This blog post is applicable to both women and men, but I am going to focus a bit more on women since in my practice women struggle so much more with weight loss than men. For many women it has become a 24/7 obsession that takes over their life, or is at the very least a constant annoying buzz in the background.
I thought I would share some of my experience, insights, and my deep empathy for women all over the world who struggle each day to balance their own health with the health of so many individuals who depend on them.
I've had women who are busy working professionals, mothers, spouses and daughters/daughter-in-laws break down in tears in my clinic as they try to understand how they gained so much body fat and a growing list of medical conditions like hypothyroidism, adrenal fatigue, digestive issues, chronic migraines, anxiety/depression, prediabetes/diabetes, infertility and more.
Women have spent countless dollars on supplements, consultations with various health practitioners, multiple diets and diagnostic tests often to have very little success despite so much invested time, money and emotional energy.
I want you to take the time to read this blog post as a way to understand your health situation more clearly, to develop a little more self-compassion, and also to evaluate what you are really trying to accomplish when it comes to your health.
When Expectations Exceed Genetic Limits
In my talks about diabetes I often tell audience members not to be a victim of their own genes. Despite nearly every family member being diabetic, if he/she makes the right lifestyle changes then often they can be the one to never develop diabetes. Unfortunately this optimistic view does not always apply to our own physical body. Elements such as our height, our body shape and our ability to achieve a specific body composition may be dependent on our genes and ancestry.
My dietitian Prerna often has patients ask her to outline the exact eating and exercise plan she follows, hoping they will magically transform into a mirror image of her. What they don't realize is that Prerna's current health and body composition is not just dependent on what she eats and how she moves each day.
Much of her health was also inherited from parents and even grandparents who passed on health-promoting genes that were the byproduct of their very own optimal lifestyle practices, including her paternal grandmother who lived until the age of 104! These genes gave Prerna a strong foundation for optimal health from day 1 and she took that to the next level by focusing on a lifelong commitment to optimal nutrition, exercise and stress reduction practices.
In my own case I'm thankful that my parents also led very active and healthy lives. My late father even during his intensive MD, PhD training in Kolkata, India would regularly train with a gentleman named Monotosh Roy, who famously was the first Indian and Asian to be awarded Mr.Universe in the Group III Amateur Division in 1951.
Athletics and exercise run strong on both sides of my family and this is the reason many of my cousins and uncles inherited relatively athletic frames. If my ancestors did not have such a strong tradition of physical fitness, my own body frame and shape would likely be much different than it is today.
Evolutionary and Epigenetic Adaptations
The science of epigenetics now tells us that our physical and emotional make-up is heavily influenced not just by our parents, but by multiple generations before that. The permutations and combinations are endless and explain why your child may often look and behave so differently than you and your spouse.
In addition, the environment, emotions and food your mother was exposed to during her pregnancy had a direct impact on your own development and genetic expression. For example, if your mother was pregnant while living in heavily polluted urban India or China during an emotionally stressful period, then your tiny brain and body were directly exposed to all types of pollutants and stress hormones which set the course for your short term and long term development.
Whichever environment a pregnant woman is exposed to is messaged directly to the fetus via chemical messengers in the bloodstream, which in turn provide a biological snapshot or crystal ball to the fetus of the world he or she will likely be entering.
If the mother eats abundant carbohydrates and sugar, the baby will already develop a body shape and metabolism that will put it at risk for future diabetes, obesity and heart disease. If the mother experiences trauma or chronic stress, then those stress hormones will cross the placenta and influence the development of the fetal brain to be more sensitive or reactive to stress.
Fathers are not off the hook. A field of science called paternal epigenetics now tells us that before conception, fathers who are inactive and eat unhealthy foods increase the risk of their future child developing obesity and chronic health issues. This remarkable study done in mice showed that paternal psychological stress actually caused offspring mice to have livers that produced excess sugar through a process called gluconeogenesis.
Many of my patients who have stubbornly elevated morning blood sugars despite their best efforts with diet and exercise, may have inherited a liver from their parents that is exquisitely sensitive to emotional stress and overproduces sugar in the morning. They can counteract these morning blood glucose spikes by focusing on stress reduction and mindfulness practices, especially in the evenings before bedtime.
Late bedtimes and/or checking messages on your phone or some other screen before bedtime can be a powerful trigger to morning blood glucose spikes, especially if you inherited a sensitive liver that reacts by pulsing out extra sugar upon waking.
The image below from this study highlights how different lifestyle factors fathers are exposed to actually can alter the sperm and impact the development of future offspring and how they think, feel and behave. I think it's key for families to acknowledge the critical role a father's lifestyle plays in the health of future children since in many cultures, the blame for health conditions in offspring is pointed at the mother.
In reality, no one should be finger pointing at either parent since parents do their best to ensure the health of future generations and there was really no general public awareness around the field of epigenetics. I'm presenting this information as an explanation to individuals who are struggling with their weight, their blood glucose, their body weight, their mood, etc. despite their best lifestyle efforts.
For couples planning to get pregnant, this information makes a strong case to prioritize stress management, in addition to exercise and proper nutrition, in order to maximize the chance that future generations have the most optimal emotional and physical health.
Unlike our ancestors, we now have overwhelming scientific evidence about the impact of our emotions and lifestyle behaviors on future generations, so there's no excuse for us putting off making these critical lifestyle changes.
If you're beyond pregnancy planning and have children already, do everything possible to ensure optimal emotional and physical health so that their future children (aka your grandchildren) have the lowest risk of suffering from chronic health issues. Most of the families I see in my clinic are putting most of their time and resources into academic enrichment, which will do nothing to reduce the risk of chronic health issues for future generations.
Weight Loss Expectations
Why am I talking about the multigenerational impact of genes on your body and health? Because as much as I believe in the body's innate ability to heal, reverse disease and thrive, I also see men and especially women setting unrealistic goals that are far outside of their genetic capabilities.
Perhaps you are participating in a group exercise or bootcamp class, enviously watching how other women carry little to no body fat despite them doing the exact same exercises as you day after day, week after week. As a matter of fact, you may be working and sweating harder than they are!
How about a friend who tells you about an incredibly effective diet or detox program where she and her friends lost a bunch of weight? You sign up expecting the same results and either see no weight loss, minimal weight loss, or temporary weight loss with weight gain the minute you stop the diet. By the way, you are doing this diet in addition to the already mentioned intense exercise program. Sound familiar?
When I see patients, especially women in my practice, I like to tell them from the beginning that I am not a weight loss doctor. My goal is to prevent disease, possibly reverse disease, and improve lifespan and overall quality of life. If weight loss happens along the way, then that is a bonus.
Once we can shift the goal away from exclusively weight loss, we can focus on a healthier lifestyle approach that does not involve self-hate and self-torture.
By the way, if you are surrounded by others who are obsessed with weight loss and external appearances, I suggest you consider hanging out in different social circles where individuals place greater value on more meaningful issues and respect you for who you are rather than how you look.
Coming back to genetics, think back to someone in your family who you think represented optimal physical and mental health. Now ask yourself, did he or she have a 6-pack? I have several examples of older family members, especially my grandmother who I featured in a chapter of my book, who to me represents the essence of healthy aging. Her memory in her 80s exceeded my own, her ability to deep squat and hip hinge far exceeded my average 30 year old sedentary patients, and her skin was glowing. Was she overweight? A little…but who cares.
I have female patients who are skinny, stressed out and dealing with chronic aches and pains including migraines, memory loss, hormonal imbalances, autoimmune disease, and premature hair loss. Sure they have a lower body weight and less body fat than my grandmother, but I would argue that my grandmother is far healthier.
Eating a nutrient-deficient diet for the sake of weight loss, working out excessively without adequate rest periods or restorative exercises, short-changing sleep and performing little to no mindfulness practices like meditation (my grandmother rarely missed her twice a day ritual of prayers and meditation) has left them in a black hole of emotional frustration and physical exhaustion.
Know Your Limits
As a woman or man struggling with weight loss for years or even decades, you need to make a decision. Ask yourself the following question:
Do I live out the remainder of my life continuing this perpetual cycle of self-torture, self-hate and fat-shaming every time I look at older pictures of myself or the clothes I was supposed to fit into years ago, or do I take a completely different approach that doesn't leave me miserable and depressed…feeling like a failure?
Life is too short. You decide. I would encourage you to try the latter. I'm not telling you to give up, but to simply think about setting some different goals.
I have taken care of women of all shapes and sizes for several years and my slender female patients are no happier than my overweight ones. Reducing your body fat may transiently make you feel good, but if we don't make more meaningful changes to help you feel better, your happiness will be short-lived.
A few points to consider:
1. Respect Your Ancestry: Think of someone who symbolized optimal health in your family. Again, did she have a 6-pack? Did she run marathons, attend daily bootcamps, and eat nutrient deficient meals to starve herself into weight loss? Did she sleep 5 hours a night? Did she experience chronic stress without any regular daily prayer or meditative practices? This person's path to optimal health was likely much more natural and required far less effort than what you're doing today, because she wasn't pressured by peers and society to achieve an unrealistic body image.
2. Respect Your Inherited Body Shape: If you come from a family of overweight women with wide hips, then you can make changes to minimize those tendencies but you may not be able to drop into a size 2 dress. As a youth I fantasized about having more vascular or “veiny” muscles, but no matter how much weight I lifted or how hard I dieted, those magical veins never appeared!
The problem is if you push your body beyond its natural genetic boundaries, you may be putting yourself at risk for injury and other health conditions by overdieting, overexercising, overstressing, and undersleeping.
3. You Can't Do It All: You are juggling a busy professional and family life and just don't have the time to do everything necessary for you to achieve what you consider an optimal body composition. I have some patients who are elite athletes with personal trainers, nutritionists, chefs and psychotherapists who work around the clock to ensure they are performing at the highest levels. Even with all of these resources, it's still a struggle.
For the rest of us mortals, all we can do is put out our best effort each day to eat a little healthier, move a little more often, get to bed a little earlier, and manage our stress a little better.
4. Beware of Advice from Others: Just because a specific diet or exercise worked for one person, it may either be ineffective or harmful to you. Remember that well meaning advice-givers are genetically and metabolically different than you. When a specific diet or exercise plan works for them, often they become a zealot preaching the exact same diet to everyone around them.
I see this often in couples where a low carb or keto diet works great for the husband, but has no impact on the wife whose weight is far more intimately tied to a complex combination of autoimmune, hormone and stress/sleep issues.
The husband may tell her to just go lower and lower on carbs, but this can often make things worse for the woman and even contribute to fatigue and mood disorders. If you're not doing well on low carb or keto, read this post about my 7 Top Concerns about Keto.
5. What Example Are You Setting? Moms who are constantly critiquing their own bodies and placing such a large emphasis on body weight and size are sending a message to their children that weight really matters. These children will likely follow the same tradition and route of self-hate and body shaming. Unfortunately I've had some women tell me that their own mothers and fathers directly shamed them because of their body weight or even their darker skin color. It is essential that we create an environment for our children that focuses on overall health and not weight or physical appearances. Learning to accept yourself will help your children do the same.
The Power of Reframing
Now take all of the information from this post and think of how you can retell your own story by reframing your prior “weaknesses” and turn them into strengths. Leading psychotherapists often say the ability to reframe negative situations into more positive or hopeful ones (aka “cognitive reframing”) is one of the most important skills that can lower the risk of mental health disorders in adults and children/teens.
For example, you might despise the excess weight around your hips and buttocks, but this study which discusses the “brain/butt theory” explains how mothers with more generous thigh/buttock regions have smarter kids since these areas contain larger amounts of brain-nourishing Omega-3 fats.
Instead of cursing those hips, thank them for providing extra nourishment to your child's brain cells during the critical period of fetal brain development. Your hips and butt may be the reason your child excels in math, science, english or some other area!
Instead of resenting the fact you are so emotionally sensitive, think of how that makes you a more caring parent, friend, and colleague.
Instead of letting a recently diagnosed health condition make you feel weak and powerless, reframe it as a new challenge and opportunity for you to prioritize your own health and the health of those you care for. I often tell my diabetic patients that our goal is not just to reverse your own diabetes, but to do everything possible to make sure your children and grandchildren don't become diabetic also.
Remember that based on our discussion of epigenetics, making sure your child is healthy from an early age will significantly increase the chances that your grandchildren will thrive too.
In my own personal case, developing metabolic syndrome and prediabetes gave me the fuel to dig much deeper into the research and develop content and resources to help others. Likewise, many of my well-informed and motivated diabetic patients have also become health champions for their own family, work colleagues and community members who developed similar issues, providing them with a deeper connection and purpose than they had before they were diagnosed.
We Are Mosaics
Think of yourself as a multigenerational mosaic. The end product of a myriad of endless genes from multiple ancestors, each of whom had complex emotions, physical and metabolic attributes. Instead of focusing on a specific, individual tile in that mosaic that may contain a stain or blemish, which may represent your body shape, your weight, or a specific personality trait…step back and appreciate the fact that the same people who passed these genes onto you, sacrificed so much so you could be here today.
Apply that same concept to parenting. In the chaos of everyday life, we are often guilty of obsessing over specific personality traits or “defective tiles” in our own children. Only when they leave our homes do we really get to appreciate the big picture and beauty of what we have created. Perhaps we can do that more often while they are still under our roof.
Most grandparents have that unique ability already. They look proudly and compassionately upon their own grandchildren, appreciating them as a perfect work of art, rather than obsessing over individual details like they might of when they themselves were busy first time parents.
I hope the title of this blog post didn't mislead you into thinking I would share some magical tips on how women can effortlessly lose excess body fat forever. I also hope it didn't discourage you into thinking that successful weight loss is a hopeless pursuit.
Rather my goal was for you to step back from the madness for just a moment and think about what you are trying to achieve and why? Will your friends and family love and respect you more if you are thinner? If so, then those relationships need to be changed or improved, not your body composition.
I've also noticed that in my practice when men and women shift their focus away from weight loss, they uncouple all of the accompanying emotional frustration and unmet expectations that often go along with their health journey. In many cases this uncoupling actually leads to slow, but sustainable weight loss over time. Even if it doesn't, women still benefit because they realize they can feel happier, healthier, more energetic and even reverse/prevent health conditions without losing a single pound.
Now without setting unrealistic expectations, I would like to share that I did partner with Digbi health, a wellness company that is using gut and gene data to help with weight loss and diabetes prevention/reversal.
Although I have seen a significant number of my patients lose weight and improve their blood glucose, I'm more excited about the deep insights these programs can provide about your personal metabolic tendencies and how to customized your diet and lifestyle accordingly, which is why I'm an advisor to Digbi.
For weight loss, try their Control program here and for Diabetes prevention/reversal try their D-Feat program here. Digbi is offering a 30% discount for my audience, so follow the links if you're interested.
Digbi has been so successful that they recently partnered with Blue Shield of California, who offers Digbi through their Wellvolution platform. If you have Blue Shield of California, Digbi's covered as a benefit.