Ep 118: How to help our children form a healthy relationship with food? With Charlene Lichtash, MD Obesity specialist

Happy New Year! To bring in the new year, this weeks Ask Dr Jessica talks to Dr. Charlene Lichtash, a board-certified internal medicine resident who specializes in obesity medicine and metabolic health, discusses strategies for raising children with a healthy relationship with food.  Dr. Lichtash advises parents to teach their children to differentiate between whole and processed foods and to focus on replacing rather than restricting foods.  She emphasizes the importance of understanding the underlying issues that may drive children to misuse food. Dr. Lichtash also provides tips and guidance on how to help younger children develop a healthy relationship with food.

Dr Lichtash 

To find out more about Dr Lichtash her website is www.drlichtash.com. She founded her clinic with the purpose of bringing a comprehensive solution to weight-related issues. She works with her patients one-on-one and help them heal both their physical and emotional hunger, correct any metabolic disease caused by hormonal drivers of weight, and help remove the burden of weight-related concerns. Dr Lichtash's work is deep and individualized. 

Takeaways

• Understanding the health consequences of obesity 
• Teaching children to differentiate between whole and processed foods can help them make healthier choices.
• Creating a positive and unemotional language around food is important for developing a healthy relationship with food.
• Misusing food can be a sign that a child is feeling unresolved or incongruent in some way.

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.

Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.

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The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Transcript

Unknown: 0:00

Hi everybody I'm Dr. Jessica Hochman, paediatrician, and mom of three. On this podcast I like to talk about various paediatric health topics, sharing my knowledge not only as a doctor, but also as a parent. Ultimately, my hope is that when it comes to your children's health, you feel more confident, worry less, and enjoy your parenting experience as much as possible. Hi, everybody. Welcome back to Ask Dr. Jessica. I hope you all had a wonderful New Year's. I really like New Year's personally, I like taking the time to reflect on the year before. I also really like thinking about fresh starts and new beginnings. So speaking of new beginnings today to kick off the first podcast episode of 2024. I am talking to an obesity specialist Dr. Charlene lift Tosh. So I know that as parents, we all want to raise healthy children. And a big part of that is raising children who have a healthy relationship with food. So I'm excited to introduce you to Dr. Charlene. She's an amazing resource. And today we're going to talk all about how we can teach our children to not only be healthy eaters, but also how we can help them have a normative relationship with food. And before we get started, I would like to remind you that you can help support ask Dr. Jessica by subscribing to the podcast by leaving a five star review. And also by sharing the podcast with friends. Dr. Schilling, thank you so much for coming on the podcast, I'm so excited to talk to you. Thank you, thank you for having me. I'm really excited to be here. Also, can you explain to people listening what you do for work? Sure. So I am board certified in internal medicine, and I have a specialty in obesity medicine. So most of my practice was as a primary care physician and a hospitalist. But in 2020, I started this clinic, which I sort of consider my passion project, where I focus on treating people who have obesity, or overweight, diabetes, or pre diabetes or any other metabolic diseases, you know, as a primary care in hospitals, Medic medicine doctor, I was taking care of many of the consequences of metabolic disease like type two diabetes, and high cholesterol and high blood pressure. And now in my clinic, I'm focusing on reversal and prevention of this disease. And for our kids, in particular, for their success. In life in and around having a normative relationship and simple relationship with food. We need to really understand for ourselves, what we are trying to develop in our kids and why we're trying to develop that for our kid, you know, about one in five kids has obesity in the United States. And so imagine what that means for the consequences. And what that what that ultimately can cause the children, as adults, and later in life, when they're just, you know, when they get faced with all of the consequences that quietly developed as they were children. I'm thinking probably a lot of people can relate to me. But what I worry about is I want to teach my kids how to be healthy eaters, and to eat when they're hungry. And I know myself when I'm stressed, I'm admittedly pulled to the freezer, looking for ice cream. And I know that's not the best habit. And I'm sure in your experience, you notice that there's a lot of psychology involved in eating and habits. So for parents that are listening, can you give some strategies to help us encourage our kids to make the best nutritious, nutritious choices without causing stress and anxiety around eating? Yeah, so first of all, in response to what you just mentioned, I think it's very important to understand and accept the truth about food, which is that it brings us joy brings us a sense of physical joy. And denying that is not healthy either. So it's important not to have any magical thinking when it comes to food. And one of the things that we can do to ground our children in the truth is to really teach them that we can separate the universe of food between whole and end, processed foods. And specifically with processed foods. I'm referring to the processed carbohydrates. So processed carbohydrates are like pasta and cereal and rice and bread and, you know, I put those in the processed category, and to teach them that you you can put metaphorical glasses on and see the universe of food between whole unprocessed because our our kids minds are inherently unencumbered by the concern about over eating and body weight. But these things these narratives these harmful beliefs around food and narratives around food and bodyweight they develop when we begin with untruths that we implant In our children that we give our children and we feed them when they're when they're young. So are you saying that as parents, we should be avoiding those foods, those processed foods entirely? I think the first step is to really teach the kids how to separate between the universe of foods a whole unprocessed, and then to understand ourselves as parents, that we don't have clear satiety centres for processed carbohydrates. So for us, let's think, you know, if you think about your favourite whole food, there is a point at which your body reaches this threshold threshold of fullness. And then there is no more joy to be had in that food. Like, for example, if you were to eat steak, and you love steak, and you're eating this delectable piece of steak, you know, if you're being asked to eat a second one, after you're finished with the first one, how would you feel it would feel almost intolerable to do that for you. Yet, if you had a cake brought out at that same time, you'd probably find room for it. So really being clear in ourselves that our bodies don't have a satiety centre for the processed carbohydrates. So it would be more of a lie to say to ourselves or to our children, that, you know, you just don't have the willpower and to blame ourselves and to develop those narratives about, you know, that are rooted in self blame and shame around food in our bodies, where the truth is that it's not about willpower, it's just about our biology, we don't have a satiety centre for the processed carbs, and therefore, we shouldn't be expected to use them for our fullness. And so we need to start with that as our premise, when we're deciding what our kids are going to eat. How can parents educate them? How can parents educate themselves? Exactly what is the difference between processed and unprocessed foods? I make it really, really simple, especially with kids, I tell them listen, if it came from nature, then you can eat it. So meaning it didn't come from the earth, or did it come from an animal, then you can have it, if it that if it had to go to a factory before you ate it, then consider it more of a fake food. And so you can have some, you know, the volume of the language and the tone that we use around those types of food. They're not alarmist they're dispassionate, you can use it for your joy sometimes when you need it. But really, our bodies thrive on the foods that come from nature, and to give our kids the confidence and ownership to be able to differentiate between foods that came from nature and fake foods. There are fake foods, and then there are real foods, and sort of to make it that simple. If it's factory produced, it's a fake food. If it came from the earth or from an animal, then it's a whole food and it belongs in in my body, my body evolved or was created to eat those things. Okay, no, and I think I think this is true with my kids. What I say to them is the foods you want to think about eating the most are foods that come from the ground. And if you lead if you lead by eating with foods that come from the ground is really hard to get into trouble with weight, because I hear some parents that will caution their kids from having too much fruit, for example. And my line to that is I've never seen a kid obese from having too much fruit. I think also what some of the language that you just mentioned is so important. Because a lot of times our tendency is to try to restrict our kids and to put like clear lines around what they can or cannot eat. But one of the things that we should do to create healthy relationship with food and our own in our narrative that is healthy and positive around food and light and unemotional is to really allow them to understand how they can replace foods rather than restrict foods. One of the most kind of simple examples is, you know, my kids were at my sister's house and she had Oreo cookies, and they wanted some and Oreo cookies. They're the most highly processed foods, right? Like what what part of that is whole. But replacing that dessert with maybe an ice cream that is very simple and has real whole ingredients like cream and eggs and sugar and knowing that they are good at being able to identify what is more processed and what is less processed and knowing within what they're eating, what is processed and what is not not in a way that's extreme. Just to give them a little bit of that inner voice so they understand, you know what belongs in their body. And what is more just for Little bit of joy. But, you know, the joy runs out at some point. And they can use it once in a while. But it's not what is nourishing them. I tried to teach my kids when we go out for ice cream, now want to get a larger size. And I explained to them think about when you taste the ice cream, the best bites are the beginning bites, the first few bites always taste the best. And you'll notice that as time goes on, and you eat more ice cream, it's not as enjoyable. And so I'm trying to teach them to be in touch with their hunger cues and their tastebuds because I'm hoping that bringing awareness to that will help them want to consume less. And I think that if you were a parent that was restricting, and telling them and overriding that voice by giving them a bunch of narratives that feel like they are less or are incapable of finish, you know, of being able to, to moderate what how much they're eating, and you put all those additional layers in their mind, then that, that sets them up for those narratives that then override that sense of joy that they get when they're eating, meaning they're not really eating for joy, they don't really get the sense of joy, and then feel like they can move on. They always feel like what many of my patients told me is, I can never get satisfied with food, I just I start and I can never stop. And so giving them that very quiet confidence that they can listen to themselves, that we're not restricting that we're just understanding that there are certain foods that are meant in our to be in our bodies, that give us a joy that are also, you know, that are also healthy. And then there are some foods that like once in a while it's fine. But whenever the joy runs out, you decide and then you can stop. I think the educational piece is so important with how parents talk to their kids, because I agree with you Whole Foods in an ideal world are the best and less processed foods fantastic. But the reality is when you take your kids out and about in the real world, there is processed food, everywhere you look birthday parties, school functions, friends, houses, relatives, houses, it's really everywhere. And so I think the only way to really get around that is for kids to have the education so that they're more empowered to make better decisions for their bodies. It's a slow process that doesn't feel so top down feels inside out for the child. Like they have these tools, they have this frame of reference. And so when you give that to the kids over time, and you teach them really like, you know, if you're hungry, here's an avocado, there's an avocado on the refrigerator, why don't you just open that up and you can just enjoy that that there doesn't have to be this monumental event or this monumental, you know, reaction every time that they're hungry, they can actually enjoy Whole Foods without feeling like they're, they need to expect another accompanying, you know, processed carbohydrate with it. It sets them up for healthy habits for life. And, you know, one of the central goals that we have is and common goals that we have as parents is to raise kids who are confident, who trust themselves or independent thinkers. And it really means fostering over time, this development of an inner voice that strong and with respect to food, it's allowing the child to hear and be directed by their innate hunger signals. However, uncomfortable that may be for us as as the parents, you know, when it comes to food, it's a sacrifice that we should make, I think as parents to give the kids the authority, even to refuse an invitation to food when they're when they're not hungry. Because we're giving them the opportunity to you know, eat when they're hungry and to stop and to decide when they want to stop during a meal. I think something I had to learn over time was it's okay not to finish my plate, it's okay to throw food away. So I just think really, as you mentioned, tuning into your hunger cues, being okay stopping knowing that it's okay if you have to throw food away. It really is ultimately better for you. I think that's one of the most common narratives that I hear from patients who are adults who have struggled with, you know, yo yo dieting and have been through every weight loss programme before they come to see me which is often the case. And we really need to work on removing those narratives because being wasteful or you know, any other xpect question that you put on food that food cannot necessarily are any function that you place on food that food really can't produce, you know, for example, food is not meant to carry the burden of me not being wasteful. It's only there, you know, to give me a sense of satisfaction of my hunger and some joy. And so people carry narratives that so far depart from those truths about food. And that those narratives tend to override that inner voice, and that that mindfulness around eating so that when they're adults, they really need to work on removing all those messages. So wouldn't it be so much better if we didn't have to impart those things to our children and, you know, create that complication when they're young. And nobody's perfect. We all create, we all carry narratives into our adulthood. But it's really important to simplify our relationship with food, and our bodies and not have such a loud volume or loud voice in her head. It's constantly ruminating around, you know, narratives, false narratives that we have around food. So I'm just I'm just curious, you treat patients that are obese, when you talk to them. I'm so curious the psychological relationship they have with food? Can you explain to people listening, what are the most common incorrect narratives, as you explained? Because I think that'll help parents as we raise our kids so that we don't repeat the same mistakes? So maybe, can you? Can you explain what you would view as mistakes so that we don't repeat these narratives to our children? I think one of the biggest mistakes and I think like one of the headlines that I can put on that is the amount of anxiety that there is around food. And I think that, you know, some some, some parents are really afraid that their kids are moving in the wrong direction in terms of their weight, some are worried that they're not eating enough, and maybe they're too picky. The amount of stress that we place on food is very unhealthy. And it's it's very bad messaging to children, are we in our country don't have a big problem with malnutrition, we need to be confident that our kids can be nutritionally replete if they listen to their own hunger signals. And so I think one of the biggest sort of headlines to what you're asking me is, there is a lot of there are many, many narratives. Everybody has their own individual, what I call emotional hunger narratives that really drive their expectation for more joy out of food and food can truly give them and they're, they're good, it can be grouped with sort of the understanding that they stem and are rooted in a sense of anxiety around food, you know, oh, I'm hungry, I feel panicked without even maybe even thinking. Consciously, they're subconsciously feeling panicked. Oh, no, what if I can't find enough food to make me fool? Or what if, you know what if I start eating, and then I start eating, you know, the wrong kinds of foods, then that makes me a failure. And I'll never really gonna, I'm never really going to kick this problem. So people a lot of times, say they start out the day, feeling very confident, like they can do it. And once they start eating, it feels like it's snowballs. But it snowballs, with a level of anxiety. And with a list of narratives that tends to be very individual for, for every person that I mean, it seems similar to any kind of addiction, where once you start, it's hard to stop. Yeah. So addiction, it's, you know, what is addiction? It's basically I mean, one of the ways you can think about it is starting with some sort of bad feeling, right? It's this, you know, amorphous, nebulous, bad feeling, and then finding a pathway to suppressing or silencing that feeling for a minute, using something that is completely incapable of dealing with the root cause of that problem. And so what happens with food a lot of times is that people start with all these, you know, concerns about whether or not they'll ever be successful with a diet and will they ever be able to lose this weight and things like that, and they're rooted in a lot of other you know, quote unquote bad feelings. And they essentially turn to a pathway of emotional hunger to suppress those feelings. But what happens at the end of every type of addiction, whether it's a shopping or food, or you know, it doesn't matter what type of addiction, they have drugs, they end up always at a dead end, none of the initial, you know, none of the initial root bad feelings were ever dealt with. In fact, there were compounded. Now with all the other ramifications of using their, you know, their vehicle for addiction. I noticed for a lot of families with a stress round eating seems to have an uptick is when they start to notice their child gets a little bit overweight. And once they noticed the weight percentiles, or they see a little bit of you know, adipose tissue on the body, they get nervous, and then they start talking about it more. And then I don't know if talking about it more actually helps a situation. So what advice would you give for a family where they start to notice that their child, you know, is starting to gain more weight than might be healthy. I think it's very important not to put that on the child. Because remember, the child is not only born with a simple relationship with their hunger, they're also born with a very simple relationship with their bodies. And complicating that relationship by putting this concern in the child will only backfire. It's only going to create a much more complicated relationship with food where they start blaming themselves and feeling lesser than and feeling like there's something wrong with their bodies. Whereas it really isn't that there's something wrong with their bodies. It's really that we're giving them fake foods and expecting them to respond normally to that. And what happens is their hunger because it goes from something that is, you know, something they can trust, to keep them healthy, to something that is very erratic. And so fixing the erratic hunger signals, is incredibly important. But as parents, we need to do that quietly. So what we need to do at home is to really start replacing the processed foods with real foods, and then resetting their hunger signals. And we do that we can do that, as adults. So, so much more, we can do that with children, without the added complexity psychologically around food, and their body weight that we're going to create if we put the onus on them. And then they feel lesser than as a result, I find a lot of parents don't want to disappoint their kids. So for example, in the annual checkups, I talked about eating habits often. And some parents will tell me I know, we eat too much, you know, in and out, or fast food or donuts, but my child is used to it, and they'll be disappointed if I take it away. So for example, this week, I had a conversation with a family where their child goes to soccer. And they made it a habit that at the end of soccer practice, one of the parents brings doughnuts for everybody. And they don't want to tell their child, you can't have doughnuts and all your other friends that play soccer or having doughnuts. So they're in a little bit of a bind, where they don't want their child to feel different. What advice would you give to a family like that in that situation, but there aren't a lot of those events in the child's like week, or, you know, month, that really count like that do not really counts for that child, at the end of the soccer game. It's this joy that they're really looking forward to. And, and, and that isn't the problem. The problem is everything else around it. So I would not tell my child that can't have the donut, I would ensure what we were talking about before, that I'm creating this sort of lens that my child looks at food through that they understand that sometimes the donut is joyful, and it is and it's, it's a truth, just like you said, sometimes we want ice cream. And, and that's okay. And that's, you know, that's the only role that that plays in our life that don't it only plays the role of joy in a kid's life. Nothing else. It doesn't make them full, it doesn't do anything else for them. And so I wouldn't per separate on the donor, I would work on doing a philosophical change within the household. I even think sometimes, you know, one of the things that I recommend is play a game with your kids. Tell them you know, what are processed foods, what are fake foods or Whole Foods, or when they're looking at the dinner table where what here is whole what here's processed, you know, and so that they really get that sort of language going. So that the donor is not something that's really going to make them have a high BMI at the end of the day. But it's everything else and their mentality around Food, because those small experiences like I wasn't able to eat the donut when everybody else in my soccer game was or my soccer team was able to have the donut, those, you better believe those are things that children remember as adults that truly influence how they perceive their bodies, how they perceive themselves and the relationship that they have with food. Whereas they'll never remember that you chose not to go to in and out, instead, you chose to go to, I don't know, one of the other whole food type, you know, restaurants where they could eat, you know, some chicken and quinoa, you know, they'll never remember that. But they'll remember that you told them that they can have the doughnut with their friends. I mean, honestly, what I was thinking is, I wonder about talking to the other parents about changing a culture, why not bring some delicious cut up fresh fruit? Why do they have to get doughnuts after soccer practice? That is such a good point. We I totally agree with that. The culture needs to shift I think a lot of in Los Angeles, particularly a lot of that culture has shifted, but there's so much more work to be done. And I also find parents are so they're afraid to disappoint their children. They'll say to me, but they're used to, you know, they like Chick fil A, they like in and out. They like McDonald's. And they're afraid to change course, I guess what I'm trying to say is I think parents are too afraid to say no to their kids sometimes. And it's at the detriment of their kids health, ultimately. And I think parents need to take a look at themselves and be introspective and ask why they're afraid of doing that. Because children are so resilient. They can develop new habits very easily. Whereas really, it's us adults, maybe we're feeling insecure about something, or maybe we are worried about, you know, disappointing or not being good parents or creating any kind of, you know, narratives in our children. But really, it's not about food, don't put it on food, food can't really carry that burden, right. And I distinguish it between having kids feel hungry, and having them try a different option. Because I think a lot of parents worry that their children will be hungry. So they want to give them foods that aren't healthy options just to see them eat. But I do think that there are so many foods available that are delicious, and tasty and satisfying, that are whole foods. So I just want to say that to parents listening that there, there is a way to provide ample wonderful foods to kids. And I think ultimately, by providing those healthier options, you're doing them a favour in the long run, because you're helping them cultivate better habits for when they're an adult. Definitely like, I can give you an example in my own household, my daughter last night, wanted something sweet. And I don't really keep those you know, I try not to keep I'm never perfect, but I try not to keep those processed desserts in my house. And so she made herself a smoothie. She's seven years old. And she took some raspberries, almond, almond, water, ice and a banana. And she made a smoothie. And she made it for her sisters also. And they enjoy and there was nothing. There's there's no when there's no complexity around it. When there's no sense of like I'm restricting you or I'm I'm, you know telling you you're bad or incapable I don't trust you. Then the child learns to function within the Whole Foods universe. We provide it for them. Charlene if I'm hearing your right it sounds like last night you want it the parenting game last night last night. I think I did. Yeah. Not only did she make a healthy meal, but she did it on her own. And she shared with her siblings. Yes, she shared with her siblings. Congratulations. Thank you. Okay, so can you tell parents I'd love to hear what are some practical tips that parents can take from today's talk that they can implement in their own home. So I know we talked about having less anxiety, having good whole food options in the house having good conversations around food. Is there any other tips that you can offer parents to foster healthy eating in the household? I think having a I would say having a very positive language around food is important. It doesn't just need to be that you're you know that the emphasis on food is low because I think the emphasis on eating and food needs to be low our bodies are going to eat when we're hungry and they won't eat you know, naturally we won't eat when we're not hungry. But also guiding them towards finding the foods that they like that are with In the whole foods category and in a positive way, not in a punitive way, or in a way that we're that is imparting concern and anxiety and worry. Absolutely. And I also think eating together, eating with other people or eating as a family makes a difference. I find a lot of people who are obese when you talk to them, they eat a lot in secret, they eat a lot in private. And so I think encouraging people to do it together, it's so much more fun when you eat together. So I don't know, you know, in your experience, if you find that with your patients, but I think really encouraging families to eat as a as a unit, not only does that create memories, but I think ultimately, it's healthier. I think it's healthier. I think also, one of the things to think about is why do people like to eat in quiet or in private, it's because they develop so much shame around food, so that they can't, there's just too much of there's too much noise. One of my patients calls it monkey chatter. There's too much monkey chatter when they're eating, especially when they're eating around other people, because then they feel judged, or they feel like you know, someone's watching them get the second helpings of apple pie. Exactly, exactly. So creating, what happens when you're eating together is you're just creating a light and positive relationship with food. And everybody models that at the table, there's no restriction and why and what how you didn't finish all your food and you didn't, you know, there's people starving in other countries and you're, you know, you're you're not finishing your plate, you know, all those narratives need to be put aside. And there needs to be a very just simple and positive relationship with food that we foster in our kids. I think also, there's a lot to say, for being good role models, you tend to want to copy people's actions rather than words. So I think if you're a parent that tells your kid all the time, eat healthier and make better choices that may fall on deaf ears. But better I think is to model for your kids. Show them how you cut up healthy fruits and vegetables, how you prepare healthy, balanced meals be a role model. And I think that goes a long way. Definitely children pick up the messaging that's quiet that subtle, in our in the way that we behave in the way that we see food the way that we relate to our own body. So without too much pressure on the parent, we also need to have model healthy behaviours. Also. Can you share with parents? Are there any warning signs that they should be aware of before they get into a place with really bad habits around food? So I, I think an answer to your question. Children naturally develop some sense of self consciousness as they as they grow older, and they compare themselves with other children. And they can develop sort of unhealthy habits where they can direct their anxieties. And one of the things that I think parents should be aware of is that a lot of times when kids are misusing food, it's really because there's something within them, that is feeling unresolved. And so what I would recommend is that when you see your kids are starting to kind of go in that direction, of overeating, or of you know, hiding food, or of misusing food in any way to really focus on getting to know your child and asking them, you know more about what is inside of their core, what, what is inside of their identity that feels this like sense of incongruence where they're directing their attention into this type of negative behaviour. Does that make sense? Yes, I'm just thinking like, practically speaking my seven year old, I don't know that she would give me that deep of an answer. I know, she will just say I want the candy. Right. So I think when it comes to a younger child like and, you know, a seven year old, it is a truth about candy that I get brings brings them joy. But I think that the red flags can develop later on, where children start sensing that there's something wrong with them or with their bodies, or with their relationship with food. And then it converts or it leads to them misusing food, in order to sort of self soothe or give themselves a sense of comfort and really getting to focus on who my child is and what is their need. That they're sort of directing their anxiety into food. That's where the real crux of the solution lies. Okay, so tell families if they want to talk to you and they want to get go It comes from you, where can they find you? So you can visit my website, Dr. Lifts tosh.com You can call my office or you can email me. For more information on how we can work together. My practice is very much geared towards a relationship with my patients. I am committed to my patients when they come to me, they I'm committed to their success. So for parents who want to come to speak with me for some consultation or advice on their children, they can set up appointments to see me or any adults who are dealing with these issues, who've gone through the gamut of weight loss programmes and really want to work on clearing both their physical and emotional hunger. They can just reach me through the website or call my office. Thank you so much, Dr. Charlene lift Tosh, thank you so much for coming on. And I appreciate all of your advice. Thank you so much, Jessica. It was really a pleasure. Thank you for listening, and I hope you enjoyed this week's episode of Ask Dr. Jessica. Also, if you could take a moment and leave a five star review wherever it is you listen to podcasts, I would greatly appreciate it. It really makes a difference to help this podcast grow. You can also follow me on Instagram at ask Dr. Jessica See you next Monday.