The expectation of quick weight loss creates a following. I'm gonna do this quickly, so quick leads to this black and white perfectionistic thinking. You know, all right, I it's gonna be four pounds a week, here I go. Uh-oh, didn't hit it, or rather had a bad night, and of course you step on the scale. That just reinforces it for you right there. Uh-oh, I have objectively I have failed.
SPEAKER_00The scale might be measuring your weight, but for many people in a GLP1, it's also measuring fear, shame, and whether they believe the medication is working. And the answer may not be to throw the scale away. It may be to just completely change what that number means. Welcome to the GLP One Hub Podcast. I'm Anna Reisdorf, registered dietitian and GLP1 user. And today I'm joined by Brian Baummel, a registered psychotherapist who has lost 100 pounds himself and kept it off for nearly 14 years and recovered from two eating disorders. We're now talking about why a single weigh-in can send you into complete spiral, how the scale can actually be used as exposure therapy, why shame creates urgency and all or nothing thinking, and why you're expecting your GLP1 to eliminate every craving or thought about food and maybe setting you up to feel like you failed. This is such an important episode with a lot of food for thought. So let's get into it. Welcome to the GLP1 Hub podcast. I want to welcome today Brian Baummel, registered psychotherapist. We are going to talk about some things that keep coming up in my audience all the time, about the scale and how much control it has over us in this journey and how I see maybe it could impact our journey in a negative way and make us panic. Or Brian is going to tell us all the things that it that it that this little device does for us. So, Brian, can you start by introducing yourself and telling people what you do, a little bit about your professional background?
SPEAKER_02Sure. Thank you for the introduction. I am a registered psychotherapist in in Toronto, Canada. I've trained in the deep form of psychotherapy. So I believe I have a depth of understanding around emotionality and some of the unconscious issues that go on as we try to lose weight. I also am someone who has lost 100 pounds and kept it off for almost 14 years. Of equal importance to that is I overcame two eating disorders that caused the weight fluctuation. So exercise, bulimia, followed by binge eating disorders. So I like to say I have the street cred to talk about, to talk about this. And the street cred sort of fades into the background because what people enjoy talking to me about, or what they what they enjoy talking to me about, is the fact that I've been there, the fact that I understand it, and that there's really very little judgment on on my part. And if I had to go right to the end of the podcast right now, I would say if people could stop judging themselves the way I don't judge them, then their issues with weight would would would rapidly improve.
SPEAKER_00Mm-hmm. Yeah, definitely. So a lot of what we were speaking about before we got on the call was that people really have a lot of judgment around what their weight might be doing, what their food cravings might be doing, what their habits mean about who they are. Can you talk a little bit about why we do this, like why we are so hard on ourselves when it comes to this issue?
SPEAKER_02Well, because weight is immensely personal. Period. The end. All of those fears and all of those concerns are entirely legitimate or grounded in the way we operate psychologically. Weight influences our health. We cannot deny that. Weight influences how society treats us. That may not be the right thing, but in in the situ in the therapy situation, who do we change? Do I change the patient in front of me or do I change 8 billion people in society? So we are judged on on that. I will not deny that fact. I will equally say that that should not be the case, but it is. So there the the you know the the fear and the importance is grounded in fact, and it becomes how we manage those facts that therapy, uh, therapy addresses.
SPEAKER_00Right. So I think one of the things I really wanted to talk to you about is how stepping on the scale can make or break your day, your week, your month, anything like that. I know for me this morning I stepped on the scale. I liked the number that I saw, and I was like, it's gonna be a good day, right? Which is terrible.
SPEAKER_02And I I I cannot tell you how many scales I have stepped on and said, this thing's broken. Why is it every scale I step on is broken?
SPEAKER_00I get it.
SPEAKER_02So we both have conflicting relationships with scales. Now, what happens is you step on the scale, you get a number back. And if it's not a good one, all of those doubt and questions that you pointed out five minutes ago come rushing back in into us. Am I am I doomed to be this weight? Why isn't it moving? How the medication isn't working anymore. And it's actually not the medication's fault, it's my fault. The medication works for everyone else, it doesn't work for me. So the moment we see the number on the scale, all of those thoughts come rushing right back into us. And as a therapist, those are the thoughts I want to explore with people as they step on uh as they step on the scale. So we talk about the scale being exposure therapy. Exposure to what? Exposure to these thoughts.
SPEAKER_00Okay.
SPEAKER_02Exposure to all of these thoughts. So I use cognitive behavioral therapy. Actually, I have adapted cognitive behavioral therapy for eating disorders. I have adapted it more for a weight management approach. Part of that protocol is what CBTE calls collaborative weighing, where the patient and the therapist or provider weigh the patient and then talk about the weight. And here is what I say to patients every every time. Some of them get a look of panic on their face.
SPEAKER_00I would be nervous about that.
SPEAKER_02Well, let's see. I want you to be honest with me. Please be honest. But here's what I say. Here is exactly what I say. I say, when you weigh yourself, you will never, or when you report your weight to me, you will never hear me say, yay, you're down five pounds, or you're up three pounds. If you ever hear me say that, hit the exit button on your Zoom or video program and fire me on the spot. Sure. That is not the purpose of this. Purpose is exposure therapy. And that is exact, and exposure therapy is exactly what you think it is. Just like if you have a fear of flying and you go on an airplane and you survive it, you know, that's exposure to your fear. I treat the scale as exposure to your fear. So when we talk about this, we're gonna talk about things like crap. I had a great week, but I didn't lose a pound. My God, I want to quit. Yeah. Yeah. That's what we talk about. That's what we talk about. I I I I don't go, ooh, you didn't lose a pound. Oh no, I I noticed that you had ice cream. Can we switch it from ice cream to yogurt, please? Because then you lose weight. No, you have a fear that something is horribly wrong.
SPEAKER_01Hmm.
SPEAKER_02Let's talk about okay. I have only had, well, I mean, you you tell me what what you think of that approach, whether that addresses the fear or not. Let me be very clear. Somebody says, you know what, I still don't want to do this. I won't force them. That that's obvious. But what does that explanation do for you?
SPEAKER_00Well, I think that for me, like I'd be I'd be interested in knowing, okay, I gained a pound and here I am in a spiral of some kind, or this isn't working, or I'm gonna quit the medication, or I'm the only one, you know, all these things. So how do you then take somebody like me from that state of mind to, I don't know if it's like neutralizing the thought, like where do we go?
SPEAKER_02Well, of course, so of course it is neutralizing the thought if you want to to get to it, but that becomes incredibly individualized in in someone. I mean, what what I would say is, you know, you you put on a pound and and you actually let me just give an example, different ways of of treating this. There's one individual that I that I work with that has a number of or a constellation of issues going on in in his life, and he reports his weight to me, up, down, left, right, whatever it is, and I yawn. I practically yawn. I go, yeah, all right. What else is there to talk about? After six months of this, so just yeah, okay, that's great. He goes, you know what, Brian? Every time I report my weight to you, you don't say anything. Well, that's because it's not important in all of this.
SPEAKER_01Right.
SPEAKER_02That is someone that that that's a technique that I have used based on the individual's profile. Whereas with with with with you or something else, I may say, My God, you haven't lost weight. If I sort of extend that, it's like you want to stop. Am I right? Say more about that.
SPEAKER_00Right. So, like for me, it would be like, oh, well, this isn't worth it, right? Because there's the cost involved with the GLP one. There's the inability to maybe eat things you want to eat. Or I know that before the GLP one, I'd be like, Well, this diet isn't worth it. Tracking these calories isn't worth it, doing this Weight Watchers isn't worth it. Like if I'm not seeing a result, right? Because I'm a businesswoman, I A plus B and I get C. Like, that's how my I think. Your body doesn't work like that.
SPEAKER_02Well, that's right. Your body doesn't work like that.
SPEAKER_00Right.
SPEAKER_02That's right.
SPEAKER_00So that's where like I still want to control it in the same way I can, you know, send out an email, make 10 sales.
SPEAKER_02How how long is it going to take you to realize it doesn't work like that? Do you see what I'm doing? I just I I challenge the thought. Like, how how many, yeah, oh uh how many, how long is it gonna take you to realize your body doesn't work like that?
SPEAKER_00You know, ne I guess never because I've got a degree in nutrition.
SPEAKER_02Should have gotten a degree in business.
SPEAKER_00Right? Yes.
SPEAKER_02So so you you now you you can see it I'm playing off of off of you, giving some facts around all of all of this, holding the the position. I I'm basically taking the position of your body, which is I will not respond in the way you expect.
SPEAKER_00Right.
SPEAKER_02Yeah. There are some times where I may say, talk to your body right now, tell your body how frustrated you are with it. Why don't you or or or why don't you and your body go into a back alley and beat it into submission? Come on.
SPEAKER_00Great, great. That's not a good thing.
SPEAKER_02And and by the way, that's where restrictive eating disorders come from or purging disorders come from. I'm gonna beat you into submission. I will only eat 800 calories a day. Now that this is an overly simplistic view of very overly simplistic disorders. But you know, that is where somebody wins the war over their body and like, yep, I got you. I need eight, I'm eating 800 calories a day and you can't stop me. Well, when you get hospitalized because your heart rate goes down to 50 beats a minute, it will stop.
SPEAKER_00Sure, definitely, definitely. You guys remember my conversation with Beth a while back, the one that became one of the most popular episodes? Well, Beth is from Tide Wellness, and that conversation is the reason I'm comfortable telling you about them today. So many people lose weight on GLP1, feel amazing, and then six months later, they're back to where they started because the program ended or the provider disappeared or they were never set up for the long haul. But Tide Wellness is built differently. Licensed providers to actually adjust your dosing as your body changes. A real care team you can message when you hit a plateau or have a question or need help, nutrition guidance designed specifically for how GLP1s change your appetite. And if you've got questions, you can book a consultation and actually talk to a provider, a rare find in this space. If you're looking for more than GLP1s, they also do microdose GLP1 programs, hormone therapy, longevity peptides, and the kind of support that matters when you're trying to fill your best long term. Tide is built with support by a team that really cares. Go to tidewellness.com backslash GLP1 hub and use the code GLP1Hub50 for $50 off your first month. Again, it's TideTy D E wellness.com backslash GLP, the number one hub, and the code is GLP1Hub50. So let's say you're a person at home and you are, you know, panicked, stepping on the scale multiple times a day, or comparing yourself to your neighbor who lost 50 pounds while eating McDonald's every day, whatever, right? What are some of the things you could tell yourself, or if you can't work with a therapist like you, to maybe not tie your worth or your days, how well your day is going, or how well the medication is working for you, or any of these things to that number?
SPEAKER_02One of the most important things to realize, and this is going to be very counterintuitive, is that that number does represent some factors to it. I went to my doctor about three weeks ago. They had a uh should be he he had a new receptionist on staff. And before I went in to the appointment, and this has rarely happened, she said, before you go into the exam room, step on the scale, looked at the number, wrote it down, put it on a piece of paper, put it on the doctor's desk to look at. Now, there is a lot of core there is a lot of data that you're you're a nutritionist, there's a lot of data that correlates, I'm using the word correlates, weight to certain conditions. It's not necessarily causative.
unknownRight.
SPEAKER_02We don't need to get into a statistical debate here, but there are correlations around weight and certain conditions. So I think part of it is to recognize that there is some weight to the weight, but what has to change is how we respond to it and the amount of shame that one feels about themselves when they step on on the scale. Shame is a very, very challenging emotion to deal with. And what ends up happening is shame takes a little bit of a truth, you know, there is some weight to the weight, and then it conflates it to I'm a bad, bad person. And then society reinforces that, and then we act on on on that through eating even a bit more.
SPEAKER_00Right.
SPEAKER_02So there's a whole whack of shame that comes in.
SPEAKER_00So why are why do humans have this sort of like shame? Is it that we is it part of that we want to like be included and accepted? And when we're not, you know, we're out of the tribe, and so we're gonna die alone in the woods. Like what where does this come from? Because all of us feel it about something, like your outfit is bright, or you know, as I'm getting older, now I'm old and I don't like that and this kind of stuff.
SPEAKER_02Shame is what we call an aversive emotion. We do things to to avoid it. And so let me give you, let me give you an example of how all of this works, including the scale. So let's say in about two months from now, you are going to a a wedding and you realize, oh my god, I've got 30 pounds to lose before then. You do the calculation. Uh two to uh two months is eight weeks, 30 pounds, that's about eight pounds a week. A little high, but yeah. 32 divided, oh, it's four pounds. Sorry, four pounds a week. 32 divided by eight is four pounds a week. So about four pounds a week. All right, two months, eight weeks, four pounds a week. Let's go. Let's let's do it, right? Right? Here's what happens eventually, in a very short while, you will fail. And you will fail for reasons beyond your control. If you are exercising, maybe you get injured. Maybe you just get sick with a cold and can't go to the gym that day. Maybe your your family needs attention. It's over the summer, maybe you go on a vacation. Maybe you go to a summer cottage or whatever, and you know, the only food there is hamburgers and beer. You are stuck. So you will eventually fail in a very short period of time. And people view that as a lack of resolve on their on on their part. But the expectation of quick weight loss creates a following. I'm gonna do this quickly, so quick leads to this black and white perfectionistic uh thinking. You know, all right, I it's gonna be four pounds a week, here I go. Uh-oh. Didn't hit it, or rather had a bad night, and of course you step on the scale, that just reinforces it for you right there. Uh-oh, I have objectively I have failed. So quick leads to perfectionism, leads to black and white thinking, leads to failure. Now, the question is what causes quick? So I've got this quick leads to black and white, leads to perfectionism, leads to failure. What causes quick? And that's shame. That is shame. So remember, the person's individual goal was at this wedding, for this wedding, I want to lose 30 pounds. And the reason why they want to lose 30 pounds is because they don't want to be in pictures looking the way they do, because that is shameful. Oh my god. I'm in family pictures. This is a way I'm gonna be memorialized for 40 years. That's shameful. You all will always at these weddings have the insensitive uncle or relative who goes, who who goes, you know, they've got Ozempic now. You should try that. You should try that. You know, and they've got insurance coverage. And in Canada, they now have the I'm in Canada, they now have the generic version of it. The cost is one quarter. Hey, come on, it's one quarter, I'll even pay for your Ozempic. Eek. That's shameful. Yeah. You try on the clothes for the wedding a week before and realize, uh oh, I am not fitting into those. So that is shame. So the equation now becomes shame leads to quick, leads to black and white thinking, leads to failure.
SPEAKER_00Right.
SPEAKER_02That sort of chaining allows me to treat people psychologically on any one of those points. I could treat the shame, I could treat the quick, I could treat the black and white thinking, or I can treat the failure. And what I have found in years of practice is treating the black and white thinking, which is a thought, a cognitive thought. Oh my god, well, black and white thinking doesn't make any sense. It's an irrational thought. I have found that that doesn't work very well. I am a depth therapist, so I can treat the shame. The issue with treating just the shame is it takes a long time, and it's not necessarily what people sign up for, but I can treat the quick a little bit. Because if we get rid of the quick, we get rid of the black and white thinking, we get rid of the failure. So I use cognitive behavioral therapy to slow people down. And part of that is the collaborative weighing that I talked about. Okay, the scale's not moving as quick as you want. What do we do here? Do you want to abandon this? Do you want to make this effort the same as all the others? Where if it's a scale doesn't move, you end it because you can end it. You don't need to come back. Right. So that's a little bit about how shame leads to quick and how I work with the quick and how I work with the scary.
SPEAKER_00So let's say you do need to, for your health, lose 30 pounds, right? Let's say you don't have a deadline, like there's no wedding in two months or whatever it is. Would that be maybe a better approach to like kind of take away the time? You know, I like to tell people to focus on habits. Like, what are the habits you can control today? You can go for a walk or you can drink water, or you can, you know, how do you feel like reframing it a little bit so that you work on the habits that could potentially get you to that 30 pounds, but you you don't know when, you don't know if you will. But that's kind of how I try to reframe it. Would that be a good way?
SPEAKER_02Here's the thing with with habits, and I'll talk so I'll talk about habits for for a moment. What I'm doing is working on on the psychology. Habits are absolutely a factor, but let me explain it with smoking as as an example. Smoking, if somebody smokes, let's say they're addicted to it. Smoking, I think you're in the states, but smoking is actually highly legislated because there are very few places you can actually smoke. Yeah, you can smoke inside your home, you can you can smoke on your property, but you can't smoke in a workplace, for example. So somebody who is addicted to cigarettes will have the following pattern or the following habituation at work. Come in at nine, wait until 10 30, 10 30 break, break outside, smoke. And over decades, 10 30 break outside smoke, 10 30 break outside smoke. That's It's a habit.
SPEAKER_00Yeah.
SPEAKER_02That is a Skinner Pavlov habit. It is the addiction that has caused the habit to begin with. So we have a number of different ways of treating this. You can treat the habit by saying what can you focus on today? What small changes can you make? But for the smoker, if you don't address the underlying addiction, habit change isn't going to last very long. If you don't address the underlying psychology of shame around eating habits, 8 p.m. Netflix food, 8 p.m. Netflix food. That could be caused by binge eating, could be caused by food addiction. So if you it could be and all of that has shame and stuff around it. So you can change the habit, absolutely, but you have to address the underlying cause as well. Habit change is exactly as as you mentioned. It is what small change can you make today? What can you control today? Can you replace one habit with another? And I that that's not changing one addiction to another addiction. That's that's not good. But but you know, can you change the habits in in a mild way? One thing I often tell people to do if if they've got that sort of 8 p.m. Netflix eat, I'll say, take your iPad, lie in bed, and change the location of the Netflix for for yourself, because there's likely an association between 8 p.m. couch and eating. So you can change the location of the habit. So that that's a little bit about how I work with habituation. It's a factor, but underlying the habituation is the same psychology that we've talked about.
SPEAKER_00Right, right. So one last thing that I did want to ask you about is food noise.
SPEAKER_01Yes.
SPEAKER_00Which is sort of obsessive thoughts about food and eating. And to some extent, the GLP one does quiet that.
SPEAKER_01Yes.
SPEAKER_00It doesn't take it away completely. Like I am a food person. I will always think about food. I just came back from Japan. My entire trip revolves around what I was going to eat in Japan. Like that was just what I want to do with my life. But how people seem to get really anxious about the food noise and it never, they want to never think about food. They want it to be completely suppressed.
SPEAKER_02There there is shame coming in again. And just let me explain another aspect of shame, if if I could. So the desire is I never want the food noise. Okay. That now, oftentimes, rather, oftentimes, I get people coming into my practice. I'm in Toronto, Canada, and they say, Brian, I want to be the person that wakes up in the middle of February at 5.30 in the morning and is glad to run a marathon outside. I want to come home. Yeah. Yeah, you're you're shaking your head. No, to that. Sometimes I do work out at 6 30 in the morning in the middle of February. I can tell you no one at that gym is happy to be there. If anyone if anyone actually walked into that gym happy in the morning, hey guys, are we happy to be? We would descend on that person like a pack of hungry wolves and tear them to shreds. Okay? So what we have in that gym going person, that marathon going person, and in the person that never wants the food noise is an unrealistic expectation of who we can be. So here is what shame does. Shame, when we are overweight, obese, having issues with food, makes us say, underneath all of it, I do not like where I am, I do not like who I am. When that happens, it is normal for us to create a different version of ourselves. It is normal. So people seeing seeking therapy outside of, wait, Brian, I'm depressed. I can't get out of bed in the morning. All I want to do is get out of bed. I'm anxious. All I want to do is just not be triggered in when I see my family. So the function of wanting to be a different person is normal. But when that function is shame-based, the person we want to become gets way overshot and way overcompensated. I don't like who I am. Rather than being a normal person, I'm gonna be a superhuman one because I don't like who I am. So when we begin to put it into that context, I say, is shame driving this idealized image of the right, right. And once there are there are some phrases in therapy, name it to tame it, heal it to the it to heal it. So once we name shame, once we can begin to to feel it, can we begin to get a more realistic expectation because the food noise isn't going away? And Anna, I can tell you, I will say this, you you you said it yourself. The GLP one does not entirely take away the food noise. I bet I I I I don't read a lot of research studies. I bet you do. Are there studies that show the food noise doesn't go away completely?
SPEAKER_00It it I mean, it just suppresses it, suppresses some of those cravings, some of the out-of-control feeling, but we still need food, and so our bodies are still going to want that. And then there's a social aspect or a cultural aspect, like when I went to Japan, like that was for me part of enjoying the culture. So why would I want that to go away?
SPEAKER_02Because shame wants to turn us into the person who says, I can go to Japan and just eat the seaweed off the sushi. Yeah, no sushi rice for me, no carbs. So we have to recognize the role that shame plays in all of this. And it's the same role that shame causes that quickness, and shame causes us to look at the scale and go, eek, I haven't lost a lot of weight yet, I'm doomed in all of this. So, as a therapist, by exposing people to the scale, I expose them to their fear, I expose them to their shame. And and I hope the audience realizes that I can work with that very dynamically depending upon the patient that I see, but always very respectfully.
SPEAKER_00Yeah. So if people want to work with you, are you able to work with people in the United States or is it just in Canada?
SPEAKER_02I I can only work with people in in Canada. And my website is Aleva Psychotherapy A-L-I-V-A Psychotherapy.com. You can also search my name in in Google, um Brian Baumall. Last name is spelled B-A-U-M-A-L. I'm I'm fortunate that uh no one else has has my name. So of course, now now of course there is going to be a a doppelganger of me that has all of these horrible things said about just luck. Uh but those are the ways that people could find me, either searching my name or going to going to a Leva psychotherapy doctor.
SPEAKER_00Awesome. Well, thank you so much. This has been very, very insightful. I gave me a lot to think about, a lot of food for thought of what the the underlying thing is, because I see a lot of panic out there and I want to help, you know?
SPEAKER_02It it's it's very true. I I do think that sometimes people put, again, too much weight on the GLP1, like this is a thing that's gonna do it for me. And then if it doesn't do it, they think it's it's a personal failure on their part. They think if they have the slightest bit of food noise, it's a failure on their part. If the appetite comes back, it's it's a failure on their part. Of course, if they come off of it and then the weight comes back on, it's a failure on on their on on their part. Sure. And that is entirely illogical, but it's the shame coming into crew, well, all right, I've lost the weight, now I've done it. I I'm now a super human being. I can come off of this. That's the shame overshoot, making someone think they are superhuman.
SPEAKER_00Right, right.
SPEAKER_02When when they are not.
SPEAKER_00So definitely something to look into yourself for, see if that might be affecting how you're thinking about this whole thing. So, Brian, thank you so much for being here. I really appreciate your time.
SPEAKER_02My my pleasure, Anna. Thank you very much.
SPEAKER_00Thank you so much for listening to this week's episode of the GLP One Hub podcast. I learned so much from Brian and how, you know, I still find myself having my day controlled by the scale, even to this day. And it's tough. It really is. So I really appreciate him coming to share our insights. And if you want more support from people who really understand your journey, make sure you check out the GLP One Hub membership. You can find the link for that in the show notes. And in there, we provide you with monthly challenges, meal plans, um, and general updates, as well as a community who really understands what you are going through as well. And I hope to see you in the next episode.