Confessions from an Obesity Physician: The Things I Do Right
Welcome to the second part of my series, "Confessions from an Obesity Physician."
In the first part, I opened up about the things I advise my patients to do that I sometimes struggle with myself. Now, in this segment, I'll share five key practices that I consistently follow and recommend to my patients. I'll dive into why these practices are essential and how I make them work in real life.
It's important to emphasize that the advice I provide isn't just based on personal experience—these are evidence-based practices rooted in medical research. I believe in a balanced approach that combines scientific data—like studies on medications, diets, and exercise—with the individual needs of each patient. Even if there's strong evidence supporting a particular strategy, it doesn't mean it's the perfect fit for everyone.
It really bothers me when professionals suggest what worked for them without considering if it applies to others. Effective advice should always be personalized. After more than a decade in this field, I've learned that one-size-fits-all advice doesn’t work. If something isn't working for you, it just means we need to find a better fit—and that's perfectly okay.
Confession 1: Why I Believe in Breakfast
Let me start by sharing one of my core beliefs: I’m a big advocate for starting the day with a meal. You’ve probably heard me mention this before, and there’s a good reason why. It's not just my personal preference—there’s solid evidence behind it. The National Weight Control Registry, which tracks people who have lost significant weight and kept it off for at least a year, shows that certain habits are key to maintaining weight loss. One of these habits is eating regularly in the morning.
According to the registry, about 78% of successful weight maintainers eat a morning meal daily. This suggests that beginning the day with food can be important for keeping the weight off. Of course, there are exceptions—22% manage without a daily morning meal. They might eat breakfast some days or not at all, but the majority found that a regular breakfast was helpful.
I’ve seen a similar pattern with my patients. Many who come to me for guidance don’t start their day with a meal and often end up overeating later. They might skip it because they’re not hungry or it’s just not a habit, but this often leads to increased hunger and less control over eating later. However, when they begin their day with a balanced, protein-rich diet, they usually manage their hunger and portions better throughout the day.
That said, breakfast isn’t a must for everyone. Some people do great with intermittent fasting, and skipping this first meal fits well into their routine. It’s all about finding what works best for each person. When I work with patients, I take a comprehensive look at their needs to see if a morning meal would be beneficial.
Personally, I’m a fan of eating in the morning, though I didn’t always feel this way. As a kid, I often skipped it because I was in a rush or just not hungry. But as I got older and paid more attention to my nutrition, I noticed how much better I felt starting my day with a good meal. Now, I make sure my breakfast includes plenty of protein and healthy fats to keep my energy stable and avoid mid-morning cravings.
In short, I think a nutritious breakfast can be a great tool for most people—maybe about 80%—but it’s not essential for everyone. The key is to listen to your body and find the routine that best supports your health.
Confession 2: The Power of Daily Exercise
Exercise has been a regular part of my life for as long as I can remember. Even as a teenager, I was always involved in some type of sports team, regardless of my skill level. I showed up to practice, put in the effort, and stayed active. When choosing a college, one of the deciding factors for me was the quality of the gym facilities. I attended the University of Denver, which has a beautiful gym with an Olympic-sized swimming pool. The inviting atmosphere of the Ritchie Center made it an easy decision.
As I became more interested in biology and medicine, I learned how powerful physical activity is for our health. It doesn't matter what your current weight is or your goal weight—exercise offers incredible benefits for everyone. Personally, I’ve found that working out regularly significantly boosts my physical and mental well-being. It gives me more energy and keeps me in a better mood, making it easier to stay consistent.
I've made it a point to exercise most days throughout my adult life. This commitment is supported by data from the National Weight Control Registry, which tracks people who have lost significant amounts of weight and kept it off. The registry shows that 90% of successful weight maintainers exercise for an average of an hour each day. This substantial amount of physical activity plays a key role in preventing weight regain, whether you’ve lost 10 pounds or 100.
The benefits of daily physical activity extend beyond weight management. Studies show that getting about an hour of movement a day can reduce the risk of heart disease, cancer, and many other conditions, and it’s often linked to longer, healthier lives. I understand that dedicating an hour every day to being active might sound daunting, but the key is to start somewhere. Even a short walk can make a difference, and you can build up to longer or more intense sessions over time.
Staying active doesn’t have to be structured or require special equipment. Most people in the registry were simply walking—no gym memberships or fancy gadgets needed. Start with whatever feels manageable, even if it’s just a few minutes a day, and gradually increase from there. Incorporating exercise into your daily routine, whether a gentle stroll or a high-intensity workout, can become as routine as brushing your teeth.
Confession 3: The Role of Regular Weigh-Ins
Another important habit for maintaining weight is regular self-weighing. I know stepping on the scale can be a challenging experience for many people. It can sometimes be emotionally triggering or lead to feelings of anxiety. I even have an episode dedicated to discussing these challenges. However, according to the National Weight Control Registry, one of the habits that successful weight maintainers share is weighing themselves at least once a week. In fact, about 75% of those who have successfully kept off weight do this regularly.
The idea here is simple: knowledge is power. If you don't know your current weight, it's hard to know if your efforts are moving you in the right direction. Personally, I weigh myself about once a week to stay informed. However, there have been times when my scale's battery died, and I didn't bother to replace it for months. During those periods, I've found myself gaining a few pounds without realizing it—usually around five. For someone like me, who has maintained a consistent weight most of my life, even a small gain can feel significant.
These unintentional gains have happened because I lost that regular feedback from the scale. Without it, I wasn't as aware of the gradual changes in my habits, like having dessert a bit more often than usual, which can add up over time. For me, the scale serves as a useful tool to help me stay on track. It's a form of feedback, letting me know whether what I'm doing is effective or if I need to make some adjustments.
That said, if you find that weighing yourself causes stress or triggers negative emotions, it may not be the best strategy for you right now. It's essential to approach the scale with a neutral mindset, using it as just one piece of data to gauge your progress. The goal isn't to judge or criticize yourself but rather to gain insight into whether your current habits are aligning with your weight management goals.
If you can maintain a neutral stance and view your weight as just a number—one that provides valuable feedback—you might find regular weigh-ins to be a helpful part of your routine. It’s a simple way to check in and see if reality matches up with your perception of how things are going. For me, it's been an effective way to ensure I'm staying on track without letting things drift too far off course.
Confession 4: The Habit of Packing My Lunch
I've been packing my lunch for as long as I can remember. It started in childhood, with my mom either packing my midday meal or encouraging me to do it myself. This quickly became a habit that stuck with me as I grew up. Even during my residency, when there was free food in the cafeteria, I often chose to bring my own lunch despite my hectic schedule. Now, in my professional career, I still make it a point to pack my noon meal almost every day.
Of course, there are exceptions—like when someone brings lunch to the office, and we're able to request something healthy. These occasions are a nice treat, but on a regular day, I avoid eating out. I can’t even begin to calculate how much money this habit has saved me over the years. On the rare occasion that I forget my lunch, I usually head to a nearby Thai place. And every time I do, I'm shocked by how much time it takes, even though they’re pretty quick, and how expensive it is to eat out. It’s a stark reminder of why I pack my own midday meal.
Packing my midday meal allows me to control what I eat and ensures I have a healthier, balanced option. When I prepare ahead of time, I’m less likely to make impulsive choices that might not be as nutritious, especially if I’m feeling stressed or pressed for time. While I haven’t looked up specific data on the benefits of this habit, I can confidently say it has served me well, both for my health and my wallet.
For those who work from home, I’ve found that this practice can still be incredibly beneficial. Many of my patients who are now remote workers struggle with deciding what to eat during the day. They often intend to make a healthy meal but end up skipping it or snacking on whatever they find in the kitchen. To combat this, I’ve encouraged them to prepare their lunch the night before or first thing in the morning, just as they would if they were heading to an office.
Having a plan in place brings structure and intention to their day, helping them stick to healthier eating habits. Whether you’re going into the office or working from home, having a pre-planned meal can be a great strategy to ensure you’re eating nutritious, balanced food while also saving time and money. It’s a simple yet effective way to maintain control over your diet and stay on track with your health goals.
Confession 5: The Power of Eating Consistently
One final habit that has proven effective, according to the National Weight Control Registry, is maintaining a consistent eating pattern. For some, this might sound a bit monotonous, especially if you enjoy trying new recipes or savoring diverse foods. But the data shows that sticking to a routine can be a key factor in successful weight management.
In our household, we often eat the same types of foods regularly. For instance, we might stick to the same breakfast options for long stretches, rotating through a set of tried-and-true recipes that align with our health goals. This approach keeps things simple, satisfying, and convenient. By eating similar meals frequently, we maintain a sense of structure that supports our overall health.
The idea isn’t to avoid special treats or new dishes entirely. When we do indulge, whether it's making enchiladas or enjoying a meal out, it becomes a special occasion rather than a routine. This approach aligns with the 80/20 rule I’ve mentioned before: aiming to eat healthy, consistent meals 80% of the time, while reserving 20% for enjoyable treats. This balance helps maintain both health and satisfaction.
Having a routine can also prevent overeating. When certain foods are part of your regular diet, like scrambled eggs for breakfast, you tend to feel more satisfied with smaller portions. You’re less likely to overeat or binge because the familiarity of the food reduces its novelty and the urge to consume more than you need.
By establishing these consistent eating patterns, you not only simplify your meal planning but also create a stable foundation that supports healthier eating habits. This consistency can make a significant difference in managing your weight and maintaining overall well-being. And, when you do decide to enjoy something special, it becomes a treat that enhances your experience rather than disrupting your routine.
Thanks for joining me for this second part of "Confessions from an Obesity Physician." I hope sharing these practices gives you helpful insights into what works for me and my patients. Remember, it's all about finding what suits you best and making adjustments as needed. To get the full picture and hear more about my personal insights, check out the full episode.
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