Roots to Health with Dr. Craig Keever

When Culture Meets Calories: Rethinking Weight, Food, And Willpower

• Dr. Craig Keever • Episode 18

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Obesity is personal, cultural, and biological—and we open all those doors with clarity and compassion. We dig into what the numbers really mean, why BMI needs a companion like waist-to-height ratio, and how visceral fat drives risk for hypertension, type 2 diabetes, sleep apnea, and certain cancers. Craig shares a candid journey from a BMI of 41 to 27, highlighting what actually moved the needle: whole-food, plant-based meals, steady daily movement, better sleep, mindful eating, and the patience to let slow progress add up.

We challenge common myths and redirect the conversation to what’s actionable. Tofu isn’t disrupting male hormones; excess body fat can, because adipose tissue produces estrogen. Genetics may load the gun, but environment pulls the trigger: ultra-processed foods engineered for “cravability,” aggressive marketing, and food deserts make healthy choices harder than they should be. We look at how to build a sustainable plan that respects real life—budget, family traditions, stress, and time—without shame or quick fixes.

You’ll learn how fiber-rich meals support the gut microbiome, why 30 minutes of moderate activity five days a week changes trajectories, and how simple tactics like tracking occasionally, eating without screens, and setting a consistent sleep routine can stabilize blood sugar and curb cravings. We also discuss when medications or bariatric surgery fit, and why policy shifts—especially around school lunches—must be part of the solution. If you’re ready to start, start small: one swap, one walk, one win. Subscribe, share this with someone who needs a hopeful plan, and leave a review with the first small change you’ll make this week.

Thanks for listening to Roots To Health!

The information provided in this video is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video. Dr. Craig Keever is a licensed pediatrician, but the content shared here is general in nature and may not be applicable to your individual health needs.

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🎨 Connect with Amy Keever for art, creativity, and inspiration:

Website for plant-based Cuisine : https://www.wildflowercuisine.com/
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SPEAKER_05:

Welcome everybody to the next episode of Roots to Health. I'm your hosts, Dr. Craig Kiever, and my lovely companion and personal vegan chef, my wife Amy. And our co-host.

SPEAKER_02:

It turns from a wife to a companion. I wasn't sure, but while that was going down.

SPEAKER_05:

And and should I not forget to mention co-host.

SPEAKER_02:

That's right.

SPEAKER_05:

That's right. That's right. So uh I've chosen a topic today that um, you know, is is maybe a little difficult for some people to talk about. Um certainly was for me for a long time. Uh it's uh the topic of obesity and how that's affecting us and why it's such a uh an important topic to uh tackle at this point, um, and and has been for some time now. Um recent statistics that I've read uh in in this country, um 70% of the entire population of this country is overweight, and um 40% of this country is obese.

SPEAKER_02:

And obesity doesn't necessarily look like what you think it looks like as far as the line.

SPEAKER_05:

Correct, that's for sure. We'll we'll dive into a little bit about that uh in a bit. But some other statistics uh more relevant to my uh pediatric practice um in the 60s, and there's not a whole lot of really good research data um before the 60s. Um and I uh didn't see the actual sources for this particular point of information, but it seems reasonable uh that um the information from the 60s indicates that about five percent of children between the ages of two and nineteen were considered obese at that time. Um compared to current statistics, uh approximately twenty percent.

unknown:

Wow.

SPEAKER_05:

So we've gone up fourfold.

SPEAKER_02:

That's what that's those years that you're supposed to just be able to eat a horse almost and be able to.

SPEAKER_05:

Yeah, you're exactly right. Uh you know, our metabolism is at its best during those years, and yet uh we see an increasing, steadily increasing number of kids being uh considered obese. Well, why is this uh such a big deal? I mean, this is certainly from a medical standpoint not about fat shaming. Um, you know, this is about the real impact uh on our uh bodies um about the carriage of excess weight.

SPEAKER_01:

And yeah, it's important to just be able to talk about this because part of the problem is that we're not talking about it.

SPEAKER_05:

That's correct. And and I mean it is a difficult, I mean it it's a very, very complex topic. Okay. There's no one simple answer. And uh so that in part makes it somewhat difficult because you've got people on one side saying this is the right way, and on the other side, this is the right way. I I don't know that anybody can say there is one right way. There's a lot of ways to help um the obese and and um get to someplace uh more healthy should they want to do that.

SPEAKER_02:

And the balance of yes, love yourself right as you are, right how you are, but the balance of, but let's not look let's not be so into that that we're like embracing just eat the cake, do whatever you know.

SPEAKER_05:

There is definitely a balance to be had with that. Um so and and I speak of about that coming from a point where um not too many years ago, uh my body mass index, the BMI, was uh 41. So, yeah, ultimately um obesity will um uh cause a much higher incidence of uh chronic health problems uh from hypertension, which can lead to heart disease, heart disease is another one, um uh diabetes, uh strokes, cancer, uh all of these things are a much higher risk uh if uh your weight is at a point where you're considered obese.

SPEAKER_02:

And isn't it true that you know you hear this, uh, it's absolutely false, but people talk about tofu being bad for men, that it can be, you know, leading to estrogen dominance, but fat actually carries estrogen, is that right? As far as how it elevates that level of estrogen in a man's body by by the more fa the more weight that they have on them. So that's more cause of it.

SPEAKER_05:

Yes. Uh overweight people, I think, tend to have more trouble with the estrogen because but because adipose tissue fat yeah, fat tissue does produce its own uh estrogens. Um so yes, that's exactly right. So um the definition of obesity, what what exactly is it? Well, um, as I've mentioned already, and Amy's mentioned, the BMI is uh one critical tool in measuring um our uh level of um obesity or not. Um and it's been medically defined as a uh body mass index of over 30. What is body mass index exactly? Um it's a calculation uh that we use to kind of determine um weight for height, and is this appropriate? Um, how do we get it? Well, um uh you basically you take your um won't say this correctly, your weight in kilograms, and divide that by your height um in meters. Um and that will give you your body mass.

SPEAKER_02:

Or go on a calculator like I do.

SPEAKER_05:

Or go on a calculator, but but that's how it's calculated. Right, and it's actually not just weight divided by height, but for those mathematically inclined, which I'm really not, um, it's actually um uh weight divided by meters squared in height. I don't know why the math put that in there, but that's that's what it is. Um so it's actually uh we divide our categories up into essentially three sections. Um when we're talking about BMI. Um a normal healthy BMI is considered between 15 and 25. Um when you reach over 25 to 30, you're considered in the overweight category. And um when when you get to over 30, then that's considered obese. Um, you know, the word obese has certainly a social stigma to it. Um and um that it's really just a um a medical classification.

SPEAKER_02:

Um so having said that, um and I get that because women have such a stigma to like don't gain weight at all, you know. So maybe there is a way to reframe it and resay it. It's just an it's just a percentage higher than what you need to be.

SPEAKER_05:

Yes, yes. I uh yeah, I can't emphasize enough that that this uh is a medical condition um and not uh a social sigma.

SPEAKER_02:

And and and like uh like we mentioned, I mean it it is a very complex topic, you know, uh in the same way that um any person, what we eat and our is affected by so many things, our culture, our history, um uh our physical nature, uh I mean everything at you know but you're living proof that to see that BMI go down, like things changed in your body, things change like that.

SPEAKER_05:

So now I would further this to say that while yes, BMI is an important tool to use in diagnosing obesity, it is a crude tool. Okay, and why do I say that? Uh we've talked before, I think in previous podcasts, uh, about um well, as a for instance, my favorite example is Arnold Schwarzenegger, right? So you take a person who is incredibly physically fit, huge muscles on muscles, um, a very skinny waist, and that Arnold Schwarzenegger in his prime clearly had a body mass index greater than 30. I don't know of anybody that would have called him obese. Right. Right? So there are limits to um the term body mass index. Now, when you combine the body mass index and the number you get there with um uh um proper waist size, um that becomes a different matter. So, as a for instance, as I mentioned Arnold Schwarzenegger, his waist size was certainly um less than half of his height. Okay, when we talk about a waist size, an appropriate waist size for a man um would be about half of your height in inches. Um and on the flip side of that, if you got a person, uh you know, your average Joe who has a body mass index of greater than 30, but oops, our waist size is multiple inches more than half of our height, well that becomes a much more stronger indicator of actual obesity, right? So yeah, it's it's good to clarify those kind of things because um just to And why is that so important as far as the waist size? I mean, they just go it has to do with uh percent of body fat. So if your waist size is low, um then your percentage of body fat, which is really what we're getting at here with the term obesity, uh, and and had our bodies having just too much of a too high of a percentage of fat.

SPEAKER_01:

Visceral fat, especially, is really dangerous.

SPEAKER_05:

And visceral fat contributes more to the the uh health problems for sure, in terms of I think uh how that messes with our blood pressure and our hormones and uh probably any number of things that I'm still not yet aware of. So uh causes of obesity um multifold, you know, uh certainly genetics can play a role in that, okay? Um but uh there's there's much more than just that. And like we do say in the plant-based world, uh, you know, genetics may load the gun, but nutrition pulls the trigger.

SPEAKER_02:

I mean, so much so that it can actually turn off certain genes to support your body better.

SPEAKER_05:

Exactly. Precisely correct. Yeah.

SPEAKER_02:

That's never knew that before I got into plant-based seeding.

SPEAKER_05:

So, yes, not only can the kinds of foods we eat uh tip our genetic um profile into expressing certain genes that help us, it can also do that in the other way. And and um, you know, we eat processed garbage, and that's going to tick things in a different direction for our metabolism.

SPEAKER_02:

You know, people think that they have this like insatiable appetite, but what they don't realize is they're eating the very foods that are causing that insatiable appetite. They're new addictive qualities.

SPEAKER_05:

Precisely. And there are, you know, we've mentioned this before too, you know, the companies that make uh these processed foods, many of them have specific departments designed to make their foods more cravable, which is another word for addictive. You know, uh, so it's it's a problem, it's a real problem here in this country.

SPEAKER_01:

Um cheese has that, yeah, yeah, for sure.

SPEAKER_05:

Um, so another uh um uh base cause of uh obesity, uh if we're looking at things to kind of try to single out is lifestyle patterns. So to include our diet, as we've talked about already, you know, um our food choices do make a difference. Our exercise choices do make a difference. Um you know, in my own story, um, you know, I got to the place where my, as I mentioned, my BMI was 41. Um, I never looked in the mirror and thought, wow, you're obese. You know, uh, but that's significantly over 30. In fact, that's pretty close to uh I I would have to read more statistics on this, but uh pretty close to morbid obesity. I never saw myself as that big, right? You know? Um, so there's a lot of perceptions that go on. Uh and and as this country has become bigger, um the public perception of what is acceptable has changed because it's almost being touted as like you're you're kind if you just say, hey, this is good to be this way, or this is good to feel this way.

SPEAKER_02:

And nothing that we're saying is about not loving yourself. It's like to have this thing to the point where like just you know, just do what you want to do, feel what you want to feel, like that's a dangerous way to live.

SPEAKER_05:

It is a dangerous way to live. It's kind of a part and parcel of kind of the American way. I want to do what I want to do, that I'm gonna do it.

SPEAKER_02:

This does not happen to this degree in other countries.

SPEAKER_05:

That's correct. Although there is a worldwide trend as well uh towards ADC.

SPEAKER_02:

Just it everything with Americans is about indulgence, and not to be so negative, but it's like it's it's just that indulgence of like, I want what I want, you know, I want to do what I want to do, and definitely is happening worldwide. That's right. I think because of our influence, maybe.

SPEAKER_05:

Well, possibly, uh quite possibly. It's certainly related to, I think, the num the amount of processed food in our diet. Right. Um, and that's kind of what I'm was getting at with thinking about um, you know, the increase in uh childhood obesity uh from the 1960s at about less than five percent to now nearly 20 percent. Um and that's in large part, I think, related to all these processed foods, which all these processed foods are certainly infiltrating markets throughout the world. And that's what we're seeing as as the influence towards the chest was on the rise for children and cholesterol.

SPEAKER_02:

I can't get over nine-year-olds getting tested for high cholesterol now.

SPEAKER_05:

Yep. And and uh another uh cause um at the base of the uh obesity epidemic, um uh food deserts. You know?

SPEAKER_02:

This is a big deal. This is quite still my heart.

SPEAKER_05:

It's a very big deal, you know. Uh if you don't have access within a certain distance of your home to actual healthy foods, I, you know, the concept of food deserts was um not even on my radar uh until a nurse practitioner that I now have working with me talked about that and that's one of her passions and and and whatnot. And uh, you know, you you can be right smack dab in the middle of the USA um or a big city and be right in the middle of a food desert.

SPEAKER_02:

Its own level of racism in in areas.

SPEAKER_05:

Yes, it happens all over places, especially and uh the the biggest problem is very often in the uh many neighborhoods uh there's no grocery store that carries good foods. All you've got are these convenience stores, and you've got people living near them that don't have the kind of access to transportation, right? And so all they can do is get food from a convenience store. And you and I both know that ain't no way to live. That's why we pack our food. That's why we pack our food. That's why traveling can be such a difficult uh time on plant-based eating.

SPEAKER_02:

Yeah, you really gotta get dig in your heels and try to figure out, you know, how to do it because you bet it's not hard, but it's just something to kind of figure out.

SPEAKER_05:

And uh, you know, along those lines with food deserts, uh, you know, the the uh the other uh thing in that area would be marketing. Marketing for all these processed foods has an impact on a large number of people. Uh it's it's uh uh kind of a difficult thing um to overcome because they do make these foods uber tasty and uh cravable um and and then very convenient. They're nice, pretty packaged, and easy to get, you know.

SPEAKER_02:

I've always said I'm a f you know, I've always been a sucker for marketing because it's just yeah.

SPEAKER_05:

So other factors involve, of course, uh psychological factors. Uh uh, I've been guilty of this um two numerous times to count, is stress eating, yeah, you know, uh things like that or emotional eating, you know, that that's uh a very common thing that will contribute uh potentially to obesity as well as other medical factors. Now, I will say as a pediatrician, um when I look at medical factors uh causing obesity, they're fairly rare, okay? Um, you know, like hormone disorders and and um maybe not quite as rare are medications that um cause weight gain. All right. Uh but I can tell you that um it's it's very real when the parent starts to think about um my kid may be having a trouble with obesity and we need to figure this out. The very first thing, and probably rightly so, the very first thing you want to rule out is a medical basis for it. And so instantly we're wanting all kinds of blood work and let's let's figure out what's the problem. Um sadly it's just not that simple.

SPEAKER_04:

Yeah.

SPEAKER_05:

Uh they are very good lab, there are very good labs to have, a good panel to make sure that many things are where they need to be, and we can work with the things that are not, but um, we I don't often find an answer um in the medical realm.

SPEAKER_02:

Which is why lifestyle medicine is so critical because it's saying, what do you have around you? What are you doing? What are your patterns? You know, all those different things.

SPEAKER_05:

For sure. So um the next thing we'll kind of move on to is um what are the health risks associated with obesity? And I think we've kind of hit some of those with the cardiovascular disease, uh, diabetes. We did not yet mention sleep apnea, and as Amy had mentioned, certain cancers are all definitely um increased risk with all of those things uh with with excess weight. Um mental health uh also impacts uh obesity, uh depression and anxiety. Um, and and as we kind of mentioned, the the social stigma uh of this will also have an impact. So now I'd like to kind of uh turn and and look at approaches to um prevention and and treatment, because uh um to further on with my story that uh I covered uh pretty well in podcast number one of this series. Um but uh having come from a place where my body mass index was 41 and uh currently I'm in the overweight category.

SPEAKER_00:

Um my body mass index no one would look at you and ever think that, you know.

SPEAKER_05:

Yeah. But uh yeah, my body mass index is now uh right around 27. So um, and uh I I guess I would like to expound on that just a little bit right now, in that um I I use as we as we mentioned uh the tool of body mass index and the tool of of waste size um to kind of guide me on my journey. Uh and what do I mean by that? Well, um, you know, uh some of my uh issues, including high blood pressure and high blood sugar, um are very related to the amount of excess fat I have in my body. Um and as I've experienced so far, the further I uh the closer I get to uh my what's uh presumed to be my ideal weight based on body mass index and waste size, uh the better control I get of those things. Um, you know, even to the point of just a few months ago, um uh I was still carrying 10 pounds more than about two or three months ago, 10 pounds more than I'm carrying right now. Um, and I just couldn't get my blood sugar to drop significantly below 140 or maybe into 130s, right? Uh just 10 pounds later, and I'm I'm down to uh below 200 pounds now. Um, and all of a sudden my sugars are 115 to 120, and you recover if you ever had stuff that's a little bit more decadent.

SPEAKER_02:

It just seems like a snack cut.

SPEAKER_05:

Right. So I've often said in this journey, because interestingly, um, when I first started this journey in earnest, um, I thought, you know, I don't want to lose too much weight, I don't want to look like an Auschwitz victim, right? Um, and so I set this goal in my mind of 220 pounds, which seemed like a very reasonable goal. I thought this is this is a good thing. And I talked with my lifestyle medicine doctor about that, and she didn't say much about it at that point. Um, but later, then when I had uh reached my goal of 220 pounds, um, and uh started to reassess and figure out what what is my next goal, she said, I wondered if you were gonna be satisfied with a weight that was still considered in the obese range.

SPEAKER_00:

I was surprised you wanted to still be obese.

SPEAKER_05:

Yeah, yeah. And and that goes to show, you know, how our public perception, the the the general public perception has become a lot different.

SPEAKER_02:

And that's where this is a different type of uh you know uh healing or different process at Western medicine because you are coming to someone and saying, Are you wanting to change this?

SPEAKER_01:

That's right.

SPEAKER_02:

And it and it's it was such a loving thing for her to do, but you had to be in the right headspace and the right type of person to say, Okay, I hear you. Because if you can't hear it, you know, you can't very much so.

SPEAKER_05:

This is this is very much uh akin to or similar to um an alcoholic. You can tell an alcoholic all day long you need to quit drinking, you're an alcoholic, it's going to kill you. It won't make a bit of difference until something inside turns and says, Ooh, alcohol is killing me. And then it becomes a different story. Well, in the same way, that's kind of what happened to me um with food. Uh and so, so uh, how do we address this issue in nutrition um with with for obesity? And and I can tell you my journey and I can tell you the um things that have worked for me. Um there are many ways to attack this. And I'm not going to sit here and say, oh my gosh, this is the only way to do it. But many, many people have success with a whole food plant-based diet. Yes. I it's it doesn't get any simpler than that.

SPEAKER_02:

I mean, I will tell I will just plug this little book, or it's not a little book at all. But uh, for those of you listening, How Not to Diet by Dr. Greger, and it's full of just little tips and tricks, even if you are plant-based and you're like, well, I just can't get the needle to, you know, move. So it's yeah, it's really very much so. It's it's a way to not starve while you're losing.

SPEAKER_05:

And and the other beautiful thing about this is that it's a journey. Okay. This is not something, yeah. This is not something that when I started this journey almost five years ago, that I clicked on and all of a sudden, boom, everything happened right. Okay. This is a journey of test and measure. Yes. Very much test and measure. So I would change my way of eating, and and and and at first it was a big change, okay? Because the first thing I had to wrap my brain around was everything I could not eat anymore.

SPEAKER_00:

Right. Right.

SPEAKER_05:

I can't eat meat, I can't eat dairy, I can't eat processed.

SPEAKER_00:

People's faces after you're ugly. Right? Oh, wow.

SPEAKER_05:

So, yeah, the processed food, the sugar, and the oil. Lose all those five things. Well, I'm the first to sit here and tell you I did never do it perfectly.

SPEAKER_00:

Oh, me too. Yeah. Yeah. Right? I always say I did it bad for or did it good. That's it. Yeah. You know?

SPEAKER_05:

But I did it well enough for long enough that at some point when I really got the picture, because it took a while to get that picture. For sure. Right. And it took your assistance because you've been plant-bathing.

SPEAKER_02:

It's a whole different way. Yeah. It's like it's a whole different thing. It didn't have to be hard, but it's a different one.

SPEAKER_05:

Yeah. And once that got triggered in me, um, then my weight loss really started in earnest. Now, here's the other difficult thing about the weight loss journey with this for me. It was a slow process. Right? Two to four pounds a month. Usually closer to two. All right. That seems very often very unsatisfying.

SPEAKER_02:

There is a level of emotional maturity that has to take place with this because you have to go, okay, I'm doing this. I mean, I'm doing this. And so there has to be a a level of that where you go, I can't get so fixated on those numbers, you know, to feature that way.

SPEAKER_05:

And and and as well, I think the term lifestyle is very apropos because unlike previous times that I tried to lose weight and go on a diet.

SPEAKER_01:

Yeah, not a diet.

SPEAKER_05:

Right? This is not a diet. This is a lifestyle change that I'm committing to.

SPEAKER_02:

Do you feel like now that um if someone said like, oh, do you hunger, you know, like are you just craving me, or are you craving cheese? Do you does that even enter your mind now?

SPEAKER_05:

It really doesn't.

SPEAKER_02:

It really doesn't for me either.

SPEAKER_05:

I mean, it took me honestly, uh, I can kind of remember having some of those cravings probably about the first year, year and a half. Um, but since everything has changed for me, I don't. I feel so much better, I move so much better.

SPEAKER_02:

That when you go into a restaurant and you see somebody eating a big steak, is there any kind of part of you that's like There's really no pull for me to s to do that? I I do know that like cheese was always something for me that I was like, oh man. But the ethical side of this really is the was the kicker for me to be able to go, okay, that's important to me. So um, but I just wish people understood. It won't always feel like this. It will always feel like you've got this addictive kind of addiction going forward.

SPEAKER_05:

For real. And and at some point the the meter really changed for me, and it was no longer about what I can't eat, it became what I can eat.

SPEAKER_02:

And we're so much more foodies, I feel like, now, but there's so many more variations of what we eat. And that is the one thing I'll say about having that decadent meal once a week or whatever, is you know, if you need to have something that tastes like fettuccine alfrey, I can do that. You know, like you you can do that. And so um it's not like you're ever gonna not have those familiar tastes. It's just you're gonna do it with plant-based.

SPEAKER_05:

Precisely. Uh, yeah. I mean, and having you around to uh, you know, bring about some of those comfort foods of old, uh, only done from a plant-based uh uh viewpoint uh has been very, very helpful.

SPEAKER_02:

Which is well, I'm glad. I mean, it's exciting to get people in front of the food because they have this perception of like grass and cardboard. Yep.

SPEAKER_05:

That was yeah, we've talked about that before. I used to think that, oh, before I became uh plant-based, um, I used to just think, well, I'm gonna be eating salads all the time and grass and cardboard and never be satisfied. And nothing is further from the truth.

SPEAKER_02:

There's a lot of things that don't look like they're vegetables at all that are vegetables in your meals.

SPEAKER_05:

So, in terms of other things involved in the treatment uh of obesity, um physical activity, and this fits so well with the whole lifestyle medicine uh principles and pillars of health, you know. Um, I didn't realize again, just like when I looked in the mirror and and didn't see a BMI of 41, um I didn't look in the mirror and see a sedentary guy.

unknown:

Right.

SPEAKER_05:

Right? I'd always been, I would say, moderately athletic, you know, uh not certainly not one that excelled in it in athletics, but I did enjoy being active. I used to ride my bicycle a lot, uh, take walks and any number of things. I was a football player and a wrestler in junior high and high school, um, you know, baseball as a younger kid, all those things. But physical activity uh is a really big deal. Um and it wasn't until I sat down in front of Dr. Morgan, my lifestyle medicine doctor, that I realized how sedentary I had become. Because uh we started talking about what, you know, in terms of my lifestyle, how was I gonna change this aspect of it? How was I gonna become more physically active? And um so we sat down and we kind of talked about some numbers of well, you know, the easiest thing is walking and just getting steps. That's a good way to start um how many steps can she sing to me, how many steps can you give me every day, five days a week? And I was looking at these things and then thinking, well, I could probably get that most of the time. Uh no, she said, no, we're not talking about 80% of the time or 50% of the time. We're talking about 100%. 100%. And what that came down to at that point in time.

SPEAKER_00:

Very clear.

SPEAKER_05:

Yeah, very clear. And that came down to at that point in time, 5,000 steps a day, five days a week. Yeah. Okay. And there are some people that can't do that. Yeah. Okay. So does that mean you're sunk? Well, no, you start where you're at, but I will say that the scientific evidence points to the amount of of exercise that truly makes a big impact on our. physical health and um getting in physical shape is 30 minutes a day five days a week of something that elevates your heart rate whether it's walking biking swimming right anything you you enjoy doing do it for 30 minutes a day five days a week and that will really begin to make an impact but if you can't do that start where you're at well like the the lady that talked about um weight training she said you know if you're not doing anything just picking up this one little gallon thing will be heavy for you that is your max or that is where animal analogies but you know don't try to eat the elephant all at once just right a little bit at a time just try to figure out how to how to do that. That's right.

SPEAKER_02:

Because that will get overwhelming.

SPEAKER_05:

Yeah it will so those were the two biggest things I think that I did in changing from a BMI of 41 to currently 27 and still working on you know it's uh it's all about test and measure so I'm still working on getting down defin those last 15 to 20 pounds. Um another thing uh another category of of approaches to treatment of obesity um behavioral changes to include mindful eating um you know I got and and am still really in the habit of wolf it everything down I eat fast I and I've always done that I used to blame uh all this on residency and that I had to learn how to do that as a resident but no it was there before that and combined with during residency there was no time to sit down and enjoy a meal and the food that was there was all processed garbage you know that's when my weight game started in earnest.

SPEAKER_02:

Well and I know we're gonna be talking about this more in depth but um just the fact that like the TV's on and just yeah just not being present with oh this really tastes good and just taking a pause and really focusing on the food.

SPEAKER_05:

That's right. And I think that's going to be a topic of a future um uh podcast uh and so we'll get to that uh at that episode but um tracking your habits you know um it's just kind of getting a sense of where you're at and and what habits are good for you and what are not tracking your food and tracking your food yeah I mean that's a wake-up call um a chronometer as we've talked about before on the podcast uh there are a number of apps out there we have found chronometer to work very well for us um but uh just doing that and and even if you don't do it every day you know I think I went through a a period of several months where we pretty much did it every day um and I haven't done it for a while but when I get backed up against a wall that's probably the next thing I need to go to if I'm not getting results on my health like I want with the blood pressure with the blood sugar and weight gain or whatever.

SPEAKER_02:

Well and it's also helpful to just pull it up like hey what what's in a half a cup of you know steamed rice. I mean like what's the calorie count? What's the fat grams? Like just something real easy and I still say the Walmart ad is really nice too because you can look at their the backs of the whatever the label is look something up really quick.

SPEAKER_05:

You bet.

SPEAKER_02:

Yeah.

SPEAKER_05:

Sleep is another thing that has uh a real impact on um weight management uh you know so that's uh important if you're having difficulty sleeping um you know trying to figure out where's the problem here and and take care of that as best we can that's a catch 22 because if your nutrition's off you will have trouble trouble sleeping.

SPEAKER_02:

Right and so you know you may need it and it's almost exacerbating everything else but to be able to get that nutrition right is critical.

SPEAKER_05:

Yep.

SPEAKER_02:

And exercise.

SPEAKER_05:

And exercise that as well yeah yeah all that feeds together literally um and then you throw on top of that um which we've talked a little bit about on previous podcasts um the gut microbiome yeah that's huge it's huge uh in terms of uh you know how your body's dealing with all these calories and the germs in your intestinal tract will either help or hinder.

SPEAKER_02:

And it is driving your immune system.

SPEAKER_05:

It's driving your immune system and your metabolism. So um so yeah the the the quicker we can get um to a whole food plant-based diet and increase the fiber in our diet because that's one of the biggest deals in uh plant-based nutrition is healing that gut microbiome and the more healthy bugs that we get in our intestinal tract the better everything gets so really eliminating things that are causing the bad backup of bad bugs precisely because they can really take over your goodness yes there are some medical prevent uh um uh interventions um uh that in in extreme cases are are needed uh bariatric surgery and prescription medications I you know needless to say those are not things to just jump to right away and I don't think anybody that's going that route is jumping to those things right away.

SPEAKER_03:

And I have seen it change lives. Somehow you know there there are it definitely can turn things around per se.

SPEAKER_05:

Yeah they can be very very effective in the right person that but it but it's something to be uh pursued with much thought and and changing habits.

SPEAKER_02:

I mean it's not it's not just about a diet as well it's about changing your whole mindset.

SPEAKER_05:

That's exactly right. I mean you know this concept I've seen that too where they go right back to the way things yeah the concept of a pill for an ill and okay I'm gonna go to my doctor and get my obesity taken care of with whatever well you're right if you don't change the lifestyle it's coming back. Yeah that is it that's just kind of what to say sadly how it works. Um but uh at the end of the day uh one size does not fit all you know I've been very very blessed um in my journey that for the most part I've done this without a lot of intense medical intervention right you know it really was uh and has been so far for me a a process of just changing my mindset.

SPEAKER_02:

And if someone's out there at a different state or somewhere where they really need help, like get that provider on your side that's a lifestyle medicine nutritionist, doctor, you know, because it really was helpful even with you being a physician to have that guidance of someone just dosing you down on your medicine. Truly is the the doctor before this was like not the interest.

SPEAKER_05:

Yeah I had an internal medicine physician for a number of years that uh as I started to improve yeah and I started to improve and lose weight and things were going the right way I wanted to start coming off my medicines um and he was he just had no interest in that you really need that like that guidance the whole team like that's our goal is to be able to form a whole team of of you know lifestyle medicine coaches you know co aside physician all sure so yeah and another thing uh that I've uh failed to mention is the kind of the role of society and and uh policy in in in all of this it's uh uh you know one of the biggest problems I see is our school lunches oh it's heartbreaking it's heartbreaking uh you know the problem is all these big companies uh meat dairy egg have all infiltrated the government to a point where uh they're now dictating to us uh what needs to be in the school lunches as a pediatrician I have to write notes to the school ridiculous to say please don't give this kid dairy.

SPEAKER_02:

I did it for my kids and it's like and and it they stayed on that worse than anything I've ever seen. Yep. And they're subsidizing so you know when we would school the the the lunch ladies would make us homemade meals not anymore. Like all that stuff I mean not saying it's not going on somewhere but I'm just saying subsidizing like you know burger joints and things like that. It's like oh it's and it's hard as a mom when you really want to bring your kids a packed lunch and they can still get it at school. They can still get around it. So it's frustrating.

SPEAKER_05:

Well uh in closing um I'd like to just uh rehash just a just a second here that uh obviously you know there's so many facets uh to treating obesity uh and um it's it's just a a really complex issue that will take time um and continues to take time and and forethought and planning and you know it but it can be uh tackled.

SPEAKER_02:

And don't let the words get in your way of your your own body's healing because once that momentum started for you it was like just you were just off the ground running.

SPEAKER_05:

And I'd like to say too that this is really not an issue that's a question of willpower.

SPEAKER_04:

Right.

SPEAKER_05:

All right there is nothing that anybody needs to feel guilty about or you know feel like I'm just I just I just can't do it. I don't have enough strength. Yeah you know it really takes uh a a monumental effort yes uh to uh uh change a mindset because some of these uh things that feed into the obesity epidemic are so innate and so cultural and so personal yes that that to to this was my mom's recipe it was my grandma's recipe it's like absolutely and holidays all those things you know they do come together and it it is it is very very much very personal so as a small tip uh for anybody is starting to struggle with this or or go on this journey um you know just pick one thing yes one thing whether that's um I'm not gonna eat this thing anymore not a whole category of things just things right or I'm gonna get a little more active I'm gonna take a walk right doesn't matter how long it is but just pick one thing and start that journey.

SPEAKER_02:

Well the two things I would mention is um physicians committee has an app called the 21 day kickstart and you can just get it download it for free and it's really a great guidance program. And then we're also doing classes with Food for life if um I'm you on physicians committee if you look up in your state you can find someone who's doing it online or in person and that's what I do as well. And so trying to find a class that can you can get in and I mean like we're doing I'm doing a class tonight and it is so cool to see everybody come together that didn't know each other and they have insta community and they're instantly helping each other. Yes. The energy is palpable. So get with your community find a class find something that you can do that will help you just break it down where you don't feel along because I think that's a big part of it.

SPEAKER_05:

It is yeah community is huge. That was a big part of my journey if you uh listen to my podcast on on uh how I've gotten where I am now well thank you for tuning in and uh we'll see you next time.

SPEAKER_00:

Alrighty take care

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Amy Keever

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