you sleeping
Speaker:better. Yeah, I was gonna say, listen to our whole podcast on sleep.
Speaker:That's a great, great episode. And we talk about why that
Speaker:is and how like your metabolism as a, it takes energy and things to
Speaker:digest that food. It makes you hotter. It's hotter when you're hotter, you can't sleep.
Speaker:And then when you're not sleeping, it. Raises a lot of sugar, air levels, all
Speaker:of that. There's a link to that one. Yeah, you're right. There's nothing magical that
Speaker:happens that is. At 8pm or I have people that are, that are
Speaker:night, they're shift workers and they're like, well, I don't really want to eat at
Speaker:night. I'm like, that's when you're awake, that's your day, you know, that's your day.
Speaker:Like shift your day. Like you have to, you have to. So yeah.
Speaker:Okay. You talked about counting calories, accountability, just kind of
Speaker:documenting, logging it. What do you think about like the Weight Watchers point system?
Speaker:You know, I think at its core it's not a bad thing
Speaker:because it simplifies it. It's basically doing calorie counting for
Speaker:you now. I think that it's changed multiple times
Speaker:over the years. I don't know what their structure really is anymore.
Speaker:And I know, I see sometimes they'll pop up on things where I'm like
Speaker:you. I don't know, like on my Facebook again that like nutrition, Facebook,
Speaker:all things Things will come up and it's like, oh, Weight watchers groups,
Speaker:they're like, this is a zero point meal. And I'm like, how is
Speaker:it all? And I understand the idea behind it, but like,
Speaker:I don't know. But I think, I think as a concept and it's been proven
Speaker:that it works. Okay. I think it's, it's got some decent research behind it.
Speaker:Interesting. All right. And let's
Speaker:see here. I have a few others. You
Speaker:talk a lot about, of course, bariatric surgery. We talk about
Speaker:those early post operative periods. What do you think about doing
Speaker:long term protein shakes?
Speaker:Up to one a day is kind of what I tell patients. If you're going
Speaker:to replace a meal with one, I think replace up to one meal a day
Speaker:or do one as like a supplement, like in between. You know, if you
Speaker:need something to help boost your protein, maybe you have a hard time meeting that
Speaker:goal with just food at meals. You can do them. But
Speaker:I don't want, you know, people are like, well, I'll just get a drink. Three
Speaker:protein shakes a day. Be done. Eat food. What do you think about
Speaker:programs like noom? Noom.
Speaker:Oh, gosh, Noom has some kind of negative
Speaker:vibes on like some disordered eating issues. It's kind of like an
Speaker:old school. It felt like they tried to not be that way,
Speaker:but it was like, I don't know, new gives off that, that
Speaker:vibes to me. Yeah. How do you feel? And this
Speaker:is kind of taking a deep turn here about
Speaker:someone who now, you know, a lot of people are saying like adulthood.
Speaker:Obesity of course starts in childhood and it goes into this
Speaker:family dynamic and you obviously have a child
Speaker:now and you can see that it's really hard to control
Speaker:this individual is a little baby's preferences and what they like and what they don't
Speaker:like and all that kind of stuff. Yeah. So how do you feel that
Speaker:this topic of health and good nutrition and balance
Speaker:from a professional registered dietitian, like, how do you introduce
Speaker:it without diet shaming or making
Speaker:somebody feel like, you know, sometimes
Speaker:when people come to see us, they'll say like, I remember being a little girl
Speaker:and going to my first like Weight Watchers meeting and you
Speaker:know, that whole thing like how, how do you do it though? I think that
Speaker:it's, I think that first is really trying
Speaker:to approach especially kids nutrition from like a very weight neutral
Speaker:standpoint. Weight loss isn't appropriate
Speaker:under a certain age because you're, you might try to
Speaker:have no weight gain, no further weight gain kind of thing, but kids are still
Speaker:growing taller. So you try to not, like, necessarily lose
Speaker:weight. Kids are curious. So I think answering their
Speaker:questions, but being, again, taking out those, like, good and bad
Speaker:labels when they talk. And I think that's something that's really hard for people to
Speaker:do because they have that mindset of like, Doritos are bad.
Speaker:You know, like. And it's like, well, no, maybe it's something that we don't have
Speaker:all the time in our house, but it doesn't mean that if you go to
Speaker:your friend's house that they're bad because they have Doritos.
Speaker:So I think really trying to keep it very, like, moral. Food is.
Speaker:Food is amoral. Food has no moral value. So trying to keep that
Speaker:neutrality within it, I think is really important. I've
Speaker:talked about it before, but I always put out Kids Eat in Color as like,
Speaker:one of my favorite nutrition accounts. It is focused completely on
Speaker:kids nutrition. And a lot of what they talk about is just teaching
Speaker:kids what different foods do. So, you know,
Speaker:carbs give us quick energy, protein builds our muscles.
Speaker:You know, red food is good for our heart. You know, what
Speaker:do they. What is the different function in those foods, you know,
Speaker:teaching kids. Okay, if you, you know, say you overate on Halloween
Speaker:candy, how did your stomach feel after that? Did you not feel great?
Speaker:Okay, so maybe next time we won't eat as much candy. But also not
Speaker:saying that again. Candy is bad, right? You have it sometimes.
Speaker:Halloween happens once a year. Like, you know, so I think that it's just finding
Speaker:that good balance in there. There's also things
Speaker:like you can do kind of restriction that they
Speaker:don't notice. So, like for me instance, we're not giving Elena
Speaker:juice. She's. I'm. I'm kicking juice down the line as
Speaker:long as I can. She doesn't need to know that juice exists because it
Speaker:doesn't. She doesn't need it. You know, sure,
Speaker:on her birthday, she had a little. She had a cupcake or she, you know,
Speaker:and had some frosting with it. So she had some added sugar. But other than
Speaker:that, she doesn't get added sugar, and that's okay. I'm not
Speaker:telling her that sugar is bad. She just doesn't really know that it's an
Speaker:option. Yes. I mean, she gets it occasionally it gets snuck in there.
Speaker:I've seen it happen. But, you know, it's. It's very minimal
Speaker:kind of thing. And so it's. It's. Again, it's not putting like a
Speaker:hierarchy on the food but it's just. This is just what we're doing right
Speaker:now. And sure, she's gonna drink juice in the future, and she's gonna
Speaker:have cupcakes, and that's part of life. Um, I
Speaker:don't really like juice, so for me, it's not. But, you know, I just think
Speaker:it's one of those things that, like, kind of control what you can let go
Speaker:of what you can't. And they're going to get a lot of negative
Speaker:messaging in the outside world. So try to not give them negative messaging
Speaker:at home. They're going to get targeted with ads. There's so much
Speaker:advertising to kids when it comes to food. And that's its own
Speaker:separate moral issue. Right. You think of
Speaker:the characters that are sold on kids foods and the bright colors
Speaker:and where do they actually put things on shelves? And that's its
Speaker:own issue. Well, I mean, awesome
Speaker:answer. Very good. So my final
Speaker:question to you, which, I mean, we
Speaker:get this. Every single patient, I would say, almost universally,
Speaker:is overall, like, what is eating going to be like
Speaker:after surgery? I know you talked about kind of, I like food.
Speaker:I culturally need it at this time. I want
Speaker:to participate. This is how I celebrate. This is how I grieve
Speaker:things. I have an emotional connection to it. There's so many different layers that's
Speaker:beyond just eating for substance. How do you
Speaker:feel like, for the most part, life is life from
Speaker:a nutrition standpoint. After bariatric surgery. I tell patients, when they bring
Speaker:that up, like, they're like, okay, what is this? What is. What does it even
Speaker:look like after surgery? I get that question for sure. I'm like, in the
Speaker:long term, the ultimate goal is for you to be on a general,
Speaker:healthful diet, which is very similar to what we
Speaker:recommend. I mean, if you look at the USDA guidelines, it's the plate method of
Speaker:eating. It is getting your protein, it's getting your vegetables,
Speaker:it's getting your, you know, any of your plants in there,
Speaker:it's getting some starchy foods. We're going to reinter. Most likely, we're going to reintroduce
Speaker:those into the diet. It's the thing that we've held back the most is carbs
Speaker:and starchy foods. Eventually, you're going to increase that because you're going to want to
Speaker:stop losing weight. So we look at how do we add those things back in
Speaker:in a way that supports your ongoing goals, which for most people is going to
Speaker:be maintenance of that weight loss. Right. So we want to keep. We want to
Speaker:maintain and Then it also includes some of those, like, fun
Speaker:foods. Like, you're gonna eat birthday cake again, you know,
Speaker:now, Right now, maybe you're gonna eat a piece that's this big or this big
Speaker:or this big. However, maybe you're having a piece that's this big in the future.
Speaker:Yeah. But you're gonna enjoy it. You're gonna have it. You're gonna be a part
Speaker:of the celebration. You're gonna have, you know, Christmas cookies or whatever
Speaker:it might be. Maybe you're not trying every single one, but you're gonna have your
Speaker:favorite one, you know? So I think that ultimately the goal
Speaker:is just to be on a generally healthful diet. And to me,
Speaker:that includes all different types of foods. Yeah, yeah. Life is not
Speaker:over after this fact. It begins. Absolutely. And you're like,
Speaker:I always say, you're cool, you're creative. You get it. Try. You know,
Speaker:I don't want people to feel like they're on a diet forever. No. They
Speaker:just are going to eat like all humans do. Exactly.
Speaker:I think that this will ultimately, there's so many other layers from a goddess
Speaker:olic standpoint and a hormonal standpoint and just really a food noise
Speaker:standpoint. So that changes if you're on a medication that
Speaker:alters that whole kind of process or after
Speaker:surgery, it's the same kind of phenomenon as a little bit more supercharged.
Speaker:But all of those things make it easier in a way that maybe
Speaker:you don't even realize how hard it is and how sometimes unfair it
Speaker:is that you are struggling with this disease and that
Speaker:afterwards it just kind of puts you on a level playing field on how other
Speaker:people think. Like, I might not think about it as much as you do because
Speaker:that's just chemically how I'm wired differently. And
Speaker:so it sets it again. And you're not going to have to be dealing with
Speaker:some of these same kind of difficulties and challenges. Yeah, yeah. And
Speaker:that is definitely the other side. When you have that tool in place, like
Speaker:it sounds, you're like, how is this going to be possible? It's like you just.
Speaker:You can't until you're in it, and you can't fathom it until you're like,
Speaker:oh, that's what they're talking about. Like, my brain is clear from all
Speaker:these other things. Yes, you can do it. You will do it. You will not
Speaker:be the one random soul that is not successful. Everybody is. And we just,
Speaker:like you said, we have to maintain that it's a journey and
Speaker:it's fun and we can make it fun. And if it's not fun, if it's
Speaker:boring or it's redundant, let's change that. Yes, absolutely.
Speaker:No steamed broccoli and unseasoned baked
Speaker:chicken breasts over here. That's all people can see. That's the only visual you get.
Speaker:Ashley likes that. No, no one likes that. It's too dry. It's gonna get
Speaker:stuck. You're gonna be like, this is horrible. So listen, you got a lot of
Speaker:ideas there. You have a lot of different recipes or
Speaker:just I guess that. Yeah, there's so much out there and. And
Speaker:food should still be fun. It should still be enjoyed. There's going to be
Speaker:periods, especially on a surgery journey, where things
Speaker:look a lot different. And it's not saying it's easy, but it's
Speaker:doable. You'll get absolutely. You'll get through it and you'll come out the other
Speaker:side just so much better. Amen. Yep. Cheers.
Speaker:Cheers. All right, well, this was fantastic. I heard a lot of things. So
Speaker:glad I did. I really enjoyed it. And if you're still listening, I hope you
Speaker:loved Anna and everyone knows that you're this hidden gem.
Speaker:Hopefully not hidden, but like a well used, polished gem within our program.
Speaker:This stuff comes back to embodied library. I know. I was like, way back then.
Speaker:I could not have said that. That. That thing always trips me up. Like I
Speaker:cannot remember, like, what trans. I don't need to remember any.
Speaker:Obviously. Unsaturated. I can't remember that. Never.
Speaker:I just always think of it, like, saturated. Like it like saturates your. Your.
Speaker:Your vessels. It's like sticky. Yeah.
Speaker:Unsaturated, is it? Okay, well, fast. They come along
Speaker:for the ride. We all hope that you keep coming. Along for the ride. For
Speaker:the long call. Yes. Here we go. All right, well, you can find us
Speaker:on Instagram at the weightlosscollab. You can find Dr. Dovik at Dr.
Speaker:Dovik. You can find me at Hannah Schuyler.rd. check us out
Speaker:on bodybyberiatrics.com and we'll see you next time. Thanks,
Speaker:guys. Bye.
