fasting

Managing Hunger to Optimize Health

Dr. Trevor Cates: Welcome to The Spa Dr. Podcast. I am Dr. Trevor Cates. Today we are talking about managing hunger to optimize your health. My guest is Dr. Katrina Ubell, who is a master certified life and weight loss coach and host of the popular weight loss for busy physicians podcast.

Dr. Trevor Cates: After completing her pediatric residency at children’s hospital of Wisconsin, Katrina worked in a private pediatric practice for 10 years. During which time she lost 45 pounds in 12 months without surgery pills, unhealthy crash diets or fitness apps. Now retired from medical practice, Katrina has leveraged her experience as a pediatrician and as a mother to help other busy doctors prioritize their health and achieve permanent weight loss.

Dr. Trevor Cates: In this interview, Katrina explains the difference between emotional hunger and true physical hunger and how people with busy schedules from working parents, to ER doctors, can stay healthy, focused, and energetic, even when they can’t eat three nutritious meals a day, because they’re so busy. Katrina also discusses pitfalls to look out for, with intermittent fasting. That’s because it’s so popular right now, but this is something there’s an aspect of this that a lot of people don’t want to talk about, and she shares some things with us today in this interview. So please enjoy the interview

Dr. Trevor Cates: Katrina. It’s great to have you on The Spa Dr. Podcast. Welcome.

Dr. Katrina Ubell: Thank you. I’m so excited to be here.

Dr. Trevor Cates: Yeah. You have made an interesting transition. You went from being a doctor to being a health coach. Most people either become a health coach and then a doctor or maybe one or the other, but not that direction. So why did you decide to do that?

Dr. Katrina Ubell: Well, I really struggled with my weight for ever, as a young kid, not so much necessarily, but definitely in high school, I would lose a bunch of weight when I was on the swim team in the fall and then I’d gain it later in the year. I was definitely using food to make myself feel better. You know, I was definitely an emotional eater, even though I had literally no awareness that I was an emotional leader.

Dr. Katrina Ubell: I really did not know that about myself. I just thought I liked food. And then I struggled in college. I went to a particularly challenging college and of course chose what everyone considered to be the hardest major. And then halfway through that decided to go to medical school. My senior year before applying to medical school, I was taking so many credits and I had some required classes that even overlapped.

Dr. Katrina Ubell: I had to get special approval from the professors to let me run, halfway through this class, across the campus, then to this other class. I have been a pretty ambitious person and a high achiever and definitely used food to make that possible. Then with medical school, it really hit. It was just like, okay, now you don’t get to do any of the other things that you really like to do that are fun and enjoyable for you.

Dr. Katrina Ubell: All you can really do to make yourself feel better is eat. Because you really can’t do what your body is telling you to do. You can’t sleep when you want to sleep. You can’t eat, when you want to eat, you can’t go to the bathroom when your body is telling you, you need to go. It really just kind of became the one thing that I had that got me through.

Dr. Katrina Ubell: I kept thinking, I just need to get to my attending life. Like I need to get out of my training. Of course residency was the same way. And I thought that was going to be the solution. And then I could always lose weight through Weight Watchers. I’m a lifetime member, but I could not keep it off for longer than honestly, like even a couple of weeks.

Dr. Katrina Ubell: I was not willing to keep counting points the rest of my life. And I didn’t really understand how that could be a problem. I kept just thinking like, this problem will just solve itself. And then I will just eat a little more “normally”, and then I should be able to keep this weight off.

Dr. Katrina Ubell: And of course that never happened and then threw in some pregnancies and I always lost the baby weight, but then I would just go back to eating at night and eating before bed, and eating even at work to make myself feel better and then I’d gain it back again. What ended up happening was I was getting close to my 40th birthday and I think those milestone birthdays, we often have kind of a life reevaluation. And I was definitely doing that, rethinking everything.

Dr. Katrina Ubell: I had lost the weight after my last child. I knew I was done having babies. I really swore to myself, I mean it this time, I am not going to gain this way back, except I did. I was like, crap. This is so hard. The thing about this is when you’re in practice. I was practicing as a pediatrician. I had a great practice. People can tell that you struggle with your food.

Dr. Katrina Ubell: They can see it on your body. It’s not like it’s a quiet thing, similar to skin issues. People can see that on you. There are things you can do and you can address it and you can whatever. But it is pretty obvious. There is this added layer of shame and humiliation for doctors who are overweight, because we kind of feel like hypocrites.

Dr. Katrina Ubell: Here I am telling you how you should feed your child so that he or she can grow up healthy or how the family should be doing certain things. Then I know full well that I am not doing those things. It is like this misalignment, it just doesn’t feel right.

Dr. Katrina Ubell: At the same time, I found life coaching for a totally separate issue. I was struggling with a relationship in our family and I felt like I needed some help. I felt like it was probably me who was the problem, but I didn’t know what to do. And I had already tried therapy a number of years prior, and I had found it to be helpful, but I didn’t think it would be what I needed in this case. So a friend who literally had taught me Pilates years prior, she’d actually moved away.

Dr. Katrina Ubell: She had one time mentioned to me, Hey, I think I want to become a life coach, which I didn’t even really know what that meant. I just heard that term on Oprah when she would have Martha Beck on. I guess it’s just a coach for your life. But anyway, I thought, well, I should just reach out to her and see if she ever did that, because maybe that’s what I need.

Dr. Katrina Ubell: She just finished her training. She did two sessions with me and completely changed my life. She taught me some basic tools. This is the best thing ever. I actually considered becoming a coach right then. But we were in the middle of a massive house renovation. My youngest was 12 months old. It was just not a good time, and I thought maybe later.

Dr. Katrina Ubell: So fast forward a little bit longer. I was really just not feeling super satisfied with my practice anymore. I think in hindsight, I was really feeling very stagnant. I couldn’t have really articulated it in that way then. I don’t think I had the awareness around it, but that’s for sure what was happening for me. I just didn’t see opportunities for growth anymore there.

Dr. Katrina Ubell: Not like I knew everything. Certainly not. Like I’m an expert in all things, pediatrics. I felt like, give me any baby who can’t sleep and I will get them to sleep. Give me any baby or young child with growth issues or eating issues. I can fix it. It just didn’t feel that challenging anymore. I just was dissatisfied for some other reasons.

Dr. Katrina Ubell: And I thought, you know what, I’m going to just take a break. And I am granted, walking away from a 10 plus year practice that I had worked so hard to develop and nurture and really train these people the way I wanted it to be like, and you can’t recreate that. There are no take backs on this. You can’t go back. But I really strongly felt like this is what I need to do.

Dr. Katrina Ubell: While I was waiting, I gave them six months notice, while I was waiting to leave, I was like, Oh, that’s right, I wanted to be a life coach too. Maybe I should do that. Never thinking I would ever have a business. I just wanted to know it for me and my kids and that kind of thing.

Dr. Katrina Ubell: I basically signed up for coach training and an intensive seven months long weight loss program using the same tools, all at the same time. I did everything all at the same time left and became a coach and lost way more weight than I ever thought I could. Literally, I did not think it would be possible for me as an adult to lose that weight.

Dr. Katrina Ubell: I just became obsessed with telling people about it and helping other people. I had struggled so much as a doctor. I literally had googled weight loss for doctors, weight loss for physicians. Certainly somebody must be helping the doctors lose weight and all that came up were medical, weight loss clinics. And I was like, I don’t need shots. I don’t need pills. I don’t need surgery.

Dr. Katrina Ubell: I need something different that is going to help me. I felt like I had worked with a nutritionist and she just didn’t get my life. She was just like, okay, in the middle of the clinic in the afternoon, you have to stop and eat a snack. And I was like, never going to happen. I’m just, no. When I’m already behind, and you know, people don’t like waiting in the doctor’s office.

Dr. Katrina Ubell: When I’m already behind, I am not going to stop and eat something. I kept thinking it doesn’t have to be so complicated. Why does it seem so hard? Shouldn’t humans just know how to eat in a way that is healthy? Why is this so difficult? So anyway, I just learned all of this stuff and I thought, you know, there might be some other doctors who want help with this too.

Dr. Katrina Ubell: Because I know I struggled so much. So I thought I could give a business a try. Why not? I’m so glad I did because I fell in love with entrepreneurship, which was fun, a little extra. But I have also helped over a thousand women physicians in clinical practice to lose weight, and to lose it permanently. We do that by working on our brains because that was the key part I was missing.

Dr. Katrina Ubell: I kept thinking I needed better systems. I was vegan for five years. Maybe that’s what I need to do. I kept thinking it was about the food and I had to really learn that it actually isn’t about the food. I mean, yes, it helps when you eat food that supports your body, but it’s your brain.

Dr. Katrina Ubell: It is totally your brain and your whole experience of your life that you’re creating with your brain that determines how you’re eating, how you’re supporting your body. And so the weight loss is just kind of like this added extra kind of bonus result when you learn how to manage your mind. And so I’ve been doing that now for four years and I couldn’t love it anymore. I love it so much.

Dr. Trevor Cates: That’s great. Fantastic. Well in the beginning, I said health coach and you’re saying life coach and I’m sorry for saying the wrong thing. I think of them as very similar, but maybe you can explain to everybody what is the difference between a life coach and a health coach.

Dr. Katrina Ubell: Well, I mean, the first thing you have to understand is that these industries are highly unregulated. Literally anybody can just put up their shingle and say, I’m a life coach. I’m a health coach and maybe have no training at all. Maybe they were just interested in reading articles online or whatever, just have their own opinions.

Dr. Katrina Ubell: So what that actually means, you have to look into it to see what does the person actually mean? I’m master certified as a life and weight loss coach. What that means is that I have gone through specific training programs for my regular certification, then my Master certification. I have learned life coaching tools and then I’ve learned specifically how to apply them to the problem of being overweight and overeating. So that’s what I think of when I think of a weight coach.

Dr. Katrina Ubell: My understanding, because I never really looked into health coaching, but my understanding is that most health coaching programs are focused more specifically on nutrition, healthy living, and things like that.

Dr. Katrina Ubell: While that is amazing and great, I think it’s variable on how much of a skill level a health coach will have in terms of helping you really dig deep into your beliefs and your thoughts and your emotions and that kind of stuff.

Dr. Katrina Ubell: I often will do two hour long coaching calls with my clients and group calls, and coach eight or nine people. We don’t talk about food once. Because they are all trying to lose weight. Because it’s not about the food. The food is what makes our lives tolerable.

Dr. Katrina Ubell: So what we have to learn is how to make our lives tolerable using our brains, right? My brain is making my life intolerable in this area. So then I want to numb out or take a break. Or I was thinking of the easy button, hit the easy button, have a drink, get a snack, just so that I don’t have to feel it or think about it or deal with it. I can avoid it.

Dr. Katrina Ubell: And instead we’re like, okay, well, so what are you actually thinking and feeling? Maybe you want to choose to think differently about it. Maybe you can actually let food, just be there to nourish yourself and allow yourself to feel your emotions.

Dr. Katrina Ubell: We spent so much time on allowing urges to eat, reducing over desire, getting hunger to be at a normal level, but it’s actually not that hard to do that. Once you get the food squared away and stuff, the weight loss is easy. I would say that’s the least interesting part about what we do

Dr. Trevor Cates: You said some interesting things about how eating isn’t necessarily intuitive for most people like how to eat. We just think that it would be something that comes natural, but the emotional eating aspect of eating and food is what’s really troubling for people. How common would you say emotional eating is?

Dr. Katrina Ubell: Well, I would say pretty much everybody does it at least a little bit because my husband who I thought wasn’t an emotional eater when I went through my whole process, I would say he lost 25 pounds through osmosis. He wasn’t really doing any of the real work, but just by kind of paying attention to what I was doing and things like that.

Dr. Katrina Ubell: We didn’t even know you had weight to lose. We were like, Oh, look at that. It just fell off. And I remember saying, you’re not an emotional eater. And he’s like, Oh yeah, I am. Because he’s a doctor too. And they keep snacks in their office. They go to Costco and get the big, you know, those peanut butter filled pretzels and peanut M&M’s and things like that just for the staff.

Dr. Katrina Ubell: And he’s like, Oh, I totally have to go finish some notes and I’ll grab a handful of peanut butter pretzels and eat those or a patient will not show and I’ll think, Oh great. I’ll just go get a snack now. That is not because he’s hungry or because his body is needing food. I always think of it like emotional eating is eating for any reason outside of fuel for your body.

Dr. Katrina Ubell: We could probably include it there, the occasional preplanned pleasure. Because it’s normal for humans to get pleasure out of their food. Our brains are literally designed to reward us for eating because if we eat, then we get nutrients and then we’re more likely to be able to get through an illness or more likely to make it through the winter, not starve to death.

Dr. Katrina Ubell: It is normal for us to like what we eat. But what’s happened is that, which really, it has only been about the last hundred, to hundred and fifty years, humans have figured out how to concentrate the pleasure that we get from food in the form of flour, in the form of sugar and then adding it to everything. Our brains now are totally confused.

Dr. Katrina Ubell: They are like, Oh my gosh, I thought those berries were important, but this candy, Oh my gosh, this is the thing. Because it is dose dependent. Then what ends up happening when you’re eating food like that, that gives you so much of that pleasure.

Dr. Katrina Ubell: Your dopamine receptors are so flooded that the brain starts thinking we need to downregulate our dopamine receptors. This is the same thing that happens with drug addiction. Downregulates your dopamine receptors. So that eating all that sugar doesn’t make you feel as good as it did in the beginning.

Dr. Katrina Ubell: I was thinking about if you have ever seen a one year old child eat cake on their birthday for the first time, the first time getting sugar, their reaction, typically at first they are very tentative and not sure. And what is this? And it ewe it’s sticky. Then they taste it and their faces just light up. They’re like, Oh, what was that? I need more, it’s so good.

Dr. Katrina Ubell: That is what our brains do. But then when we don’t down regulate those dopamine receptors, then what we end up finding is, it’s not enough. We need more. We feel like we have more urges to have more. And if you stop eating it, you actually feel pretty bad for a little while.

Dr. Katrina Ubell: The good news is that your brain will repopulate those dopamine receptors. But going back to what you were saying about are some people just emotional eaters? I don’t think anyone is born that way. I think everybody is born knowing how much food to eat. Can you overfeed a baby? Yes, you can. But it requires effort.

Dr. Katrina Ubell: As a pediatrician, people would ask me this all the time, especially when they had really, really chunky fat babies, which is a healthy thing. That is what we want to see, but babies, when they’re done, they’re done. And if you really encourage them, they might take a little more. And then they’ll usually spit it up or vomit a little bit.

Dr. Katrina Ubell: Because it was too much. They know. And toddlers too, if they are left to eat whatever they want, they will stop. This was a big eye opener for me as I was losing weight, like this last time I had all three of my children at different ages and to be able to watch them having a cookie or something for dessert and then stopping mid cookie and saying, I’m done, I’m full. I don’t need anymore.

Dr. Katrina Ubell: I found that to be so fascinating because there’s always room for the rest of the cookie, in my mind. What do you mean? Of course you can find a crack in there for that cookie to fit. Just watching them be totally done, in the middle of the ice cream, I don’t want any more. That’s healthy. That is normal to be so in tune with your body, to know I don’t need any more.

Dr. Katrina Ubell: But if you were raised, like I was to be encouraged to finish your food, that clean plate club don’t waste that. I mean, that was a huge part of my upbringing. You learn at an early age to ignore your signals. You learn to, do I want to eat this food? Well, what am I going to do with it? If I’m not going to save it, I’m gonna throw it out.

Dr. Katrina Ubell: I better eat it because that’s what the messages that I’m getting from the people me. I think for those of us who were raised in that environment, we just have to basically re educate herself. We have to unlearn those patterns. I mean, and I will tell you, it’s taken me awhile. I still work on it. Because I still have little nuggets of it that come up for me from time to time.

Dr. Katrina Ubell: But I have had to really work on wasting food, throwing, quote unquote, wasting it, like throwing it away and really believing, eating extra food is also wasting it. It’s just wasting it on my body. Because it’s not like, Oh, later I’m just not going to eat for two weeks while I allow myself to utilize all that extra energy. No, you still are eating all your normal meals. It’s too much food.

Dr. Katrina Ubell: I really check myself in terms of how I respond to what my kids are doing. Like the other day, zucchinis is in season now I made a chocolate zucchini cake for the family and I didn’t even have any of it, but I knew that they would enjoy it. My daughter was eating it and she said, Oh, it’s so great.

Dr. Katrina Ubell: Then she left, I mean, it was probably three bites left and I remember thinking to myself, okay, yes. Okay. Today I’m winning as a mom, but she just left it. She said she was done. She’d had enough. Because growing up I would have totally been encouraged to eat that. Just finish that up. It is really becoming aware of those habits that just, you’ve probably been doing them so long that you don’t even realize that’s what they are.

Dr. Katrina Ubell: They really are habits. They encourage you to overeat.

Dr. Trevor Cates: So how do you know when to eat? And when that hunger, that feeling is more of an emotional need. We still need to eat. Right? We need nutrition. And of course what you’ve talked about sugar being as addictive as a drug, it’s basically really addictive and that is a huge issue. But beyond that, how do we, how do we know? How do we regulate that?

Dr. Katrina Ubell: Yeah. Well, so here’s what happens when you are eating sugar and flour containing foods on a regular basis. Honestly if you’re eating anything, that is pretty processed or premade for you. Probably you are consuming it on a regular basis because sugar is in so many things in particular, it is under all kinds of different names.

Dr. Katrina Ubell: You literally have to just Google the list because there’s so many of them. When you’re consuming flour and sugar on a regular basis, it really does kind of mess up your hunger signals. Meaning that when you feel hunger, it’s an inappropriate amount of hunger. If you’ve ever felt hangry, you know, the combination of hungry, and angry, or if you’ve ever been like, my stomach is going to eat itself.

Dr. Katrina Ubell: Or I feel like I’m going to faint. Like that intensity of hunger is abnormal. Because if you think about the vast majority of human existence, food was scarce, for sure in the winter it was scarce. And certainly there was not food around available for you to snack on every two to three hours. That is just not normal for humans.

Dr. Katrina Ubell: Except the snack food industry has now convinced us that it is normal. So we think if we’re not eating all of the time, then it’s going to be a problem. But when the human body is functioning normally it really feels great when it doesn’t eat. It would not make sense for you to feel like you wanted to die. If you haven’t eaten after a couple of hours, when you need to go out and kill an animal or find a tree with a root or like something that you can eat, like you need energy, you need to feel good.

Dr. Katrina Ubell: When you’re eating sugar and flour on a regular basis, your body, rather than accessing your fat stores, willingly or happily to create energy for you, it will just basically make you feel like crap. It will just make you feel like you want to die. We respond to that like, Oh my gosh, I feel bad. I need to eat right away.

Dr. Katrina Ubell: And usually what we grab is something that contains some easily digestible form of energy, like something containing flour and sugar. And then the cycle just continues. When you take a break from eating those foods regularly, what you find is that your body becomes more what’s called fat adapted, which just means, I mean, your body always knows how to access your fat and turn it into glucose for yourself. But it’s just more happy to do it essentially.

Dr. Katrina Ubell: I always think of it as when you’re fat adapted your hunger signals are like a little wave, just lapping at your ankles. It’s just little suggestions, like a little whisper, like, Hey, you know, we would like to eat right now. That would be cool. If it’s a good time and if it’s not a good time, because you’re busy or you’re just not wanting to snack or whatever, then it’s fine.

Dr. Katrina Ubell: The hunger goes away and your body, I always say it does eat it just dines in and eats the extra meals that you have stored on your body. Right. So it just happily does that. But when you’re a sugar burner, it feels like you’ve got this massive wave, just crashing over your head. Like you’re getting clobbered by that hunger. And you’re like, Oh my gosh, I don’t know.

Dr. Katrina Ubell: I have to solve this.This is a problem that needs solving and food is the solution right away. So when you can get yourself to that place of being fat adapted, your energy is so even you feel really, really good. So it’s not like, Oh, you’re not eating and you’re suffering. It’s like, you’re not eating and you feel amazing.

Dr. Katrina Ubell: I always think if you could just pay attention to the signals your body is sending you, that’s so helpful. When it comes to hunger, when you’re fat adapted, what you find is that, first of all, you’re not hungry very often at all because most of us are overeating. right? We are being confused into thinking we need more food than our body really needs. When you’re fat adapted, your hunger signals are recalibrated. Essentially you can listen to them when your body is telling you I am hungry.

Dr. Katrina Ubell: It’s probably a good idea to eat, but you just find that you’re just not that hungry. Now, emotional hunger is very similar. I always say what it feels like to be hungry, but if you really get to know your hunger and what it feels like in your body, I find with myself, with my clients, that emotional hunger is slightly different. It’s a little bit different. If you learn to pay attention, you can tell the difference.

Dr. Katrina Ubell: I will describe to you how it’s different for me. When I am physically hungry, it just kind of comes on. Gradually I start noticing, Oh, I’m a little bit hungry. And then, Oh, you know, I could definitely eat. Okay. It’s probably going to be time soon. I think I’m going to prepare some food.

Dr. Katrina Ubell: Now it kind of gradually comes on. Emotional hunger is like, boom. I’m so hungry right now. It just hits me very quickly. It doesn’t build up. On the flip side of that, it also will go away very quickly. I have found sometimes like, Oh my gosh, I’m so hungry. And then five minutes later it’s gone. I’m like, yeah, that’s not real hunger at all.

Dr. Katrina Ubell: And often this comes maybe an hour or two after you just ate a nice meal. So it really doesn’t make sense. Why am I hungry right now? I mean, I just ate. Well, probably not because you need food, probably because your body is just sending you signals to try to get at you, to eat in order to not feel an emotion or to soothe yourself or comfort yourself in some way.

Dr. Katrina Ubell: So when you’re open to exploring that and not judging yourself for every single sensation that you have, you can start to explore that and figure that out and start going, you know what, I can tell the difference here when it’s like the real hunger and when it’s emotional and it’s important to know the difference for sure.

Dr. Trevor Cates: Yeah, absolutely. And I can tell it too. Sometimes if I record a podcast and I have a little time and I’m like, I wonder, it’s not necessarily that I need food, but I can just get this. It’s a different kind of feeling. I don’t even know how to describe it.

Dr. Trevor Cates: But for me sometimes, if I just get some tea or maybe, I mean, tea is one of my favorite things because I’m in the kitchen. I get something, it tastes like tea. I like herbal teas. It tastes kind of sweet. So it’s that feeling, but I’m not putting honey or anything in there to affect my blood sugar.

Dr. Trevor Cates: I think it is important. I talk about it in my book, Clean Skin From Within, when you can do some sort of reset. In my book I have a two week program and it gets people off sugar for two weeks. When they stop eating sugar and they take it out, they realize that it’s amazing how different your hunger is.

Dr. Trevor Cates: I know it’s not always easy to make that change to just give up sugar. What are some tips for people to make that shift? Do you work with people processing these emotions? Tell people what the process is.

Dr. Katrina Ubell: Yeah. Over the years I have seen people try to do it in all different ways. I actually just recommend the cold Turkey rip off the bandaid. Just stop having it. But that doesn’t mean you stop having it. You are trying to intermittent fast and start a new workout regimen and all these other things. This is all we are working on is just doing that.

Dr. Katrina Ubell: What I tell my clients during that time is you can eat as often as you need to. Right? Because often when we’re coming off of it, we feel so hungry. We have those cravings. If you feel like you need to eat something, you can eat it. So you can have all the snacks you want. I think that actually allowing some 85% or dark chocolate for some people can actually be really helpful. Usually, I say up to two squares a day.

Dr. Katrina Ubell: Really not a ton, but just a little bit can help. I remember when I first tried that I was like, eww this is disgusting. It’s so bitter. But as your taste buds adjust, you actually can learn to like it. You don’t have to have it, but it can help some people.

Dr. Katrina Ubell: I also find that when you make sure that you’re having plenty of healthy fat during that time, not eating a whole bunch of bacon necessarily, but having a lot of avocado and olive oil and olives or things like that, it really helps you feel nicely sated. So you aren’t feeling like I’m dying, I’m so hungry. You are just really dealing with that weaning off. I have had people try to go gradually. I think it’s just in everything, I don’t know that is the best way to do it.

Dr. Katrina Ubell: I don’t actually think it’s easier for them. I think they just make it take longer and I don’t think they get a better result. I usually just say, let’s just do it. We support them. I always tell people, yeah, you may not feel great for a couple of weeks and that’s okay.

Dr. Katrina Ubell: I usually find the first week is the worst. For women depending on where their cycle is, if they are having their period during week two, that maybe is less than ideal, just because that can be when it’s harder anyway. But usually by week three week four, they are like, I can’t even believe this. I am barely ever hungry. My energy is so much better. I’m sleeping better. They start to see immediate results and it makes that week or two, that was hard worth it for them.

Dr. Trevor Cates: Yeah. As someone that has had this crazy busy schedule as a pediatrician, and the people that you help, what are some tips that you can give people that are super busy? Obviously not everybody can change jobs. What other suggestions would you have besides changing careers?

Dr. Katrina Ubell: Yeah. Well, the thing that I really pride myself on is I work with all of these different doctors who have all different kinds of specialties and all kinds of different jobs. And now in COVID time, even more so, they can’t eat if they have all their PPE equipment on. Many have all kinds of shift changes. Some of them are surgeons and they are going into a nine hour surgery, you know, my nutritionist just said, you need to eat a snack.

Dr. Katrina Ubell: She is not going to scrub out in the middle of her surgery to go eat a snack, unless literally she cannot make it right. I pride myself on saying, I’ve never worked with a doctor that we couldn’t come up with some sort of solution that worked. This is where time restricted eating or some people call it intermittent fasting can be super helpful.

Dr. Katrina Ubell: Which is so much better to do when you are already fat adapted. I always ask, get yourself fat adapted first and then your body will automatically move toward that anyway, where you find that, I’m just so not that hungry. It’s really not that big of a deal to push back a meal. What I do is I help each individual client to create their own plan.

Dr. Katrina Ubell: And I think this is important for weight loss, no matter who you are, but especially when you have an unusual schedule or an unpredictable schedule, which, you know, these days, I feel like that’s actually most people.

Dr. Katrina Ubell: What that means is looking at, what are your options and then looking at your life, looking at the foods you like and just eating those. I can’t even tell you how many healthy quote unquote, smoothies I’ve had and Healthify this, that, and the other thing. And none of those things even tasted good to me. I made a rule for myself a few years ago.

Dr. Katrina Ubell: I don’t eat food that I don’t like. If I don’t think it tastes good, I don’t care how healthy everyone says it is. I’m just not doing that. I’m just not going to do that. You look at your schedule and you figure it out for yourself. For some people they might be you know what, my days are so busy, I really would rather have a solid breakfast and then be able to fast all the way through until dinner.

Dr. Katrina Ubell: Great. But what most people find is they are like, you know what, I’m so busy in the morning. I was usually skipping breakfast anyway. Or I was just grabbing something sugary, like a breakfast bar or something like that. Are you saying it’s okay for me to just skip breakfast and not eat until lunch? I’m like, yeah, it is actually okay.

Dr. Katrina Ubell: Especially if that’s what your body naturally wants to do. So then planning out what you can eat. Here’s an example, like if you have a really short lunch break, you know, bringing like a massive salad is probably not a good idea because you can’t eat it fast enough. It takes time to chew that all up. You have to think to yourself, okay, what foods are on plan for me? Meaning not containing sugar and flour and supporting my body, tastes good to me, helps me to feel satisfied until my next meal.

Dr. Katrina Ubell: If that’s going to be five hours, six hours, seven hours experimenting with that to figure that out and then eating that. I think that having a ton of variety in your eating, especially when you’re trying to lose weight is not a good idea. It just adds complexity to something that already feels challenging. Not that you eat the same thing every day, but you don’t have lots of options.

Dr. Katrina Ubell: I usually say for dinners and stuff, come up with 10, maybe 15 that you have that are perennial favorites that your family generally is happy to have. Then you just repeat those again and again, and again. You just make it so simple for yourself, by keeping it really constrained and dialed in, and then you have to experiment.

Dr. Katrina Ubell: This is the part that a lot of people don’t like to do. They are like, especially my clients. They are like I want to get the gold star. I want to get the a plus, what are the rules? I want to make sure I lose three pounds that first week on this plan.

Dr. Katrina Ubell: I want to make sure this works and I’m feeling amazing. And really it’s going to be to a certain extent, anyone’s guess. Some people will hit it right on the head right out of the gate. But some people will find you know what, that didn’t last me long enough. I was really having a hard time at four o’clock. I need to re sort out my lunch or I’m feeling great, but the scale is not budging.

Dr. Katrina Ubell: So okay. What do we need to do? Where do we need to look at things? I always say though, if you’re losing weight for the last time, and what you’re figuring out about yourself is what’s going to help you to keep your weight off and maintain that weight loss.

Dr. Katrina Ubell: Then what’s the rush? If we were in a hurry, we can do any of the commercial diet plans out there and get the weight off only for you to still not be able to make it work in your life and gain the weight back again. So why not just go ahead and sort it all out. And then it truly is an individualized plan that you’ve created for yourself with guidance, but for yourself.

Dr. Katrina Ubell: And you’re so much more likely to want to follow that when you’ve created it. I would sign up for some diet thing and they would give you three or four weeks of meal plans and recipes. Maybe I would have eaten those things, but every recipe would take me so much longer to make, because I never made it before. I would look at things and go, I would eat that.

Dr. Katrina Ubell: My husband probably would, but there is no way my kids are going to eat that. So now am I signing up for like the short order cook, making everybody different from the same thing, when I tried counting macros. I would literally make the family a whole meal, they’d sit down to eat. And I go back into the kitchen to make my weird cobbled together meal to make the macros fit.

Dr. Katrina Ubell: I was like, no, this is not going to work. I really push my clients to make it so that it works for everyone in the household. Maybe not everybody’s eating exactly the same thing, but with some minor modifications. This is how you make it sustainable and easy for yourself. Anybody who’s busy, you just have to get into that solutions focused mindset.

Dr. Katrina Ubell: What most of us do is we like to just sit around and see why there’s all these problems and can complain about them. But what instead I suggest is that you ask your brain to find the solution. Your brain really wants to close that loop. It will do whatever you ask it to do. If you ask it to help you to figure out how to make this work, it will come up with good ideas for you.

Dr. Trevor Cates: That’s fantastic. I think it is important to individualize it, to realize where you are, if you’re alone, or if you have family members or other people. If you have been eating healthy or this is new to you. I know what we know about the microbiome, the research around the microbiome that eating diverse foods and eating different fruits and vegetables and getting plenty of fiber is really important for the gut microbiome.

Dr. Trevor Cates: But you don’t necessarily have to start there, just get into a schedule. You are talking about where you are eating at the right times and you are finding that balance. Then you can start adding in the details that some other health experts talk about.

Dr. Trevor Cates: I love what you’re talking about. I really appreciate it. Before we end, I wanted to ask you what are some of the mistakes people make with intermittent fasting? Because there are some unhealthy habits that you talk about.

Dr. Katrina Ubell: Yeah. Thank you for bringing that up. Yeah. Because some people ask, isn’t that an eating disorder? No, but it can be. So let’s talk about the differences. That is why I think some people like the term time restricted eating better just because fasting, people get hung up on that.

Dr. Katrina Ubell: The way I like to think about intermittent fasting is what you’re doing is you’re eating all of the food you would typically eat over a whole day, just over a shorter time period. You are still nourishing yourself in a really good way, you’re just eating more food over a shorter time period.

Dr. Katrina Ubell: That doesn’t mean you’re like stuffing yourself. Okay. You are not totally overeating. Like you are so full, overly full. It’s not that. It’s allowing your body to access the fat stores that you have on your body. And doing that to create the energy that you need for a longer period of time, which keeps your insulin levels lower, which is good for making you more insulin sensitive.

Dr. Katrina Ubell: The more insulin sensitive you are, the easier it is to lose weight. And the more rapidly the weight comes off. Also lowers your weight set point so that your body really wants to stay at a lower weight versus like the old way of losing weight.

Dr. Katrina Ubell: Calorie reduction where you barely eat anything. And the minute you have one cookie, you gained five pounds. You are like wow, how is this possible? That is intermittent fasting. If you haven’t eaten for a while, when you eat, you’re eating a beautiful, nutritious varied meal with food that tastes good to you and you are eating to a healthy satiety level.

Dr. Katrina Ubell: Where it turns into an eating disorder is when you don’t eat for an extended period of time. Then you have like an egg white and half a Clementine or something. That is not how this works. If you don’t eat for awhile and then you definitely eat and nourish yourself. I have definitely found that fasting is not a good thing for anybody who has a history of binge eating.

Dr. Katrina Ubell: I definitely have clients who binge and I tell them there is no intermittent fasting for them until the bingeing is done. Even then still fasting may not be good. Or like what I have seen is a big trend right now is the one meal a day kind of trend people call it, Omad, one meal a day. What people then do is they literally eat just dinner and then that’s it.

Dr. Katrina Ubell: So they’re basically doing a 24 hour fast every single day. In my mind that is the total diet mentality. Because if you do that, yes, you will weigh faster probably. But I think anybody who has any kind of history of emotional eating will have a very hard time keeping that up for the rest of their lives.

Dr. Katrina Ubell: It puts a lot of pressure on that one meal to be delicious and satisfying enough. Sometimes, and we all know this, you eat a meal. And you are like, that wasn’t really that good. Or you go to a restaurant, and it’s a little disappointing. So when that’s all you get to eat and you don’t get to eat again for another 24 hours, I find that people really do end up overeating.

Dr. Katrina Ubell: They convince themselves they need more food at that meal. It really messes with their minds or they find they are totally binging at night. So okay, we’ve got to dial this back. You need to be eating three meals a day for sure. You have to let your brain and body know it is totally being fed well.

Dr. Katrina Ubell: It is not for everybody. It’s just for us, particularly for people who have very busy and unpredictable schedules. It’s amazing. I remember one time being in clinic, wrapping it up with a patient thinking, okay, now it’s lunchtime. As I was about to say goodbye, the child was in the mom’s arms and he totally started seizing and had a first time seizure ever.

Dr. Katrina Ubell: I was just like, okay, well there goes lunch, right? I mean, this is not going to be, oh, let’s send her on her way, this was a big deal. When you are able to fast, even if you had planned to eat lunch, but you’re just really not going to be able to, because you need to be doing something else.

Dr. Katrina Ubell: It’s not a hardship. You feel fine. Oh, okay, cool. And if later I’m hungry and I have time, I can eat some of my lunch or I can wait until dinner and have a bigger dinner. You have to make sure that your brain is in the right space for that. Many of my clients find that it’s just the best news ever for them.

Dr. Katrina Ubell: It’s such a great answer. Many of them will overeat at the end of the day because they feel so sorry for themselves, for not having the chance to eat during the day. I was in this long case, I needed to go to the surgeon’s lounge and eat whatever junk they have laying there to reward myself, as a treat. When you are fasting, it just changes your whole mindset.

Dr. Katrina Ubell: You’re like, Oh, I don’t even need that. My body just totally accessed the fat that I have on my body. And that’s cool. It is important to be real clear on that. If you feel like you have any kind of weirdness around it, then it’s a no. Yeah.

Dr. Trevor Cates: Well, thank you Katrina for all this information. I know we didn’t talk about the emotions behind why people eat. We didn’t talk about how to help heal those. The reasons why people emotionally eat or have that emotional hunger, but definitely that is important. Do you have any resources or direction for people to go? We have had some people on The Spa Dr. Podcasts or talk about how to look at those emotional issues, underlying issues.

Dr. Katrina Ubell: On my podcast, which is called Weight Loss for busy physicians, there are multiple episodes on all kinds of different emotions and how to feel them urges all of that. That is free. You can find that on any platform. And then I also have some free resources that can be really helpful as well that people can find on my website, https://katrinaubellmd.com/ You can put forward slash resources or just the resources tab.

Dr. Katrina Ubell: And then I’m also always on Instagram posting things that could be helpful. My handle there is: Coach Katrina Ubell MD.

Dr. Trevor Cates: Perfect. All right, thanks again, Katrina for coming on today.

Dr. Katrina Ubell: Thank you so much.

Dr. Trevor Cates: I hope you enjoyed this interview today with Katrina. To learn more about her, just go to TheSpaDr.com, go to the podcast page with her interview and you’ll find all the information and links there. And while you’re there, I invite you to join The Spa Dr. Community, so you get our information, valuable tools such as the skin quiz, which you can go directly to the skinquiz.com, find out what your skin personality type are you an Amber, Olivia, Sage, Emmet or Heath, because there can be some hidden information in there about what that might be revealing about your health. So just go to theskinquiz.com. I also invite you to join us on social media. The Spa Dr. Is on Instagram, Facebook, Twitter, YouTube. You could join the conversation there. I hope you enjoyed this podcast. See you next time.