Episode #139 How Commitment, Courage, Capability, and Confidence Will Help You Lose Weight with Guest: Dr. Nikita Shah

In this episode of Conquer Your Weight, Dr. Sarah Stombaugh sits down with Dr. Nikita Shah, a family and obesity medicine physician in Orlando, Florida, to explore the “4 C’s” of effective obesity treatment: Commitment, Courage, Capability, and Confidence.

Dr. Shah shares how these four pillars can transform the treatment of obesity and metabolic disease by shifting the focus from short-term fixes to sustainable, empowering care. In this episode, you’ll learn:

• Why commitment is the essential first step in any weight loss journey
• How to foster courage to face challenges and overcome setbacks
• What capability really means—and how it grows with support and practice
• Why building confidence is key to long-term success

Whether you're navigating your own weight loss journey or supporting others in theirs, this episode offers a powerful, practical framework for lasting change.

Tune in now to learn how the 4 C’s can reshape your approach to obesity care.

Are you in Orlando, Florida? Visit http://weight-sense.com to learn more about Dr. Nikita Shah and get started with your weight loss journey. 

Dr. Sarah Stombaugh is enrolling patients now for in-person visits in Charlottesville, Virginia and for telemedicine visits for patients in Illinois, Tennessee, or Virginia. Learn more and get started today at www.sarahstombaughmd.com

Transcript

Dr. Sarah Stombaugh:

This is Dr. Sarah Stambaugh, and you are listening to the Conquer Your Weight Podcast.

Announcer:

Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stambaugh.

Dr. Sarah Stombaugh:

Hello everyone and welcome to this week's episode of the Conquer Your Weight podcast. I'm really excited to bring in a guest and a really good friend of mine, Dr. Nikita Shah. I think she and I have been meaning to do a podcast episode together for a long time and so it's really fun to sit down today and share our thoughts with you. I think one of my favorite things about Dr. Shah, she has a background very similar to mine. She's a family medicine physician as well as trained in obesity medicine. She is also a certified life coach and so when we think about the approach to medical weight loss, supporting patients with their metabolic disease. There is often this medical component that we're considering, but then also all of the lifestyle piece and what are some of the motivational tools that we utilize to help support our patients and give them that framework. And so today we are talking about the four C's. I will let her dive in, explain some of that to us. But first of all, welcome Dr. Shah. Thank you so much for joining us. I'm excited to have you here today.

Dr. Nikita Shah:

Thank you for having me. I'm Nikita Shah. I'm an obesity medicine physician in Orlando, Florida. And like yourself, I just love obesity medicine and helping people make sensible choices to support health, to support weight loss in a way that makes sense for them and to improve their health and well-being. Amazing.

Dr. Sarah Stombaugh:

Well, tell me about the four C's and this is a framework that you use with a lot of your patients and I'm familiar with these and we use some of these principles in my practice, but I don't think as the structured way that you might. So tell me about the four C's and how they apply to the weight loss journey.

Dr. Nikita Shah:

Okay. So I didn't create this, but this is the four C's and it's actually a business principle that's under Dan Sullivan's, uh, framework. So I'm going to give him all the credit, but I'm going to apply it from not from business, but actually within weight loss and medicine. So the four C's are commitment, courage, capability, and confidence. And when we are trying to lose weight, I think the first step of commitment, that's really your foundation. And when you are committing to the weight loss process, I think that it's important for people to recognize that this is a journey. This doesn't happen overnight. You don't drop it like it's hot. there's going to be ups and downs and seasons. And with these seasons, there's gonna be things that work, things that don't work, things go haywire. But I think while you're working with your medical team, this commitment is important and there's ultimately the commitment to yourself. So there's many commitments that need to happen, but certainly around our lifestyle and our choice to support ourselves to improve our health and wellbeing. Commitment is important because this is different from motivation. Often, I think you and I both hear, oh, I don't feel motivated to do something. Motivation fades. You're not going to feel motivated most of the time. Initially, when we're on a journey, we can feel motivation, but it comes and goes. But that commitment, that your commitment to yourself matters. And I think your commitment to your health matters. And that's the foundation for weight loss. The next C is courage. I think courage in the weight loss standpoint or the weight loss framework is just the courage to ask for help. I, I myself know that I did not grow up in an environment where nutrition, physical activity, movement, all of these things were well explained to me or understood or modeled. And even as a physician, even as an obesity as an expert, I still need help. And so we have to, we all have human brains. myself included. And so we need, we need to have the courage within us to ask for help. Courage also comes up because we have to change. And so if we're thinking about food and our social experiences and the enjoyment food brings, or the people that bring us there, the people we spend our time with, if we're trying to change our health and our habits, sometimes those same things that we do may not serve us anymore. So we have to feel encouraged. courageous enough to change our social dynamics, courageous enough to maybe not participate in food-centered social pressures. And then we have to feel courageous to ask our medical professionals, mental health counselors, therapists, dieticians, physical personal trainers, exercise physiologists for help too. So there's like this whole pool and knowledge base of people And sometimes we don't ask for help because we think we should know how to do it, but we actually don't. And sometimes somebody else can actually get us there. So that's the courage part. Capability is building the skills. You know, every single day, do you know the statistic, like how many decisions we have to make in a day?

Dr. Sarah Stombaugh:

It's tens of thousands or something. It's many. Or like our thoughts and our decisions are so many.

Dr. Nikita Shah: 

There's so many. And once upon a time, I like to go back to knowing how to tie our shoes. I don't know if you remember what it was like when we were three or four years old learning how to tie our shoes. I very distinctly remember, actually. I had to sit there and make those bunny ears and figure it out probably a bajillion times. That is the same thing with weight loss and building the skills. We don't just overnight... learn how to navigate restaurants or social situations or food environments. We don't learn overnight how to exercise or how to like still exercise when life gets hard. We don't understand how to manage our periods and like all the cravings associated with our menstrual cycle or when we lose sleep or how to choose not to have ice cream every single night. Like those are all skills we have to develop and it takes time and practice. And so that's that third C of capability. And at the end comes confidence. So I'm sure in your first patient encounter, just like mine, a lot of people tie their weight to confidence and they say, I want to feel confident. But I think the bigger thing is, is not just confidence of what you feel, but building confidence that you're done with the yo-yo and you can make small, consistent choices, learn to finally trust your body's hunger and satiety signals, know how to navigate the ups and downs. And so that's why I think these four principles from the business world actually apply to health and wellbeing.

Dr. Sarah Stombaugh:

I love this. And the way we know each other is actually through a physician business program. And I think one of the things that I am so fascinated by is we learn all of these principles in the context of growing our private medical practices or other businesses that other people may have. You and I, of course, are both in private practice. And I learn and see these things from business and then seeing that play over, honestly, in many areas of life, but seeing it play over in the context of health, in the context of weight and how we can apply it to our patients is awesome. Let's dive into some of these different pieces. Actually, let's start at the end with confidence because I think one of the things I see really frequently in my practice is that patients don't have confidence and even they're excited, they're anticipatory, they're ready to get started, but there's so much trepidation a lot of times because this isn't, you know, rarely is this their first weight loss journey. You on through different programs. They've been on Weight Watchers. They've been on numerous different exercise programs. I have patients who've had bariatric surgery before, maybe have used other or even like GLP medications and they come in and they're in front of me and they're not confident in their journey. And so tell me a little bit when that happens in your practice, how do you help your patients to build their confidence?

Dr. Nikita Shah:

I think the first thing is you're a whole person. We're going to figure this out. Number one. And number two, none of that was wasted efforts. Like actually I love it when there's been multiple serial attempts at trying to figure something out because what's different is in the past. I think there's been this whiplash of like, try a, then try B and then try C. However, if we can, I think as physicians and obesity medicine doctors, we're We know that there is a common thread through all of those diet experiences, exercise experiences, and we can kind of tease that out. So building confidence is more like, hey, I'm glad you've gone through this. I mean, it sucks, but I'm happy because we actually have a couple of clues and we can piece that together to get your next footing right. But this time, instead of trying to go from, Like I always use that ladder analogy, like instead of trying to go from the bottom rung on the ladder and go all the way to the top, let's just go to the next step. But when we're physicians and obesity medicine specialists, we're trying to say, let's also use medical interventions. And so with that analogy, it's like, let's just get you to the next rung. I know we need to get you to the top. So we know that it's likely going to require 30 minutes to one hour of cardiovascular activity in a day. We also know that it's going to require at least on minimum two strength training sessions a week to keep your muscle mass. We also know that we need a 500 calorie deficit. That's all data. 

And it just kind of sounds like into play, but if we just say, okay, you've done all of this, let's put you back to ground level and let's just take the next step. And every time we're going to progressively just pull you up the ladder while using medical tools. because our medical tools are the things that'll help us with hunger, satiety, fullness, reduce those cravings. And we can use them in a way to help people progress up the ladder. And so that confidence I think is just saying, hey, we're going to focus on helping you with your health and wellbeing, but I want you to start helping you understand that we can get through this journey. And I think part of the confidence also comes with like how much weight loss So I believe in my practice, we need to have like realistic expectations. So instead of telling someone you need to get to a quote unquote, normal BMI, perhaps that's not really an appropriate standard. So, you know, 10, 15, 20% total body weight loss with a target of X timeframe. And then we just say, all right, we're here to prioritize our health. It's not really only about weight. Weight's one part of it. But if you're picking a good breakfast, a good lunch, you're not eating fast food or processed food, I think we can all agree that you're probably much healthier. And so confidence, I think, comes from the small, consistent things, learning to trust yourself and your abilities, and knowing that maybe it's not all about weight. It's actually probably about having the stamina and energy to run around with your kids, have less knee pain, go on vacation, go hiking, and kind of live life. So it's usually the first thing that I'm trying to paint for my patients.

Dr. Sarah Stombaugh: 

Yeah. And I think it's really important because I see that the confidence develops over time. And so early on, you know, I heard you say we, we, we, and that's exactly it. It's you and your patient. It's me and my patient. It's this collaborative effort where over the experience of having worked with many other patients with similar journeys, seeing that, okay, this is absolutely possible. And I have full confidence that you as the patient are capable of this. And so let's walk along this together. And like, I, I will have the confidence and I will help you grow your confidence alongside of that because I, you know, this journey so often is done alone. And when you look at past weight loss attempts, sometimes that was the missing piece was that ongoing support or accountability or someone who, when a day was challenging or when there was a result that wasn't desirable, helping to reorient that mindset. And so I think that togetherness approach that you're describing is, is so important there.

Dr. Nikita Shah: 

Yeah. Yeah, you summarized it quite well.

Dr. Sarah Stombaugh: 

Yeah, I love that. Tell me, so coming back to the very beginning then with the commitment, what I often see is that this is the crux to like finally figuring it out. Like a lot of times people will have this expectation. You know, they've had attempts before, they've had successes before, and maybe seen weight regain for a variety of reasons. But sometimes patients will have this very clear moment to them of, oh my gosh, it becomes... you know, I've had a major medical event or I've had an experience where I'm recognizing, you know, I can't get down on the ground and play with my children or my grandchildren. Maybe I'm looking at a joint replacement surgery and in just some sort of way, my body is not functioning for me in the way that I want it to. I find a lot of times that there's this really powerful why and that getting clear on that can help give some of the motivation, um, And I guess motivation is the wrong word, but give that decision towards the importance of the commitment.

Dr. Nikita Shah:

Yes, that gives that purpose. So it's when we know our why. So you and I know that we can't control the scale. Like we actually know a couple of clues that may help, but we can't make your weight go down. We just have like some guiding light. towards what may work, but that commitment to the process of let me improve my health, my wellbeing, let me learn, let me see if I can feel better. And I think the, if we just uncouple like feeling well and feeling healthy from the weight, I think that's monumental as well. So usually when I meet my patients, they'll tell me why they want to lose weight. And it actually has nothing to do with the numerical value on the scale. It is energy. It is, energy and being able to function, move, just feel better, sleep better. And a lot of those things don't actually amount to needing to lose 50, 60, 80 pounds. Sometimes even 10, 20 pounds will do it. Sometimes you don't need to lose anyway. We just change your lifestyle and body composition. You feel good. So that commitment to health, and then also commitment to knowing that Even if the number doesn't budge, we know that our habits and our health are improving. And sometimes that is also okay.

Dr. Sarah Stombaugh: 

Well, that commitment to really challenging times where you've hit a plateau or things have stepped back, right? And seeing what can I learn from this? How is this part of the journey? Are things continuing from here versus reevaluating? As you said, what are those other pieces, those non-scale victories, and continually assessing those? Okay, that's amazing. I think... I want to say also highlight what you said about motivation is not required because I found myself talking about motivation. And I think that comes into that same motivation and willpower fall into a very similar trap as one another, that they sound like a good thing and they can be. And they're not required. And it's usually when we're basing our journey on something like motivation, there's this waxing and waning that when things are going well, I'm feeling more motivated. When I'm not seeing the movement on the scale, I'm feeling less motivated. And it can sort of spiral then out of control where we feel we sort of lost our motivation, to put that in air quotes. And so I wanted to highlight that because I think that was one of the most important things you said there.

Dr. Nikita Shah:

Yeah. we are just not going to motivate all the time. And that's just human life. And we won't always have it, but I guarantee you many of the times people make it, make it to work on time. They pay their bills on time. They get, they get many things done, even if they don't want to. And that's that same type of discipline that we need. We need the discipline to make sure we make time and prioritize our the key factors and pillars of our health and wellbeing, which do involve around our food choices, our self-care, our movement, our sleep, even hydration. Those are the bare necessities. So we have to be disciplined and committed enough to our health to make sure we develop the skills to make these things happen. Simple as filling up a water bottle. Like I think you talk about hydration with many of our medications, especially with the side effects of constipation. And it's like, All we had to do is just start practicing, like filling up the water bottle and drinking the water. And that commitment alone to staying hydrated will help us in the long run, but it seems so small.

Dr. Sarah Stombaugh:

Yeah, but it builds up, right? And it's this cumulative effect of all of these type of things to where, you know, I think one of the favorite things I see in my practice is that someone has been in a really good routine and it's sort of stepwise layered on these different things where they're really maybe emphasizing, okay, I'm going to incorporate protein into each meal or I'm going to work on my water or I'm going to work on, you know, walking every day and they sort of build up these things one after another until all of these things are happening. And then something totally crazy happens in their life. They have a work stressor, they have the loss of a loved one, they have a move, they have another financial challenge. And at the times where things could previously maybe get really off the rails, what has been really powerful for me to see is how often some of these habits stay in place. They've become the new routine despite the chaos that may be thrown. And certainly that's not always the case, but when we can take this this building, that consistent effort alongside then the courage of, hey, I'm going to do this thing. It's powerful.

Dr. Nikita Shah:

1,000%. And I think that's just practicing that skill allows you the flexibility to pivot when stuff is just hard. So when it's hard, that's when we want to be prepared. And you're a new minimum baseline. So sometimes I'll ask people in a typical office setting, at work or if you're working from home i think um many people have smart watches that track their steps and i usually see it's around 3 000 steps and then well let's try to get you to 5 000 that's just a 15 minute extra walk and once people hit that 5 000 then they start noticing okay i can actually do 7 500 we try to go from 3 000 10 000 that's really really hard because you haven't figured enough but what i love is that when people have um face challenges. They're like, no, Dr. Shah, make sure I get my walk-in. Like, this is very important for me. And I hear that a lot. And that's awesome because what's the one exercise that you can do at any time? It's walking. And what's the one thing you're going to be really happy you can do when you're 95, 90, 100? Walking. Yeah.

Dr. Sarah Stombaugh:

Yeah. And longevity data, right? Like the people who are living to 95, 100 years old. And especially, you know, I think about my primary care practice before I was in this space. And when I would see the little old 90 year old ladies, the one thing they all had in common was they walked every single day. That was such a priority for them. And so I think about that both in the context of my own life, honestly, but then also in the context of my patients and how do we support the behaviors that again, aren't just targeting a number on the scale, but are really thinking about the quality of your life as well.

Dr. Nikita Shah:

Yeah. So that commitment to figuring out that commitment to doing it, even when it's hard and the commitment to maybe I just do it for the health of it and not just the number on the scale, because we often hear like, oh, I was exercising and I didn't lose weight. So I stopped. I was eating while I didn't lose weight. I stopped. Well, let's continue. But maybe we just need to add on other medical interventions to help you change that point, help the biology and then help you lose weight.

Dr. Sarah Stombaugh:

Absolutely. Well, especially, you know, as we're thinking about exercise, some of those exercises drive up hunger, you know, where we're walking, we're burning more calories. And, you know, I think one of the interesting things we think about principles like calories in calories out, and that is both like so angrily oversimplified, right? You know, when patients are told to eat less and move more, it's like, oh my gosh, that is like, Not like that is this tiny, tiny piece of the picture. And it's so much more complex than that. And so how do we, you know, help? But one of the things that's challenging and that is true is that if our body is moving more, our body is going to ask for more food. It's going to ask for more energy. And so, yeah. working through when my body is moving more, when I'm doing exercise more, recognizing that hunger may increase with that. How do we then learn to reconnect with our body in a way that allows us to fuel it rather than to sort of beat ourselves up or to use that exercise maybe in a punishment way. And then we're just ravenous and hungry afterwards.

Dr. Nikita Shah:

Yeah. And I think this comes with asking for help. And then also just like understanding what your body is asking and then maybe undoing some of that diet mentality because if you're actually hungry and you need your protein and your plants, then I, um, I imagine your body is quite wise and likely trying to build some muscle. So maybe if you're seeing the scale go up, um, when we check your weight, perhaps you underneath the surface have actually put muscle on, improved your body composition. And I think that's part of the commitment. It's like staying on path and, uh, building that skill set. So it's just ever evolving, like knowing that things are going well, because I can't imagine if you're exercising, walking, um, eating a healthful diet that underneath the surface, things may like, things are going awry, like a strain. It was probably not pretty good. And we can do, we can figure that out in office and see what, what is actually happening. And then if there's anything to tweak, um, so maybe the way you're eating isn't is an ideal for your goal of weight loss. And then we can help you or refer you to a dietitian that can help you, but there's so many tools. So I think, so we have to keep trying and working through.

Dr. Sarah Stombaugh:

On that body composition piece, and we think about the number on the scale being this miniscule part of it, you know, sometimes that takes the forefront, but we think about what makes that up, our body fat mass versus our muscle mass, certainly all many other components as well. But we see these other shifts. And so often encouraging, even just looking for the non-scale victories of waist circumference or how my clothing is fitting, or maybe how I fit in a space like in an airplane seat or a theater seat or something like that. And we see, you know, even And as you were saying earlier, even if the number on the scale is the same or maybe going up, that there may be a shift in body size going downwards and then improve in function with it. I love that. Yeah. Tell me about this capability piece a little bit more, because I think this is so challenging to in the space of. social media, in the space of people who maybe have decades of experience of going on diets, there's a capability and then learning which tools to use. So tell me a little bit more how you walk your patients through that piece of it or how that might come up in your clinic.

Dr. Nikita Shah:

Yeah, in the easiest sense, I usually kind of get an understanding of what skills someone has when we're talking to them and then matching the next skill and progression. So depending on what pillar we're working on. So if it's exercise, you know, have you worked with a trainer before? Do you know your way around the gym or is walking enough right now? Because there's so many little skills that go into everything. So I think first is the assessment with food. Do you know, do you go grocery shopping? Do you order your food? Do you know how to prepare your food? Doing a quick assessment of what skills are there and then building from that. So for one individual, they may not be the person responsible for preparing their meals and perhaps they're dining out more often. I think the next step from that is maybe instead of ordering a restaurant or takeout food, perhaps we get you connected to a meal delivery system, knowing that we're putting a placeholder here so that you have the chance to work on one meal at a time and building that up. So there's so many skills that we have to learn to improve our health and well-being But they can be learned. And that's the cool thing is like, just if someone else can do it, so can you. Well, and you talked about this progression. Yeah.

Dr. Sarah Stombaugh:

Which is exactly it. You know, so often people are like, oh, let me... You know, you said that ladder example, which is such a good analogy of if you're in the first rung of the ladder and you're trying to get to the top of the ladder, you cannot jump to the top of the ladder. Like there's nothing you can do to jump. I mean, maybe like Michael Jordan, I don't know, like some basketball player could jump all the way up to the top and grab the top rung of the ladder. But the reality is we like move rung by rung and it's this building process of where are you now? And then where do we... really nudge you in the direction of your goals and help to support in that progress and building on one skill set after another over time. I

Dr. Nikita Shah:

use food as a good example here. So my household, I was, luckily my mom always had me in the kitchen helping her, but when we got to medical training, I never had to cook because food was always in the hospital. The hospital wanted you there. So they gave you food. So then I didn't have to do groceries. I didn't have to do that. I just had to eat what the hospital created. And that came with a lot of weight gain. And then I graduated from residency, went into private practice. There was no food around. So I had to relearn how to actually take my lunch with me, how to actually wake up in time to have breakfast. It took a while, but it was doable. And now I think we talk about years, correct? Like college and medical training and residency, years of somebody else preparing my food. Even though I had the skills to know how to navigate the kitchen, I had to still bring it in and learn, okay, this is what I'm going to prepare for myself for breakfast. This is what I'll do for lunch. This is what makes sense for myself and my family after work and then dinner. And then you throw a husband in there and kids and their preferences because nobody wants to eat the same way. They're still evolving skills. And everybody has something different that they like. So even with food, it's like maybe just walking through it with your doctor, dietitian, somebody else. Like perhaps the simplest solution is like my family, it's a food bar method because nobody I'm not going to make 10 things, but we can make sure all the components of the meal are together so that everyone can grab what they like. So my household, when it's pasta night, You'd have my protein pasta for me, gluten-free variety from grandma, and then the regular pasta for the kids. But we make sure there's protein, veggies, and everyone kind of builds. And I think that's that skill piece of knowing what works for you, your family, your day-to-day life. But it takes time to reflect on that, overcome the obstacles, and come up with a plan. So this is really not easy to do overnight. This is a progression.

Dr. Sarah Stombaugh:

Absolutely. And I love your food bar thing. We do, I call it making bowls, but we also will often have a sort of buffet arrangement where I'll know which kids' preferences or which things and... How do we eat from sort of the same base meal with a variation for the individuals in the household? And that can be amazing for people who live in community with others, particularly when you have a family, particularly when you have children who may have really particular preferences. So it's amazing to be able to build that type of skill set. I think there's an identity that comes with it too, in terms of what am I capable of? I was just reflecting on one of my patients I saw yesterday. We've only been working together for a few months. And she has this identity of, like, I don't cook. And... The fascinating thing is that she's actually been learning how to cook over the last couple of months. She lives by herself. She's cooking for one. And she showed me a picture of a dinner she had prepared in her air fryer. And she had broccoli on one side and chicken on the other side. And she showed me this plate of the most beautifully roasted chicken and broccoli. And she's like, oh, look what I had for dinner last night. Who made that? She did. And then two minutes later, she's telling me about how she doesn't cook. And I'm like, whoa, whoa, whoa, whoa, whoa. I think you actually proved that you are starting to do this. And so even thinking about what are the words that we tell ourselves, but we are and are not capable of and seeing that identity shift can be really powerful as well, because we, a lot of times have belief systems about How we show up in the kitchen, how we show up in the gym, how we show up in different areas of our lives. And like, I'm not someone who works out or I'm not someone who likes to get sweaty and recognizing that it may be worth starting to question those and rebuild the identity.

Dr. Nikita Shah:

Yeah. Common one I hear is I'm a picky eater. And then my tool as of a food list, I say, well, please just circle food from these groups, vegetables, fruits, grains. And, you know, usually people will find four or five things in each category or three to four, depending on the category that they do enjoy. I say, okay, you're not a picky eater at all. There, there is variation and stuff that you like. We just have to synthesize it in a way that makes sense for you and that you like, and you want to include. So this is your grocery list. These are the foods you like. These are the foods you like to eat. Let's just put them all together. And like it clicks. Because you're not picky. You just like things you enjoy. And then over time, perhaps you'll want to try other things.

Dr. Sarah Stombaugh:

I love that example because I also run into that a lot. And we have these belief systems that may be very limiting. And as you said, most people are still eating healthy. even if there's 20 food items across all food groups that they would eat, if you think about all the different combination of those, thinking about one particular patient, I used to do grocery store visits and that was one of my favorite things early in my practice. I don't really have the bandwidth for that now. But I would meet a patient in a grocery store and we would just walk through their favorite grocery store and what were some of the different options. And this patient was like, I don't know, Dr. Stombaugh, I'm super picky. I don't eat very many things at all. I hate fruit. I hate vegetables. I'm like, I hate all fruit and vegetables. There has to be a couple that you like. And she started with carrots and apples and a couple of berries maybe. And it was amazing. We've been working together for a couple of years now That list has actually evolved over time because she's like, what if I try just this one time, I'll just try this. So I think there is a, um, an openness to it too. And when I think of the capability, like, am I someone who's capable of trying new things? Am I open to that as well? Okay. So good. I love, I love this. Well, tell me Dr. Shah, as we are thinking about this conversation, is there anything we haven't yet had a chance to talk about that you think is really important for my audience to know?

Dr. Nikita Shah: 

You know, I think another, so we were talking about like the skills with exercise and food, but then there's also this emotional regulation piece that comes in with handling stress and then not using food to cope with said stress. So I know that you and I both also touch on that in our practices as well, but food is a source of joy for some people. So if you are an emotional eater and you eat for enjoyment, finding other things you enjoy can be helpful. Another skill can be like when you've had a bad day, we know that the foods, I always just go to ice cream because I love ice cream, but it's like ice cream isn't going to solve the problem and just bringing awareness around that. So the first time that you decide you've had a stressful day or a day that sucked or sad, mad, angry, insert sad emotion. If you've been noticing that you tend to gravitate towards ice cream or your food choice, the first time you break away from that, it's pretty empowering because now you know that you can actually just sit with that emotion or solve for the emotion without food. And I think that's another skill. So all in all, I think our conversation today is just like, there's a million things that go into managing our weight and skills that are required. And it's not just cutting dry as like take a medication, have 500 less calories a day and exercise so much more to it. That is very important.

Dr. Sarah Stombaugh:

Yeah, when it's a skill set that is personalized, it's a skill set that's evolving. And I especially get worried, you know, when I think about the context of my practice or your practice and how comprehensively we support patients and just makes me worried, maybe isn't the right word, but sad for the patients for whom maybe they get these medications online or sort of an afterthought where they get medications without a lot of support and they're craving the rest of it. You know, they are desiring to have that additional level of support and accountability. And so when you can get that, it can be really life-changing. that's something I wish everybody had. And so certainly seeing a physician who's certified in obesity medicine is a really great resource. You can find those on the ABOM. They have a physician finder tool. And then tell us, you are in Florida. So if patients are interested in working with you, how can they do that?

Dr. Nikita Shah:

Yeah, so my practice is in Orlando and you can visit weight-sense.com to learn more about me and contact my practice to schedule an appointment.

Dr. Sarah Stombaugh:

Amazing. And you're online as well. And so some good resources there. We'll make sure to link all of that in the show notes. So especially if there's any listeners who are in the Florida area, you could absolutely go see Dr. Nikita Shah. Thank you so much for joining us today. This has been a really powerful conversation.

Dr. Nikita Shah:

Yeah. And it is Friday when we're recording this. So this is the highlight of my day so far.

Dr. Sarah Stombaugh:

Yeah, me too. It's the end of the day. This is the last thing I'm doing on Friday. We're getting ready to go enjoy the weekend. So thank you for joining us. And to all my listeners, thank you so much for joining us for today's episode. We will see you all next time.