Episode 19 - Feeling Your Best in Midlife

Dr. Heather Awad is a family physician on a mission to help professional women in the midlife transition feel their absolute best.

Check out this episode for practical tips, as well as Dr. Awad's personal story of how she got started.

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Transcript

0:08

Welcome to the PurposefulMD Podcast. As a physician, you've sacrificed so much of your life for other people. Your patients, your family, your friends, and your colleagues. What would it feel like to spend time doing what you enjoy, and to live without guilt? I'm your host, Dr. Laura Suttin, a family physician, certified coach and business owner. If you're a medical professional on a journey towards your most purposeful life, a life with more time and energy and ultimately more joy, then this is the podcast for you. Before we get to today's episode, I have some exciting news that my book is now available for pre order. The book is called the purposeful MD creating the life you love without guilt. I'm really excited. This book is designed for physicians and all medical professionals to Really get back more time and energy in your life. It's very practical with exercises and journaling prompts. I'm really excited to bring this into the world. It's available for pre order today. Go to thepurposefulmd.com/book to pre order your book. It will be published October the 1st. So that's thepurposefulmd.com/book to pre order. Welcome to the purposeful MD podcast. I'm really excited to have our guest today, Dr. Heather Awad. Dr. Awad is a family doctor and certified coach who helps professional women at midlife and beyond lose weight for the last time without medication so they can live in the body they want. She hosts the vibrant menopause podcast where she discusses weight loss, women's health, and food. Dr. Awad, thanks so much for being on today. Thanks for having me. Yeah. So good to talk to you. So I know we've chatted a little bit and I've listened to your podcast and looked at your website. So I know a little bit about your story, but I, I think it's really inspiring. So tell us how you got interested in this topic. Tell us a little bit about your backgrounds and how you got to where you are today. Sure. Well, the reason I'm so passionate about this work is I, um, was a family doctor for many years and was always kind of a food as medicine doctor. So if you came in and said, you know, and we found out your cholesterol was high, I would say, well, let's talk about what you eat for lunch. So I was always trying to help people have healthy eating. And then with not changing anything that I did at all, all of a sudden my mid forties, the number on the scale just started to go up and up. I actually, in fact, I didn't even weigh myself. I just noticed that my clothes were getting tight. And then I, then I got a scale. Um, And so I tried some of the things that worked before when I was younger, when I'd had a baby and, and none of these things worked and the number just kept going up and up. So I tried some diets, which generally made me feel terrible or hungry. And so I hated those. And they didn't really work. I did finally try an app based diet and I worked super hard for six months and lost a bunch of weight. And then when it was over, I rebounded even higher. So at 50, I was just devastated because. My weight was definitely in an unhealthy range and all of a sudden it just kind of hit me that, you know, okay, I'm, this is perimenopause, this is menopause transition, there's gotta be, you know, a secret to this. So I, I dove into the research and found out how our drop in estrogen and how that changes with, um, The interaction of our food with our digestive hormones and insulin resistance that pops up a little higher. Um, and then I also went and got some coaching because it turned out I was eating a lot of my feelings. Um, when I was 30, it didn't have a big difference on my weight, but at 50, it definitely did. So I put those two things together for myself, lost 27 pounds and felt really confident that. You know, it wasn't going to come back, but then I decided, you know what, this would be a great thing to bring to people because there wasn't a lot of good information about menopause weight loss at the time. So I, that is my work. Now I help people, you know, eat well for their menopause body and lose weight, uh, at this time. Yeah. And I love that you said that about it's eating well and losing weight. And I'm curious your perspective too, because I imagine for maybe not everybody is interested in losing weight, but everybody would want to feel better and just feel more like themselves. And so I'm curious your thoughts on that too. If it's weight loss might happen, but it might not happen, but let's get you feeling better anyway. Right, right. There's a lot of inflammatory food in our general, um, world of food. Um, we all eat more refined sugar than is good for us. Um, a lot of the things that we think are good, like whole wheat bread, ends up, That it turns out that a lot of those flours are really inflammatory and highly processed. So even when we think we're eating healthy foods, um, you know, sometimes we're ending with a lot up with a lot of inflammation and a lot of insulin and blood sugar spikes, and we don't feel well, like we think, Oh, I'm getting achy and creaky cause I'm 49. But actually if you, you know, move refined sugar, you know, if you eat it less often, like you have it once or twice a week for dessert, but you're not having it every day all the time. And you don't have as much ultra processed food, then all of a sudden, you know, a number of my clients just say, you know, my joints are actually totally fine. I don't have any pain anymore. I didn't know that it was what I was eating. And then also we're looking forward, right? You know, you get to late 40s, early 50s, and you start to notice your parents health, your aunts and uncles health, and you think, what is in my future? And so, um, maybe the processed meats on the charcuterie board, you know, you look at those and they're fun and they taste good and they actually are just fine for weight loss, but they increase our risk of heart disease and cancer. And at 50, when you're looking forward, you, you know, who has cancer in the family and you think, Oh, well, maybe I don't want that because I'd like to optimize my health at this point going forward. So I definitely, you know, have a lot of those kinds of discussions with clients. Yeah. I mean, we're in the age of now cancer screenings, mammograms for women and colonoscopies and all of the different cancer screenings. And so we definitely have this kind of new awareness of, yeah, these are the things that could happen. And like you said, watching our relatives who are getting older and, and who are sometimes struggling with some of these conditions and joint pain and, and even for ourselves, I, I, I gave up gluten about three years ago. And I, all I can think now is, well, how much better would I have felt all those years of my life? If I had given up gluten 20 years before it was just one of those things where I just felt like you said, achy and creaky, and I just felt old. And I thought, I wonder what's going on here. So I, I, I gave it up and I, within probably a few days, I noticed a big difference. And every once in a while I'll eat something that doesn't I don't intend to, that has gluten in it. There's so much hidden, hidden gluten. It's just crazy. Yeah. Luckily now restaurants are becoming more, um, just aware of it. And like, even, so I live in south Texas, so tortilla chips are everywhere. Okay. But a lot of restaurants will fry their chips in the same fryer as their bake, their, you know, breaded, whatever. And so there's flour in there. So it's, it's just interesting. How all these, these things are ubiquitous and we have to just really be careful about what might be causing inflammation with us. Right. And sometimes things are worth it to you anyway. Like, you know, I, you know, I mostly don't eat sugar, but you know, if we make pie, I want to have pie or sometimes, you know, I want to a good cookie. Um, so you can still have those things, but even just cutting to a, what actually on a health scale would be called a reasonable amount really makes a difference. Yeah. Yeah, for sure. So when, when you're starting to work with, with somebody in your coaching practice, what's, what are some of the things, and I've looked at your website and just really very thorough what it looks like, what you do with your clients. What are some of the first things that you will work with your clients on what, like, where do you start if somebody's coming to you and they're, they're in their fifties and they're tired all the time and, and brain fog and weight gain and trouble sleeping, where, what's the, where do you start with them? We do start with this with refined sugar and ultra processed food. Um, and take a break from it, uh, totally for a short amount of time. And the reason is, is that if you're going to take a total break, then you have to read every package that's in your cupboard. I found out that I had sugar in my, one of my taco seasonings. And like I said, if I want sugar, I want a piece of pie. I do, I don't want sugar in my taco. I don't, I don't need it there. Um, so looking at all of that, you know, I had a client who found sugar in her can of chickpeas, which I thought that's. Hadn't seen that, but, but she had that. So noticing all that kind of stuff really helps. So we start there. Um, and then we just start talking about what food do you like to eat? Um, you know, and, and looking at meals and making sure that there's protein in your meals, because that's super important at the menopause transition. Making sure you have vegetables or berries at all your meals is very important at the menopause transition. And then having some healthy fats. And I mostly bring that up because a lot of people in the midlife world, you know, grew up in the eighties. And even though we can intellectually say, no, I know that fat is not bad and, and we made it a devil and it is not bad, actually. Um, we still all know that a gram of it has more calories than a gram of something else. And, um, You know, I try to teach people that calories are not so much math in your menopause body anymore. So, um, you need to have some fat in there for nourishment, for health and, you know, a lot, the protein and the fat help you stay satisfied. Yeah. Yeah. I it's so interesting. I don't know if there's a time capsule where we could look back at the food pyramid of the eighties, but I feel like I remember that the base of it was like bread and rice and cereals and, you know, all these things that just, we know are, can be very inflammatory because of all the processed wheat and grains and sugar and everything that goes into them. And so, yeah, I think. Retraining people in their midlife that fat, a little bit of fat is okay. As long as. You know, we're going to try to do more of the good fats, of course, then the, then the saturated fats, but kind of retraining us with fewer carbs, more proteins, more fat. I think is, is just a, it's an interesting. It's an interesting shift. And then, like you said about calories too, as physicians, I mean, that's where we start with patients when we're working with them, right? Is calories in, calories out, eat less, exercise more. And yeah, I mean, I see the look on your face, the reaction of like, Oh, it's so it's heartbreaking that, that as a society and as a medical community, we haven't made that shift.. Not just for women going through perimenopause and menopause and people in midlife transition, but just in general, I mean, with our pediatric population to our older population. And so in your story, you mentioned you had to kind of go out and learn this on your own. And I hear that a lot from physicians. We will have to go out and learn this on my own. And as a physician, you know, where to look, you know, what are the sources that are good and not so good. Are you seeing any changes in how nutrition and how, how weight and how just being at our best selves, how that's being taught in medical community or even in the general public? Well, I think. You know, the good sign is that people are just talking a lot more about the menopause transition right now you if you're midlife and you're on social media, you're going to get these things in your feed. And that is a wonderful, really wonderful change. You know, they say that You know, only a third of OBGYN programs have, uh, teaching about the menopause transition and treating it and lifestyle changes and, and they only deal with women. So I, you know, it's, it's a little shocking to me that, that they're that low. Um, and also the menopause, uh, society, I'm, I'm doing my certification this fall. So I'm, I'm doing my studying for the certification and they've just had this certification blow up. for them. There are just more and more people requesting to take the exam and, and, uh, and get more educated. So I, I think, you know, the good thing is that medical providers are really diving in and realizing that we've done a poor job with this. And it's time to learn about it. Yeah. That's good. That's good to, good to know. I mean, for, for all of us, for our patients and for the 20 and 30 year olds who are going to be in menopause in a couple decades and that they'll have somebody that they can go to for sure. So, yeah. And I know you talk a lot about diet culture as well. And really your, your approach is to move away from that because that can be harmful. And, you know, we talk about, uh, we hear about and, and no experiences of disordered eating and that type of thing. And so how does that fit into your approach when working with, working with your clients? Sure. Well, there's too many rules. in diet culture. There's so many rules and you're doing it right or you're doing it wrong. And when you're doing it wrong, you should beat yourself up. Um, and so none of that fits in with, with what I do. Um, we kind of throw out the rules, um, looking at, you know, what foods we like and what foods are nourishing and then choosing, What we like out of that bunch. Um, and then there's no, you know, most people when they come in, they're like, I'm on the wagon or I'm off the wagon with, with what I'm with my eating and, and there's no wagon, you know, there's, you start somewhere and you work it and experiment a little bit. What do you like? What is, what makes you feel good? What, fits with your lifestyle. Um, and then if it's not quite right, you just pivot a little bit, you know, and go on a little bit different path and see how that goes. So there's, you know, a lot of ways to, you know, to do this. And I work with people one on one and with groups. Um, but it's we very much customize it to what's going on for you personally, because I've got people who still have little kids at home. I've got people who are retired or never had kids. And so it's really different on what you're doing, or if you're in a job that they really don't want you to have time for a break in the middle of the day. Um, you know, it's, uh, everyone has a different situation, so we really try to tailor it so that it's simple and it works great, um, with whatever your day is like. Yeah. Yeah. Uh, one approach that I hear a lot about and I've read about is intuitive eating. I don't know if that's Is that something that you bring in and sound, it sounds a lot like it where it's like throw out the rules. And I love what you said. There's no wagon. I love that. I'm going to keep remembering that there's no wagon. So that again, it sounds like it really aligns with what you're talking about. Yeah. Intuitive eating can be great. And it is, there's a piece of that with what, what I do. So we, we want to eat when we're hungry. We want to stop when we feel satisfied and we want to give up over eating. So some people really go very strict intuitive eating and so they will sit and wait and when they feel like they're hungry enough, then they will eat. And then some people, like I said, have meetings all day and they're like, if I don't eat at 1230, I don't eat. And I want to have that lunch. So we can build that that way as well. So it doesn't have to be the pure, um, only eat according to the body clock. And some people also just want to eat at a certain time with their families. So you can definitely, you know, you, you see how it is at dinner time and you're like, I'm not hungry at dinnertime. Then we go back and look at lunch and say, well, how do we make this work for you? So we can do, we can do both, but it, but everyone would be a great idea to notice when you're hungry and, um, And notice when you feel satisfied with your food. A lot of us graze it is our food culture to kind of eat all day long. And really for the body at the menopause transition and beyond, it's better to eat meals and not have snacks. So so when you do this, you do actually start to notice when you're getting hungry, which is a beautiful thing because your food also tastes better. So that's, uh, you know, there's kind of noticing hunger cues and fullness cues, um, are, are big part of intuitive eating. And I think they're really a great thing for all people in the menopause transition. Yeah. Yeah. And just really kind of getting in touch with our, our body signals. I think that's something that at least as physicians so we, we tend to drown those out. Right. Cause we had to, when we were in training and training, they said, see food, eat food. You don't know if you'll get some. So if you see it, you better eat it now. Yeah. That gives you that feeling of fear. Like, Oh, there's food there. I better eat it. Cause when will I get food again? Yeah. Mostly, you know, There is food. Yeah. I have a tendency to eat fast and I joke with my family that it's because I never knew if I was going to get called for a code or a stat delivery or something. So it's still just so ingrained in me to, so I have to notice it now, but, but yeah, that's kind of the running joke in my house. So what I What else, as far as outside of nutrition is important for us to keep in mind, whether we're in the perimenopausal transition or when you work with your clients, what are some of the things that you, you work with them on that are not food related? Um, sleep. We, we need to get sleep. And it's a great time to bring it up because a lot of people, sleep gets disturbed with perimenopause and menopause. If you have night sweats, you're waking up. Or if you, uh, if you have the gift of anxiety of menopause, you're waking up with your heart racing. Um, there, and there are other things that are also disturbing your sleep. So really, I started using a sleep tracker, which I had not done before, which has been really, I found very meaningful. Um, sometimes people just look at the clock, but trying to get at least seven hours, and if you're nowhere near there, just adding 15 minutes, um, and, and possibly looking at, um, You know, do I want treatment for these things that are waking me up in the night? Or is there a possibility, even though I don't snore, that I might have sleep apnea that also increases at this age as everything gets softer? Um, so, you know, you deserve to have a workup for your sleep problem with a, with your doctor or with a sleep doctor. Um, so it's, it really does play in with your health. You have less risk of diseases. Um, it makes weight loss way easier. So that, that's a big one. Um, the other thing I would say is, active stress reduction. Um, because all the things that we do are passive, don't necessarily bring our cortisol down and women in perimenopause and menopause do have a problem with their cortisol flaring up. So you, you know, you start thinking if I go out and just stand on the ground, you know, for a little bit, and I may notice that I feel better. Um, long hugs, a 30 second hug with your puppy or someone at your house or with yourself, um, will release oxytocin, relaxing, um, walks, whether that's a slow walk or a brisk walk for you, just notice, you know, what, what makes me feel better. Um, looking at that active stress reduction also, it just really, um, Makes a big difference. I have a client now who's using the calm app, uh, to do a 10 minute meditation in the morning. And she said, I'm five days in, and it's like, my life has changed. She's like, I'm so much less irritable at work and I'm getting more done. And I, I'm happier. You know, she just was super enthusiastic. Five days of, of doing a morning meditation before work. Um, so this kind of active stress reduction can really make your life better as well. Yeah. Oh, that's so important. Yeah. Meditation is, or anything, anything like you mentioned, just you said standing on the grass and that's just that contact with nature. It's can be really, really healing and that oxytocin. So yeah. So sleep stress reduction. I know you talk about exercise too, within your program. Where does that, where does that fit in? Well, we don't have any proof that, um, exercise helps you lose weight. And so that's kind of the worst part of the eat less, move more lie. Right. Um, but it is very good for our health. The there's a couple of things that you get from exercise that can help you with weight loss, even though we don't have any data on it. One of them is this active stress reduction. So if you feel better because you go out and play pickleball, you know, that. That stress reduction is going to help you with your weight loss journey. Um, but also all humans in their mid thirties start to lose muscle mass. And, um, but when your estrogen drops, when you're a person who's going through menopause, then you start to lose it faster. And our metabolism is actually based on. Making everything run and maintaining what you have. So if you're losing muscle mass, then your metabolism is going down because there isn't muscle to maintain, you know, it's, it's still running your brain and your heart, but, but it really helps you to keep muscle mass by eating enough protein and working your muscles with some sort of, uh, weights or bands. Um, and those can help keep your metabolism going, which help with. Weight loss. Um, we don't, I don't tend to talk about exercise really early with my clients because we're really getting the food part down first, um, and sleep stress reduction, drinking enough water. But, but those things are important to know for exercise, you know, they really can help. Yeah. Yeah. It is interesting. Like you said about exercise, it has so many health benefits, despite what we were taught though, weight loss is not one of them. And I, again, I think that's something that we carry over from the eighties and the, the days of the Jane Fonda and Richard Simmons aerobic videos and that type of thing to get in shape. And, um, yeah, it is really interesting. I, I, am a runner and a triathlete. So exercise is definitely a part of my life. Um, but, um, but yeah, it's, uh, it, like I said, has tons of other health benefits, but weight loss may not be, may not be one of them. So, so we don't want to go out and, and, uh, do a ton of cardio and then beat ourselves up because we didn't lose weight. You know, we want to, Go do stuff that we like and, you know, do your triathlon and run and, um, and it's so good for our heart and lungs and will help us have a longer health span. So it's very important for our health in general. Yeah. Yeah. It's interesting how just that, that link again, that we've, a lot of us have been taught that about exercise and weight loss. Is when I was, I guess this was about 15 years ago, my daughter was pretty small and I wanted to lose the baby weight. And I did a program, I won't name it. Um, and it's, I, it actually kind of gave me more food if I exercised. And so it was almost like exercise was a, like a reward or. It was just really interesting the way that that triggered in my brain. And once I kind of severed that link and I do exercise because it's a stress relief for me and I love it and it's fun. Now it's not like, okay, well I went and ran a 5k so I can have this chocolate cake. It's like, you know, it's, it's, I really had to kind of break that link. And it sounds like that's something that you really help your clients with as well, which, you know, And I love that you brought that up because we hear people say that, right? I remember going to the gym, we had the Saturday morning workout, which I just loved. And almost invariably someone at the end of the thing would say, Oh, we had such a hard workout. I deserve the extra large bagel sandwich. Think you know really I know, I know. I was running, running. You deserve so many things and that's not it. Yeah, yeah, yeah. I was um, I was running the other day and a gentleman passed me and I was going up a hill and he said, you deserve a beer and a cheeseburger. And I was like, oh, none of those sound good at all. Right. But I can't have them anyway'cause I don't eat gluten so. Right, right, right. So, that's it. You want to choose something, you know, eat it and have it in moderation. Um, but, but not because you work. Yeah. And enjoy it too. I mean, I think that, like you said, you, you want to have that cookie or you want to have that piece of pie. And so you probably are really mindful of it and enjoying it and really cherishing it when you do, rather than kind of beating yourself up about or that guilt that comes along with it. And the blue zones, people are not science, but they're inspirational. The, those areas of the world where people, a lot of people live to be over a hundred, um, and they usually have to start once or twice a week. So, you know, it's, it's a great inspiration. Yeah. Yeah. Definitely. Yeah. Well, Dr. Awad, thank you so much. Is there anything else that you'd like to share with us that we didn't touch on today? You know, the one, the one thing that I often tell people is have a savory breakfast, give up the sweet breakfast, give up the sweetener in your coffee or tea. Um, If you're trying to lose weight, that might be the only thing you need to do differently. The sweet breakfast is, um, really just terrible for your health and for your weight and pivot, pivot to something else for a while. You know, a lot of people like, Oh, I don't want to give up my sweetener. I'm like, just try it for a little while and see what you think. And if you try something else for a week, if you hate it, you can always go back, but it might be worth trying because you might be surprised that You actually are very happy with a savory breakfast. Yeah. So I, I love that you brought that up. So can you give us some examples of like, what, what would, what would be maybe something that is on the sweet side that where something on the savory side that might be a little bit healthier for us? Sure. So anything that tastes sweet or has sugar in it is a sweet breakfast. Um, I'm shocked about, you know, muffins that you get at the store are basically cake. Um, you're having cake for breakfast. Um, so there's a lot of great savory breakfast though. You can make Eggs with vegetables. You can do a plain Greek yogurt or a Swedish yogurt or cottage cheese if you do dairy and have that with some berries and sprinkle cinnamon on top. Tastes great. Um, maybe a little bit of nuts if you like crunch. Um, the old fashioned oats are a whole grain, which are really nice, um, which you can add fruit to. Um, you know my, I love to tell this story that my, I thought my brother in law was weird because he would eat leftovers, like dinner leftovers for breakfast, and now of course I think he's brilliant. So he has a little fish and vegetables in the morning. He eats it up from last night. Absolutely brilliant. There are no rules on this. Um, just you want to get some protein and you want to have some vegetables or berries or fruit. Um, and that's going to start your day out really great. Yeah. I've been trying to, to, uh, kind of switch my daughter from like the sweet cereals to something a little bit with a little bit more protein in it to help stabilize her blood sugar throughout the day. Cause she might not eat lunch for six hours. There might be a break and she might not get a chance to have anything in between. So yeah. I love that. Yeah. Well, thank you so much, Dr. Awad. We got all your links. I'm going to share those in the show notes. Um, got your website here, heatherawadmd. com. We'll link to your podcast, your LinkedIn, your Instagram, and your Facebook and your YouTube channel as well. So what's the best way, if somebody wants to work with you, what's the best way for them to get in touch with you? If you go to my website, there are ways to get in touch with me there. So if you just go to Heather Awad, md. com, uh, there are multiple buttons to, uh, connect. So awesome. This has been wonderful. Thank you so much. No, thank you for having me. It's been a great conversation. While I am a physician, the information presented in this podcast is for educational purposes only and should not be considered medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Please consult with your own healthcare provider before making any significant changes to your lifestyle or routine. By listening to this podcast, you are not creating a physician patient relationship. Thank you for listening to The Purposeful MD Podcast. If you like what you hear, please rate and review the show. Please also visit my website, www. thepurposefulmd. com for free downloads or to discuss working with me as your coach.